進行性膀胱癌の化学療法 : 特に深部浸潤癌に対する根治的膀胱全摘除術にともなう補助化学療法を中心として

Abstract

1)進行性膀胱癌16例に対してCDDPを中心とした化学療法を施行し, 7例にPRを得, 有効率は41%であった.2)動注療法単独あるいは併用した8例では5例にPRが達成され(有効率62%), 全身投与8例における有効率25%より高かった.3)深部浸潤癌8例に対する根治的膀胱全摘除術後の補助化学療法の検討では, 平均生存期間20ヵ月で, 1例の再発例をみるだけで死亡例は認められず, 補助療法の有効性が示唆された

Sixteen patients with locally advanced or metastatic bladder cancer were treated with cis-diamminedichloroplatinum (cis-DDP) alone or in combination with other drugs. Eight patients were given cis-DDP intravenously, 6 patients intraarterially and 2 by both methods. Seven patients (44%) showed a partial response, 2 showed a minor response and 4 remained unchanged. Of the 6 patients treated with arterial infusion, 3 achieved a partial response while only 2 of the 8 patients administered intravenously showed a partial response. Eight patients with deeply invasive bladder cancer were treated with cis-DDP alone or in combination with other drugs following radical cystectomy. Cis-DDP was administered every week for 3 courses and every month for 12 courses at a dose of 50 mg and cis-DDP, adriamycin and 5-FU (CAF) were administered at 3 weeks interval for 3 courses and every month for 12 courses. All patients in this group were alive with a median survival of 20 months. One patient had a recurrence 5 months postoperatively. Adjuvant chemotherapy with cis-DDP or their combination was effective. Toxicity was generally tolerable.