進行期尿路上皮癌に対するM-VAC (Methotrexate,Vinblastine,AdriamycinおよびCisplatin)療法の経験

Abstract

1)転移を有する進行期尿路上皮癌の6例にSternbergらの提唱したmethotrexate, vinblastine, adriamicineおよびcisplatinからなるM-VAC療法を施行し, 効果は, PR 3例, NC 1例, PD 2例であった.2) PRを示した3例に対し残存腫瘍に対する手術療法を施行しCRを得た.2例はCR後, 各々, 1年6ヵ月であるが再発転移の徴候を認めず生存中である.1例はCR後, 11ヵ月で腫瘍死した.3)進行期尿路上皮癌においてもM-VAC療法と手術療法により治療成績の向上が期待できる

The M-VAC (methotrexate, vinblastine, adriamycin and cisplatin) regimen was used to treat 6 patients with metastatic transitional cell carcinoma of the urothelial tract. Three patients showed a partial response, all of them were made surgically disease free. Two of them are still alive 1 year and for 6 months after surgery with no evidence of disease and one other died of disease 11 months after surgery. The response in one case was no change and that in two others was a progressive disease. From our experience, we suggest that treatment with M-VAC is effective but that surgery after M-VAC appears essential for the successful management of the patients with metastatic transitional cell carcinoma of the urothelial tract.