表在性膀胱癌に対する抗癌剤の膀胱内注入療法の成績

Abstract

low grade, low stageの膀胱移行上皮癌患者59例に対してBLM, CQ, ADMの膀胱内注入療法を施行し57%の抗腫瘍効果を認めた.乳頭状腫瘍においては非乳頭状腫瘍におけるよりも高い抗腫瘍効果を認めた.3年以内の観察期間では, 注入療法施行群の再発率は34%であり, 注入非施行群に比してあきらかな再発予防効果を認めた.抗癌剤の膀胱内注入療法は, 表在性膀胱癌患者に対して有効な治療法の1つであると同時に再発予防効果もある

The effect of intravesical chemotherapy on superficial urinary bladder cancer was analysed. Fifty-nine patients with low-staged, low-grade bladder cancer were treated with intravesical instillation of three anticancer drugs (adriamycin, carbazilquinone and bleomycin). Complete response (CR) was observed in 15 out of 42 patients and partial response (PR) in 9 patients. Overall, a better response rate was observed with adriamycin and carbazilquinone than with bleomycin. Papillary tumors responded well to these intravesical chemotherapies compared to the non-papillary tumors . Intravesical recurrence of tumors was evaluated in 68 patients who received intravesical instillation of these three drugs after TUR of tumors. The actuarial recurrence rate of 68 patients was 11, 22 and 34% within 1, 2 and 3 years, respectively. These rates were significantly lower than that of TUR therapy alone. No serious side effect was seen in these patients. From these results, it is noted that intravesical chemotherapy is a useful approach for controlling superficial urinary bladder cancer.