前立腺癌に対するPeplomycinの筋注と癌組織内局注療法

Abstract

進行性前立腺癌患者に対しPeplomycinの投与をおこなった.1)前立腺癌患者8名に対しPeplomycinを筋肉内投与したが, その臨床効果はKarnofsky分類1群は1例のみであった.投与量別には, 少なくとも100 mg投与しなければ効果はまったく認めなかった.副作用として, 肺腺維症2例, 皮膚色素沈着1例, 発熱3例を認めた.2)ホルモン抵抗性前立腺再燃癌で下部尿路通過障害をともなう患者2名に対し, Peplomycinの前立腺癌組織内局注をおこなった.臨床効果は, 1例がKarnofsky分類1-A, 1例が1-Bであり, 排尿障害の改善を目的とする場合, かなり効果が期待できると思われた.副作用は, 発熱および肛門部不快感は必発であるが, ほかにはとくに認めなかった.3)組織内局注用の注射液として, われわれは水溶性剤を用いたが, 組織停滞時間はあまり長くないものの臨床効果の発現には十分と思われた.血中濃度は, Peplomycin 20 mg局注と10 mg静注の場合がほぼ同様の推移を示し, 注意深く副作用防止に努めれば1回20 mgは危険な量とは思われなかった

Peplomycin, a new derivative of Bleomycin, was evaluated clinically for treatment of prostate cancer patients. Peplomycin was injected intramuscularly, 5 or 10 mg every other day, to 8 patients with prostate cancer. Total dose ranged from 30 to 200 mg. According to Karnofsky's criteria, only one case was I-B, other cases were in group 0. Pulmonary fibrosis, one of the major side effects of this drug, was experienced in 2 cases. This anticancer agent was injected directly into the prostate, 20 mg once a week for 5 weeks, to 2 patients who were refractory to estrogen treatment and had lower urinary obstruction for relief of local symptoms. One case was I-A, and the other was I-B. No severe side effect was observed. Serum concentration of Peplomycin after administration was measured by a bioassay. Serum levels of Peplomycin after a local injection of 20 mg and after one intravenous shot of 10 mg were almost equal.