腎細胞癌に対する腎摘出術術式と放射線療法および化学療法併用の評価

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The survival rates were studied in 82 patients with renal cell carcinoma comparing nephrectomy alone to nephrectomy combined with radiation therapy and/or chemotherapy. The 3-year and 5-year survival rates of all 82 patients were 44% and 39%, respectively. In 69 patients capable of undergoing nephrectomy of these 82 patients, the 3-year and 5-year survival rates were 50% and 46%, respectively. Surgical procedures in these 69 patients undergoing nephrectomy were transperitoneal nephrectomy in 47 patients, translumbar nephrectomy in 20 patients and thracoabdominal nephrectomy in 2 patients. Examining the relationship between surgical procedures and survival rates in 33 patients with stages II and III to which surgical procedures were considered to be important, the survival rate of 25 patients undergoing transperitoneal nephrectomy was more favorable in comparison with that of 8 patients undergoing translumbar nephrectomy up to 2 years after operation, but no difference was found between both surgical procedures after 3 years or thereafter. Of 65 patients undergoing nephrectomy and survived more than 2 months after operation, 44 patients received radiation therapy and 38 patients received chemotherapy. And, 28 of these patients received both radiation therapy and chemotherapy. 31 patients received 4,000-6,000 rads postoperatively and 13 patients received 3,000-4,000 rads preoperatively. The survival rate of these 44 patients were apparently favorable compared with that of 21patients who received no radiation therapy, and its favorable effect was more prominent in patients with stages II and III. However, the survival rate was not improved further even if chemotherapy was further added. As chemotherapy, first 3 cases were administered 5-10mg of thio-Tepa, 10-20 times, 10 patients 2-4mg of mitomycin C 10-20 times, and the rest 25 patients 2-4mg of mitomycin, 250-500 mg of 5-fluorouracil and 20-40 mg of cytosine arabinoside twice a week, totally 10 times after operation. The survival rate of these 38 patients who received chemotherapy was similar to that of 27 patients who received no chemotherapy. No improvement of the survival rate due to chemotherapy was obtained in patients at every stage.
社団法人日本泌尿器科学会の論文

腎細胞癌に対する腎摘出術術式と放射線療法および化学療法併用の評価

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