膀胱腫瘍に対するBCG注入療法

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1)膀胱腫瘍10例(11腫瘍)に対してBCG 30 mgから240 mgによる膀胱腔内注入療法を施行した.2) 11腫瘍中7腫瘍に腫瘍消失,4腫瘍に20～80%の腫瘍縮小効果が認められた.3)腫瘍の大きさ別では米粒大腫瘍の4腫瘍は全例消失し,小指頭大の腫瘍では5腫瘍中3腫瘍が消失し,残りの2腫瘍にも著明な縮小が認められた.4)悪性度の判明した8腫瘍についてみるとGrade 1は5例中4腫瘍全例が消失,1腫瘍が50%縮小し,Grade 2は3腫瘍が20～80%の腫瘍縮小を認めた.5)副作用としては,膀胱刺激症状を10例中7例(70%),発熱4例(40%),血尿3例(30%)を認めたThe patients with bladder tumor (11 tumor) were given intravesical Bacillus Calmette-Guerin (BCG) therapy. The concentration of BCG solution varied from 80 to 240 mg in 40 ml of normal saline. The intravesical instillation therapy with this solution was repeated 6 times at a week interval. Seven of the tumors showed excellent response and had completely disappeared upon endoscopic examination. All of the highly responded tumors were small papillary lesions of low grade and low stage of malignancy. Regarding side effects, irritable bladder occurred in 70%, elevation of body temperature of over 37 degrees C in 40% and gross hematuria in 30% of the patients. Among them, one patient was treated with INH (0.3 g/day) for 2 weeks with satisfactory remission of the symptoms. Though the number of cases and follow up period are not satisfactory enough, topical therapy with BCG can be said to be an effective therapeutic measure against early stage urotherial tumors.

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遠藤忠雄
北里大医泌尿器科

膀胱腫瘍に対するBCG注入療法

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