Fukui I, Sekine H, Kihara K, Yamada T, Takeuchi S, Yokokawa M, Kawai T, Hosoda K, Ohwada F, Suzuki S
Department of Urology, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan.
J Urol. 1989 Mar;141(3):531-4. doi: 10.1016/s0022-5347(17)40882-2.
We treated 30 patients with carcinoma in situ of the bladder via intravesical combination chemotherapy. As an induction therapy 20 mg. mitomycin C on day 1 and 40 mg. doxorubicin on day 2 were instilled into the bladder once a week for 5 consecutive weeks. Patients who achieved complete response were assigned a maintenance instillation of mitomycin C alone every 2 to 4 weeks for 1 year. A total of 19 patients achieved complete response following an initial course of induction therapy and 2 partial responders to initial therapy also achieved complete response after repeated induction therapy, resulting in a 70 per cent over-all complete response rate. Toxicity was considerable with moderate to severe bladder irritation occurring in 20 patients but it was tolerable in the majority. Of 21 complete responses 13 remained free of disease for 6 to 43 months (average of 23 months), 5 had recurrent carcinoma in situ and 1 had invasive urethral cancer. In contrast, of 9 nonresponders 2 and 1 had invasive cancer of the bladder and ureter, respectively.
我们通过膀胱内联合化疗治疗了30例膀胱原位癌患者。作为诱导疗法，第1天给予20毫克丝裂霉素C，第2天给予40毫克阿霉素，每周一次，连续5周膀胱灌注。达到完全缓解的患者每2至4周单独进行丝裂霉素C维持灌注，持续1年。共有19例患者在初始诱导治疗疗程后达到完全缓解，2例初始治疗部分缓解的患者在重复诱导治疗后也达到完全缓解，总体完全缓解率为70%。毒性反应较为明显，20例患者出现中度至重度膀胱刺激，但大多数患者可以耐受。在21例完全缓解患者中，13例无疾病复发6至43个月（平均23个月），5例复发原位癌，1例发生浸润性尿道癌。相比之下，9例未缓解患者中，分别有2例和1例发生膀胱和输尿管浸润性癌。
