進行膀胱癌の治療の現況 進行癌・手術不適応症例の治療

Abstract

今回の検討ならびに文献的考察にても進行膀胱癌に対する確立された方法を見いだせなかった

Sixty-three patients with advanced cancer of more than T3b and/or non-resectable bladder cancer who were treated at Kanazawa University Hospital from January 1982 to June 1990 were analyzed with regard to treatment and prognosis. Thirty-one of the 63 patients had non-resectable bladder cancer; T3b in 9, T4b in 15, M1 in 6 and N4 in 4. Twenty-four of the 31 patients received anticancer therapy consisting of systemic chemotherapy, 8 MHz-RF hyperthermia, radiation or a combination of these modalities. With this treatment 9 patients achieved partial response, 4 minor response, 7 no change and 2 progressive disease. In 2 patients evaluation was not performed. Seven of the 31 patients received no treatment. One-year and 2-year survival rates with the above types of treatment were 27.7% and 16.7%, respectively, and 33.4% and 16.7%, respectively, without anti-cancer treatment. There was no significant difference between the survival rates of the two groups. Thirty-two of the 63 patients underwent operation. In 17 patients, total cystectomy was carried out, 9 and 8 of whom received and did not received respectively various adjuvant therapies before operation. One-year and 2-year survivals in the group undergoing adjuvant therapy were 33.3% and 11.1%, respectively, and 66.7% and 66.7% respectively in the group without adjuvant therapy. Survival of the 2 groups did not differ significantly. These data indicate that anticancer treatment including chemotherapy, hyperthermia and radiation dose not enhance long-term survival.