浸潤性膀胱癌に対する膀胱全摘術後補助化学療法としてのM-VAC療法

Abstract

膀胱癌にて膀胱全摘術をうけた症例のうち, 遠隔転移を認めないpT2のhigh risk groupおよびpT3以上またはpN+の14症例を対象にした.1)観察期間中(19～64ヵ月:平均37ヵ月)の生存11例, 死亡3例.再発は4例に認められたが, いずれも遠隔転移であった(骨2例, 脳1例, 肺1例).2) M-VAC群の実測生存率は64ヵ月で70%であり, 当科におけるhistorical controlとの間に有意差を認めた.3)副作用については, 重篤な白血球減少症や, sepsisは経験しなかった

Between 1986 and 1989, 14 patients undergoing cystectomy for bladder cancer, in pathological stage high risk pT2 group, pT3-4 and/or with N+ disease, received postoperative adjuvant methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC) chemotherapy. Of the 14 patients 10 were alive with no evidence of disease for an average of 41 months. Tumor recurrence was seen in 4 patients (bone in 2, lungs in 1, brain in 1 patient). Of the 4 patients, 3 patients died of cancer progression at an average of 26 months and 1 patient was alive with tumor for 30 months. Their actual survival rate at 64 months was 70%, which was significantly higher than that of the historical control groups (1974-1981: 18%, 1982-1985: 46%). Although postoperative adjuvant M-VAC chemotherapy for invasive bladder cancer seemed effective in this study, a controlled randomized study will be necessary to conclude if it could be of real benefit for these patients.