膀胱癌に対するメソトレキセートの肛門粘膜下注入療法に関する検討

Abstract

1)ラットを用いた実験的検討において, 血中MTX濃度の経時的測定により, ASIではMTXの血中への移行が緩徐であった.2)静注群では膀胱組織内MTX濃度のピークはASI群より高いがその低下が急速であるのに対して, ASI群では30分以降120分後まで比較的高い濃度を維持した.3)臨床的には, 9例の膀胱癌患者に施行し3例が評価可能で, この内CIS症例2例にCRが得られ, 他の1例はNCと判定された.4)口内炎を主とした全身的副作用が多数の症例でみられ, 血中MTX濃度の検討でもこれを裏付ける結果が示された

The experimental and clinical studies were performed to investigate the efficacy of the anal submucosal injection (ASI) of methotrexate (MTX) for bladder cancer. In the experimental study, MTX was administered to male Wistar rats each weighing from 200 to 250 gm in a dosage of 2 mg/kg body weight through two different routes, one of which was intravenous injection (IV group) and the other of which was anal submucosal injection (ASI group). The concentrations of MTX in serum and bladder tissue after injection were estimated in both groups. Serum MTX levels in ASI group were significantly higher than those in the IV group from 30 minutes through 120 minutes after injection, while the IV group was higher than the ASI group at 5 minutes after injection. Tissue MTX levels in ASI group were significantly higher than those in the IV group from 60 minutes through 120 minutes after injection. However, tissue MTX levels in IV group were significantly higher than those in ASI group from 5 minutes through 15 minutes after injection. We started clinically to use ASI for bladder cancer as a preliminary random trial in November, 1988. Between November, 1988 and September, 1989 ASI was performed in 9 patients with various bladder cancer. The dose of MTX was 50 mg every week for 5 consecutive doses. The course was repeated at 3-week intervals.(ABSTRACT TRUNCATED AT 250 WORDS)