進行性尿路上皮癌に対するBVP療法

Abstract

進行性尿路上皮癌18例に対しBLM, vinca alkaloidとDDPの3剤によるBVP療法をおこない, 完全寛解3例, 有効6例, 不変6例, 進行3例の成績を得, response rateは50%であった.効果は1～2コース終了後にみることが多く, とくにリンパ節転移に有効と考えた.2年以上生存例は4例あり, 2年生存率は, 寛解群が有意に良好な結果であった.副作用は, 消化器症状, 骨髄抑制, 腎毒性などを認めたが, すべて可逆性で重篤なものはなかった.vinca alkaloidとしては, vinblastineに劣らぬ抗腫瘍効果を認め, しかも副作用の軽微なvincristineを第1選択とすべきであろう

Since October 1979, 18 patients with metastatic urothelial cancer have been treated with combination chemotherapy of bleomycin (5-10 mg/day administered on days 1 to 7), vinca alkaloid (vinblastine 5-10 mg/day or vincristine 1 mg/sqm on days 8 and 9) and CDDP (60 mg/sqm on day 10). CR was achieved in 3 of the 18 patients and PR in 6 patients. Over-all, the response rate was 50%. Among 3 patients who achieved CR, 2 patients are still free of disease for 31 months and for 28 months, and the other is alive with cancer for 26 months. The 2-year survival rate was 58% in responders (CR + PR) and 0% in nonresponders. (p less than 0.005). In many cases, the response was observed after the first or second course of BVP therapy, and there was a relatively good response in patients with lymphnode metastasis alone. The treatment was tolerated well and common toxic effects were nausea, vomiting of moderate to severe degree (100%), myelosuppression (50%) and mild nephrotoxicity (22%). As to the choice of vinca alkaloids, vincristine seemed to be the treatment of choice because it was less toxic than vinblastine and was almost equally effective.