表在性膀胱癌に対する経尿道的切除後の塩酸エピルビシン膀胱内注入療法による再発予防効果の検討

概要

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Intravesical chemotherapy is performed after transurethral resection (TUR) of bladder tumors for reducing the recurrence rate. We determined the difference in response to two medication protocols with Ta/T1 bladder cancer. A total of 29 patients with primary superficial bladder cancer, grade 1 or 2, were entered into a randomized trial. Patients were treated with one of two intravesical adjuvant administration protocols : A or B. All patients were received one instillation of 30 nig of epirubicin (EPI) just after TUR. Group A : Early instillation group : Four instillations were done every 24 hr after the first instillation. After that, five instillations were done every week. Total dosage of EPI was 300 mg. Group B : Late instillation group : Nineteen instillations were performed every two weeks after the first instillation. Total dosage of EPI was 600 mg. The primary endpoint was recurrence which was determined with pathological diagnosis. There was a significant difference in non-recurrence rates after 12 months (A 91.7%, B 52.3%) and 24 months (A 81.5%, B 36.6%). Group A had a significantly better recurrence-free survival than group B (p = 0.03). Total dosage of EPI did not effect on recurrence of bladder cancer. The time to first recurrence was not significantly different. Intravesical instillation for superficial bladder cancer after TUR is effective in increasing the non-recurrence rate with EPI if the correct schedule is chosen.