抗癌薬リンパ管内直接注入療法の成績

CLINICAL EVALUATION OF INTRALYMPHATIC ADMINISTRATION OF CHEMOTHERAPEUTIC DRUGS

　エトポシドの乾燥粉末をリピオドールに溶解し，この溶液を術前化学療法の一方法として直接足背リンパ管から注入した．投与例は前立腺癌6例，膀胱癌3例，再発陰茎癌2例，尿道癌1例の計12例で，手術と併用して治療効果をみた。副作用はなく，生存8例（NED 6例，有効2例），癌死2例（陰茎癌と膀胱癌），腸閉塞1例，心不全死亡1例であった．また，stage D前立腺癌例でエトポシド9.29mgを左右足背リンパ管から各々注入し6日後に膀胱前立腺全摘リンパ節郭清を施行した右内腸骨リンパ節のエトポシド濃度は2.07μg／gと測定可能範囲であり，治療効果はgrade II Aであった．本治療法は手術前のリンパ節転移の抑制とリンパ節微小転移巣の治療に有用と考えた．

Twelve patients with advanced urogenital cancer (six with prostatic cancer, three with urinary bladder cancer, two with recurrent penis cancer and one with urethral cancer) were treated with the adjuvant therapy as well as surgical therapy, which consisted of chemotherapy using intralymphatic administration of the solution of etoposide and lipiodol ultra fluid. Eight of the 12 patients survived without evidence of disease and two of them survived with partial remission. Two others died of cancer and another two died of other diseases.