表在性膀胱腫瘍に対する膀胱内注入療法におけるcytosine arabinoside(Cylocide)および他剤との併用療法の検討

Abstract

7機関より得た多発性表在性膀胱腫瘍111症例について, CAおよびCAとMMCまたはNCSまたはCQとの併用による治療効果を検討した.1) CA 400 mg投与29例の有効率は48.3%, CA 200 mgおよびMMC 20 mg併用投与25例の有効率は84.0%, CA 200 mgおよびNCS 4, 000 U併用28例は71.4%, CA 200 mgおよびNCS 6, 000 U併用22例は95.5%, CA 200 mgおよびCQ 10 mg併用7例は100%の有効率を示し, いずれの場合も併用療法がCA単独よりよい結果である.2)初発症例, 再発症例別にみた有効率にはほとんど差をみとめない.3)副作用はいずれも局所刺激症状で, 全身障害を示すものはない.CA単独の場合は3.4%, CAにCQを併用した場合がもっとも高く71.4%である.MMCとの併用では40.0%, NCS 4, 000 Uとの併用は3.6%, NCS 6, 000 Uとの併用の場合は22.7%であった

The effect of instillation therapy using CA alone or in combination with MMC, NCS or CQ was examined in 111 patients (92 males and 19 females, aged 32-87 years old with an average age of 66 years) with multiple superficial bladder tumors. The response rate of 29 patients given CA 400 mg alone was 48.3%, that of 25 patients given combination therapy of CA 200 mg and MMC 20 mg was 84.0%, that of 28 patients given combination therapy of CA 200 mg and NCS 4, 000 U was 71.4%, that of 22 patients given combination therapy of CA 200 mg and NCS 6, 000 U was 95.5% and that of 7 patients given combination therapy of CA 200 mg and CQ 10 mg was 100%. The response rates of the patients given any of the combination therapies were higher than that of the patients given CA alone. But because MMC, NCS and CQ were not administered singly, combination therapy cannot be concluded to be superior to single therapy. There was little difference between the response rate of primary cases and that of follow up cases. The side effects were all symptoms of local irritation, and were not indicative of systemic damage. Side effects were seen in 3.4%, 71.4%, 40.0% and 3.6% of the patients given CA alone, CA + CQ combination therapy, CA + MMC combination therapy and CA + NCS (4, 000) therapy, respectively, combination therapy of CA and CQ producing the highest percentage of side effects.