浸潤性膀胱癌に対するAdjuvant化学療法

概要

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T3以上の浸潤性膀胱癌6例,及び著明な脈管侵襲のみられたT1 1例,T2 4例に対して膀胱全摘術施行後,adjuvant chemotherapyとしてBOM (bleomycin, oncovin, methotrexate)療法及び,そのbleomycinをcyclophosphamideに変更したCOM療法を実施した結果,11例中5例が再発なく生存し,3年生存率は54.5%あった.副作用としては消化器症状が6例,骨髄抑制が4例に認められたがいずれも軽度であったEleven patients with invasive bladder cancer were treated with combination chemotherapy consisting of bleomycin (5 mg, i.m., day 1-7), vincristine (1 mg/sq.m.i.v., day 8) and methotrexate (200-300 mg/sq.m.i.v. day 8). Chemotherapy was started about 4 weeks following total cystectomy and repeated every 2 or 3 weeks at least for one year. Five of the patients were free of disease at the mean follow-up time of 35.6 months, ranging from 21 to 50 month. The 3-year survival rate was 54.5%. Bone marrow suppression (36%), nausea and vomiting (55%) were observed, but they were not serious and well tolerated. These results suggest that this regimen could be used safely as an adjuvant chemotherapy following total cystectomy for patients with invasive bladder cancer. Further evaluation will be necessary.