浸潤性膀胱癌に対する動注放射線療法

Combined intraarterial chemotherapy and radiotherapy for invasive bladder cancer

　1996～2000年に浸潤性膀胱癌症例9例（T2b，n＝2；T3b，n＝3；T4，n＝4）に抗癌剤（CDDPおよびTHP-ADM）動脈内注入＋放射線療法を施行した。近接効果はCR 3例，PR 2例，NC 3例，PD 0例（1例は治療中，骨髄抑制をきたし肺炎のため死亡）で奏効率62.5％であった。動注放射線療法後4例に膀胱全摘を施行した。全体の生存率は1年75％，2年62.5％，5年41.7％であり，膀胱全摘群が非全摘群より良い傾向にあった（p＜0.07）。全体の非再発率は1年58.3％，5年58.3％であった。主な副作用は骨髄抑制，食思不振，下痢，臀部痛，萎縮膀胱などであった。

　A total of 9 patients with invasive bladder cancer（T2b,n＝2；T3a,n＝0；T3b,n＝3；T4,n＝4）were treated with intra-arterial CDDP and THP-ADM,in combination with external radiotherapy.Clinical response was as follows：CR was obtained in 3 patients,PR in 2 patients,NC in 3 patients and no PD.One patient died during the treatment because of pneumonia caused by myelosuppression and overall response rate was 62.5％.Total cystectomy was performed for 4 patients after chemo-radiotherapy.Overall survival rate was 75.0％for 1-year,62.5％for 2-year,and 41.7％for 5-year.In group with cystectomy survival rate was 100％for 1-year,100％for 2-year,and 50.0％for 5-year.In group without cystectomy,50.0％for 1-year,and 25.0％for 2-year.Overall no recurrence rate was 87.5％for 6-months,58.3％for 1-year,and 58.3％for 5-year.Main side effects were myelosuppression,appetite loss,diarrehea,thigh pain and contracted bladder.