膀胱腫瘍の研究 : 第2報 膀胱腫瘍の化学療法, 特に抗癌剤の膀胱内注入療法の検討

Abstract

45 patients with primary bladder tumor were classified according to grade, stage, TNM and and PGL system by UICC. Higher mortality rate was recognized with higher grade and stage. Intravesical instillation of anti-cancer agent was carried out 80 times for 29 cases. No response was seen in 38.8%, and 61.2% showed some therapeutic effect, as 30% being quite effective and 31.2% slightly effective. Single administration of mitomycin C (MMC) showed effect in 41.7%, that of carboquone (CQ). 33.3% and that of adriamycin (ADM) 41.7%. Combined instillation of CQ-I-Ft-207-1-cytosine arabinoside (CA) gave the good result in 30% and that of Ft-207-1-CA 10%. Method of instillation was every two days or three times per week in frequency and 10 instillations composed one course. Recurrence of tumor after conservative treatment of bladder cancer was observed in high rate if the original tumor was multiple and of malignancy over grade 2. Urinary cytology was made 235 times for 30 cases, and malignant cells could be detected 123 times (52.34%). This positive rate was high with advancing grade. There was a remarkable difference between grade II and grade III. Nine cases expired out of this study patients. Therapeutic significance of instillation therapy was discussed with focus on the effect on prolongation of life.