表在性膀胱腫瘍に対する注入療法 - 再発予防効果について -

Abstract

1)経尿道的腫瘍切除術(TUR)後の再発予防効果について, doxorubicin (ADR)+peplomycin (PEP)併用群, ADR単独群, 水圧療法+TUR群の3群の比較を行った.2) ADR+PEP併用群の1年, 2年, 3年の再発率は18%, 25%, 25%であり, これに対しADR単独群は1年, 2年, 3年とも35%, 水圧療法+TUR群では1年で44%, 2年, 3年は55%の結果であり, ADR+PEP群と水圧療法群の再発率に有意差を認めた.3)各群において, 多発例, high grade, high stage例では再発率が高かった.4)副作用として出血性膀胱炎症例1例, アナフィラキシーショック症例1例を認めたが, その他, 萎縮膀胱, 肺線維症, 心障害などの副作用は認めなかった

During the past 10 years, we have experienced 110 bladder tumor cases. Among them, 70 patients were diagnosed superficial bladder tumor. Of these 70 cases, 30 were treated with intravesical adriamycin (ADR) and peplomycin (PEP), 13 with ADR only and one case with PEP and remaining 26 with TUR and hydrostatic pressure technique. We studied the efficacy of combination intravesical chemotherapy with ADR and PEP and other treatments in the prevention of recurrence in the superficial bladder tumor cases. The recurrence rate during 3 years of each group, was 25% in the group treated with ADR and PEP, 35% with ADR and 55% in remaining group. 3 years recurrence rate in the group treated with ADR and PEP was significantly low than that in the group tread with TUR and hydrostatic pressure technique alone (Wilcoxon test). Side effects was pollakisuria, pain after micturition and others. Anaphylactic shock appeared in one case. From these results we concluded that intravesical chemotherapy with combined agents is more effective than that with a single one or no treatment after TUR.