膀胱内BCG注入による膀胱腫瘍の再発予防

INTRAVESICAL BACILLUS CALMETTE-GUERIN INSTILLATION TO PREVENT SUPERFICIAL PAPILLARY BLADDER CARCINOMA

　表在性乳頭状膀胱腫瘍の再発予防のためBCG40mgを48週に14回膀胱内注入した．21例中l1例が治療を完遂できたが，そのうち10例（91％）は平均12ヵ月の観察期間中，再発しなかった．一方，途中脱落10例中7例が再発した．全体では38％の再発率であった．副作用は膀胱刺激症状，肉眼的血尿，発熱，膀胱容量減少がそれぞれ86％，43％，38％，5％にみられた．再発予防を目的とするBCG膀胱内注入療法は，副作用が高率にみられるので，その適応は複数回再発例を主にし，初発例のうち，少なくともpTaとgrade 1の症例は除くべきと考える．

We reviewed 21 patients with superficial papillary bladder carcinoma who underwent intravesical instillations of BCG to prevent recurrence. BCG was given in a dose of 40 mg every 2 weeks for 8 weeks and then once a month for 10 months. Eleven patients completed the regimen. Of these, 10 were free of recurrence during a follow-up of 3 to 24 months (median 12 months). Of 10 patients who did not complete the regimen because of adverse effects or tumor development, 7 were found to have recurrence.