泌尿器科領域におけるNeocarzinostatinに関する臨床的研究 第3報 : 進行前立腺癌に対する動注療法 -特に病理組織学的効果について-

Abstract

Neocarzinostatin (NCS) was administrated to 14 patients with advanced carcinoma of the prostate (T3 or T4 in TNM system) either alone or in combination with diethylstilbestrol (DES). The infusion catheter was inserted into the common iliac artery following the Seldinger's method and 2 to 8 mg of NCS in 20 ml of physiological saline solution was injected under the obstruction of the external iliac artery flow by oppressing bilateral femoral arteries with fingers. NCS was given once a week and we performed the course for 3 weeks. Objective response to therapy was considered as complete (CR) if no tumor was demonstrated urethrography or ultrasonography and if the restoration of the elevated serum phosphatase levels to normal was seen. Objective response was considered as partial (PR) if a 50% or more reduction in primary tumor was demonstrated and if increase of elevated serum phosphatase level was seen. Subjective response was considered as complete (CR) when significant improvement in urinary disturbance, pain and performance status were seen, and PR when reduction in symptoms were seen. Histological response was examined following the Shimosato's classification (Table 2). Grade 3 and 4 was classified to CR, Grade 2 was PR, Grade 0 and 1 was no response. Response rate (CR+PR) was more than 80% in subjective findings, total acid phosphatase and prostatic acid phosphatase. Response rate by urethrography and ultrasonography was 50%, 61 % respectively. No different findings were seen in the two groups with DES and without DES. Histological response rate was 67% and no difference was seen in the two groups. Side effects were minimal and vanished soon after protocol.