膀胱腫瘍に対するAdriamycinの膀胱腔内注入療法(予報)

Abstract

Adriamycin (ADM) was given to 11 patients with vesical tumor by instillation into the bladder. Three different doses, namely (1) 20 mg of ADM dissolved in 20 ml of physiological saline solution, (2) 30 mg of ADM dissolved in the solution, and (3) 60 mg of ADM in 30 ml of the same, were administered to the patients divided into three groups for 3 consecutive days. The medication was interrupted for 2 weeks before the second instillation. This way of treatment was designated as one course of the ADM therapy by intravesical instillation. When some favourable effects were observed on the examination of cystoscopy after the first course, the therapy was repeated once more. The final judgement of the effect of the drug was made after the therapy of two courses (after four weeks). The effect of the drug was evaluated on the basis of the findings of cystoscopy as well as cystogram. When the shrinkage of the tumor was more than 50% in size after the therapy as compared with the initial size of tumor, the drug was considered to be effective. When the shrinkage more than 90%, it was judged as markedly effective. When no shrinkage or if any less than 50% was observed, it was criticized to be ineffective. In case that subjective symptoms or cystoscopic findings were worsened without any noticeable anti-tumor effect after the therapy, the drug was regarded as aggravated. According to the said criteria, the drug was found to be markedly effective in 2 cases, effective in 5 cases and ineffective in 4 cases. There was no aggravated case. The blood level after the instillation into the bladder was very low. However, the similar undesired side-effects such as depilation which is encountered in the intravenous administration of the drug were also noted in one case. Two patients who received three courses of the treatment showed redness and edema on the membrane of the bladder. This finding was suggestive of the fact that the drug has an irritant effect on the vesical membrane.