表在性膀胱癌に対する抗癌剤再発予防注入療法 Randomized Trial による共同研究の長期 Follow-up 成績

津島 知靖; 那須 保友; 明比 直樹; 野田 雅俊; 雑賀 隆史; 大森 弘之; 小橋 賢二; 尾崎 雄治郎; 松村 陽右; 棚橋 豊子; 難波 克一; 白神 健志; 高本 均; 荒木 徹; 武田 克治; 朝日 俊彦; 赤枝 輝明

doi:10.5980/jpnjurol1989.83.1314

PROPHYLACTIC INTRAVESICAL INSTILLATION THERAPY IN PATIENTS WITH SUPERFICIAL BLADDER CANCER

Results of a Randomized Prospective Study

Tomoyasu Tsushima, Yasutomo Nasu, Naoki Abeki, Masatoshi Noda, Takashi Saika, Hiroyuki Ohmori, Kenji Kobashi, Yujiro Ozaki, Yosuke Matsumura, Toyoko Tanahashi, Katsuichi Namba, Tsuyoshi Shiraga, Hitoshi Takamoto, Tohru Araki, Katsuji Takeda, Toshihiko Asahi, Teruaki Akaeda

Author information

Tomoyasu Tsushima
Department of Urology, Okayama University Medical School
Yasutomo Nasu
Department of Urology, Okayama University Medical School
Naoki Abeki
Department of Urology, Okayama University Medical School
Masatoshi Noda
Department of Urology, Okayama University Medical School
Takashi Saika
Department of Urology, Okayama University Medical School
Hiroyuki Ohmori
Department of Urology, Okayama University Medical School
Kenji Kobashi
Department of Urology, Kobe West City Hospital
Yujiro Ozaki
Department of Urology, Kobe West City Hospital
Yosuke Matsumura
Department of Urology, Kobe West City Hospital
Toyoko Tanahashi
Department of Urology, Okayama City Hospital
Katsuichi Namba
Department of Urology, Okayama City Hospital
Tsuyoshi Shiraga
Department of Urology, Okayama Saiseikai General Hospital
Hitoshi Takamoto
Department of Urology, Center for Adult Disease, Kurashiki
Tohru Araki
Department of Urology, Center for Adult Disease, Kurashiki
Katsuji Takeda
Department of Urology, Kagawa Prefectural Central Hospital
Toshihiko Asahi
Department of Urology, Kagawa Prefectural Central Hospital
Teruaki Akaeda
Department of Urology, Tsuyama Central Hospital

Keywords: superficial bladder cancer, intravesical chemotherapy, prophylactic instillation

JOURNAL FREE ACCESS

1992 Volume 83 Issue 8 Pages 1314-1321

DOI https://doi.org/10.5980/jpnjurol1989.83.1314

Details

Abstract

A randomized prospective study was conducted for the purpose of investigating the efficacy of intravesical chemoprophylaxis of superficial bladder cancers. Eligible patients were randomized into three groups: 1) adriamycin (ADM) group; intravesical instillation with 50mg of ADM dissolved in 100ml physiological saline, 2) mitomycin C (MMC) group; intravesical instillation with 30mg of MMC dissolved in 100ml of physiological saline, 3) control group; transurethral resection or transurethral coagulation only.
The characteristic features of our protocol consisted of frequent (six times) instillations of the drugs within two weeks after transurethral resection, followed by instillations on two consecutive days at four-week intervals for two years. Furthermore, large quantities (100ml) of instillation fluid containing relatively low concentrations of the drugs (500μg/ml for ADM or 300μg/ml for MMC) were employed.
One hundred and forty-four patients have been submitted to the study; 110 patients were fully evaluable for recurrence and 34 patients were eliminated as non-evaluable patients. The cumulative five-year non-recurrence rates of the patients with multiple tumors were 32% in the MMC group, 25% in the ADM group and 7% in the control group. The cumulative non-recurrence rates of the ADM and MMC groups were significantly higher than that of the control group.
It is considered that this instillation therapy with ADM and MMC is useful for preventing the recurrence of superficial bladder cancers.

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