腎細胞癌の治療 第1報: ホルモン療法

Abstract

腎細胞癌の35例に対して全例に根治的腎摘除術を施行後, 黄体ホルモンを主体とした集学的治療をおこなった.その臨床成績について文献的考察を含めて統計学的観察をおこなった.腎細胞癌の35例にゲスターゲン療法をおこなった.そのうち32例にchlormadinone acetate (CMA)を, 他の3例にMedroxyprogesterone acetate (MPA)を使用した.CMAを投与した32例に対してprophylactic groupとadvanced groupの2群に分けて統計学的観察をおこなった.prophylactic groupに関してCMA投与群はcontrolと比較して再発率, 生存率ともに有意差はなく, 予防的効果はほとんど認められなかった.advanced groupにおいて有効率は11例中CRの1例であり9%であった.Progesterone療法の副作用に関しては長期投与例において, ほぼ全例に体重増加があり, 治療後3ヵ月で肝機能障害が出現し投与を中止した1例, またインポテンツ, 閉経後の不正性器出血で投与を延期した男女おのおの1例以外はとくに重篤な副作用は生じなかった

Sixty eight patients with renal cell carcinoma were treated at our University in 1968 approximately 1983. The prognosis of these patients was studied retrospectively. Sixty six patients had also been receiving treatment with chemotherapy or radiotherapy except 3 cases after radical nephrectomy. Thirty five of the patients with Stage I approximately N renal cell carcinoma were treated with hormonal therapy using chlormadinone acetate (CMA) or medroxyprogesterone acetate (MPA). CMA was used prophylactically in 21 patients with Stage I approximately IIIA renal cell carcinoma and who had undergone radical nephrectomy. Metastasis was noted in 3 cases in this prophylactic CMA group (21 cases) and 4 cases in the control group (19 cases). No significant difference between these two groups was observed statistically. In the advanced group with Stage IIIC-IV renal cell carcinoma (11 cases), only one case with a complete response was noted after CMA combination therapy.