Kakizaki H, Suzuki H, Kubota Y, Numasawa K, Suzuki K
Department of Urology, Yamagata University School of Medicine, Japan.
Cancer Chemother Pharmacol. 1987;20 Suppl:S15-9. doi: 10.1007/BF00262478.
We have performed preoperative one-shot intra-arterial chemotherapy since 1976. However, in some cases, the results have not been satisfactory. Experimental studies were conducted to choose the drugs most suitable for this procedure. Drugs that were considered to be effective against bladder cancer, i.e., thio-TEPA, adriamycin (ADM), and cis-platinum (CDDP), were separately administered to groups of dogs via the common iliac artery or cephalic vein, and the concentrations of these drugs in the serum, bladder (mucosa and muscular layer), ileum, kidneys, and liver were measured 1 h later. The results revealed significantly high concentrations of intra-arterially injected ADM and CDDP in the bladder mucosa, suggesting that these drugs may be suitable for intra-arterial injection. It also appeared that thio-TEPA is unsuitable for this procedure. In clinical studies of 29 cases, preoperative one-shot intra-arterial injections were performed prior to total cystectomy or segmental resection of the bladder, and the effectiveness of the treatment was evaluated in terms of the histological effect, survival, and the relationship with the characteristics of the tumor. The results showed that the prognosis for cases showing therapeutic histological effectiveness (grade-IIb according to the classification of Shimosato et al.) was extremely good. Many patients in the grade-IIb group had stage-pT2 tumor or a tumor in the lateral wall. However, there seemed to be no significant differences between the drugs with respect to their histological effects.
自1976年以来，我们一直进行术前一次性动脉内化疗。然而，在某些情况下，结果并不令人满意。我们开展了实验研究以选择最适合该治疗方法的药物。将被认为对膀胱癌有效的药物，即噻替派、阿霉素（ADM）和顺铂（CDDP），通过髂总动脉或头静脉分别给予几组犬，1小时后测量这些药物在血清、膀胱（黏膜和肌层）、回肠、肾脏和肝脏中的浓度。结果显示，动脉内注射的ADM和顺铂在膀胱黏膜中的浓度显著较高，表明这些药物可能适合动脉内注射。似乎噻替派不适合该治疗方法。在29例临床研究中，在膀胱全切除术或膀胱部分切除术之前进行术前一次性动脉内注射，并根据组织学效果、生存率以及与肿瘤特征的关系评估治疗效果。结果显示，显示出治疗性组织学效果的病例（根据下里佐等人的分类为IIb级）预后极佳。IIb组中的许多患者患有pT2期肿瘤或侧壁肿瘤。然而，这些药物在组织学效果方面似乎没有显著差异。
