制癌剤膀胱注入療法による腎孟,尿管腫瘍術後の膀胱腫瘍発生予防効果

Abstract

腎盂尿管腫瘍の手術後1年以上生存した症例で, 制癌剤膀胱注入法を施行しなかった26例中, 2年以内に42%の例で, 膀胱腫瘍の発生があった.一方, 制癌剤膀胱注入法を施行した16例では12.5%と有意に少なかった.制癌剤膀胱注入法はMMC 10 mg, CQ 5 mg+CA 100 mg, およびADR 30 mgの3種のうち1つを生食20～40 mlに溶解し, 1年間は2週に1回, 次の1年は4週に1回の施行を原則とした

Sixteen patients with upper tract urothelial carcinoma underwent intravesical chemotherapy usually at 2 week intervals in the first year and at 4 week intervals in the second year after nephrouretectomy. For bladder instillation 10 mg mitomycin C in 20 ml saline was used on 7 patients, 5 mg carboquone and 100 mg cytosine arabinoside in 40 ml saline on 5 patients and 30 mg adriamycin in 40 ml saline on 4 patients. Two (12.5%) of the 16 patients developed bladder tumors within 2 years after surgery, but 11 (42.3%) of the 26 patients with upper tract urothelial carcinoma who did not receive intravesical chemotherapy suffered from bladder tumor within 2 years after surgery. Prophylactic intravesical chemotherapy reduced significantly (p less than 0.1) the incidence of bladder tumor after the surgery of renal pelvic and ureteral tumors.