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膀胱癌に対する動注化学療法として,高濃度の抗癌剤を到達させる目的で膀胱動脈を選択して動注し,その治療効果について検討した。膀胱癌患者16名に対して,8例では両側の膀胱動脈から動注し,他の8例では片側の膀胱動脈から動注した。動注前後のCTによる比較で有意差はなかったが,両側から動注するほうが,片側からよりも腫瘍縮小率が高い傾向があった(62.9±31.1%vs.36.4±34.5%;p=0.16)。また,男性全例に軽度の副作用が認められたが,重篤な副作用はみられなかった。膀胱動脈を選択して動注することにより,副作用を軽減することができるが,その際は,両側の膀胱動脈から動注することが必要と考えられる。
To deliver a dense anticancer drug to tumor,we performed the selective vesical arterial drug infusion for 16 patients with bladder cancer.Anticancer drug was infused from bilateral vesical arteries in 8 patients,and from unilateral vesical artery in another 8 patients.In three of the eight patients with unilateral arterial infusion,the infusion was performed with the opposite internal iliac artery occluded by a balloon catheter.The therapeutic effect was evaluated by CT imaging before and after arterial infusion,and also by histopathological findings after cystectomy.There was no significant difference,but the tumor volume reduction rate assessed by CT imaging tended to be higher in the bilateral infusion group than in the unilateral infusion group.The side effects of the treatment were observed in all male patients,which were mild in severity and all patients recovered soon after infusion.Bilateral vesical arterial infusion chemotherapy is thought to be useful as neoadjuvant chemotherapy for bladder cancer without severe complication.
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