Akaza H, Kameyama S, Kakizoe T, Kojima H, Koiso K, Aso Y, Niijima T
Institute of Clinical Medicine, University of Tsukuba.
Nihon Hinyokika Gakkai Zasshi. 1992 Feb;83(2):183-9. doi: 10.5980/jpnjurol1989.83.183.
We investigated the effects of intravesical instillation of BCG Tokyo 172 strain on patients with superficial bladder cancer and CIS of the bladder for tumor ablation and prophylaxis. This is the first controlled multicenter study for governmental approval of BCG Tokyo 172 strain for the treatment of superficial bladder cancer and CIS of the bladder. One hundred-fifty-seven patients (125 with Ta or T1, and 32 with CIS) were treated by 80 mg of BCG diluted in 40 ml of saline, once a week for 8 weeks. The dose and interval adopted in this multicenter study was determined by the previous Phase II study conducted by the same Study Group. Out of 125 superficial tumor Ta, T1, 83 (66.4%) showed complete disappearance of the tumor (CR) and 26 (20.8%) partial disappearance (PR), and out of 32 CIS, 27 (84.4%) showed CR and 2 (6.3%) PR. Among those patients showing CR, and PR who were treated with additional TUR-Bt, 98 patients were randomised for a controlled study of prophylactic BCG instillation. Prophylactic treatment consisted of 40 mg of BCG diluted in 40 ml of saline, monthly for 12 months. Forty-two patients were assigned to the treatment group, whereas the remaining 56 to the control group without any prophylactic instillation. Three cases showed tumor recurrence during the prophylactic phase. Twenty-five cases could not be treated for the whole course of prophylactic instillation mainly due to bladder irritable symptoms. Recurrent free curves were compared till 1050 days after the initiation of the study. However, there was no significant difference between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
我们研究了膀胱内灌注东京172株卡介苗对浅表性膀胱癌和膀胱原位癌患者进行肿瘤消融和预防的效果。这是第一项为获得政府批准将东京172株卡介苗用于治疗浅表性膀胱癌和膀胱原位癌而开展的对照多中心研究。157例患者(125例Ta或T1期,32例原位癌)接受了80mg卡介苗用40ml生理盐水稀释后的治疗,每周一次,共8周。本多中心研究采用的剂量和间隔是由同一研究组之前进行的II期研究确定的。在125例浅表性肿瘤Ta、T1患者中,83例(66.4%)肿瘤完全消失(CR),26例(20.8%)部分消失(PR);在32例原位癌患者中,27例(84.4%)CR,2例(6.3%)PR。在那些显示CR和PR并接受额外经尿道膀胱肿瘤电切术的患者中,98例被随机分组进行预防性卡介苗灌注的对照研究。预防性治疗包括40mg卡介苗用40ml生理盐水稀释,每月一次,共12个月。42例患者被分配到治疗组,其余56例被分配到不进行任何预防性灌注的对照组。3例在预防阶段出现肿瘤复发。25例患者主要由于膀胱刺激症状而无法完成整个预防性灌注疗程。比较了研究开始后至1050天的无复发病例曲线。然而,两组之间没有显著差异。(摘要截短至250字)