局所浸潤性膀胱癌における術前化学療法(M-VAC)

概要

論文の詳細を見る
1)臨床病期T2-T4, N0, M0の膀胱癌症例8例に術前M-VAC療法を2コース行い,膀胱全摘術を7例に,TUR biopsyを1例におこなった.2)膀胱全摘術を行った7例のうち5例に有効と考えられた.3)観察期間は平均26ヵ月で,1例が術後27ヵ月で癌死したが,7例は再発なく生存している.4)副作用として重篤なものはなく全例full doseの投与が可能であった.5)術前化学療法の効果を論ずる際に,臨床病期の決定においてどの程度TURを行うかが問題であるEight patients with locally invasive bladder cancer (stages T2-T4, N0, M0; 7 men and 1 woman; mean age, 72.0 years; age range, 56 to 80 years) were treated with 2 cycles of neoadjuvant chemotherapy consisting of methotrexate, vinblastine, adriamycin and cisplatin (M-VAC). Seven of them underwent radical cystectomy after chemotherapy, while the bladder was preserved in one patient. Seven patients were free of disease during a mean follow-up period of 26.2 months (range 20-30 months). However, one patient whose pathological stage was pT2, N1 died with disease 27 months after radical cystectomy. The patient whose bladder had been preserved showed no recurrence after a follow-up period of 27 months. Pathological examination of the resected specimen after chemotherapy revealed no tumor tissue in three patients; one with negative cytology and two with positive cytology. Downstages were observed in two patients. Results showed that the toxicity of neoadjuvant M-VAC therapy is acceptable and that M-VAC therapy is effective against locally invasive transitional cell carcinoma of the bladder. The problem remains of how to assess the clinical stage more accurately before chemotherapy and radical cystectomy.

局所浸潤性膀胱癌における術前化学療法(M-VAC)

スポンサーリンク

概要

著者

関連論文

スポンサーリンク