表在性膀胱腫瘍に対するBCG膀胱内注入療法の経験

Abstract

We treated 13 patients with superficial bladder cancer via intravesical bacillus Calmette-Guerin (BCG) for 1) prophylaxis of recurrent tumor (prophylaxis group, 8 patients), and 2) therapy of carcinoma in situ (CIS group, 5 patients), with a mean follow up of 13.3 and 14.2 months, respectively. BCG (Tokyo 172 strain) was given intravesically (80 mg in 40 ml, saline) weekly for 8 weeks after transurethral resection or biopsies. In the prophylaxis group, the recurrence rate per 100 patient-months was significantly decreased from 16.1 to 2.83, before and after the BCG therapy (p less than 0.005, chi-square). In 6 patients on whom previous intravesical chemotherapy (MMC and/or ADM) was unsuccessful, the recurrence rate at 100 patient-months was significantly decreased from 15.3 to 2.33, before and after the BCG therapy (p less than 0.005, chi-square). Therefore, we considered that BCG therapy was effective for the patients on whom previous intravesical chemotherapy was unsuccessful. In the CIS group, urine cytology changed to negative in all patients after the BCG therapy. Four of the 5 patients had no recurrence for a mean follow up of 13.8 months. In our cases (12 cases), OKT-4, and OKT-8 proportion of peripheral blood lymphocytes measured from immune reactions had not significantly changed after BCG therapy. This study suggests that BCG is effective not only in therapy of CIS, but in prophylaxis of previously treated cases.