Kanoh S, Noguchi R, Ohtani M, Ishikawa S, Nemoto R, Koiso K, Kitagawa R
Department of Urology, University of Tsukuba, Ibaragi Prefecture, Japan.
Cancer Chemother Pharmacol. 1987;20 Suppl:S6-9. doi: 10.1007/BF00262476.
Intra-arterial infusion chemotherapy with adriamycin (ADM) was carried out in 32 patients with bladder cancer prior to total cystectomy. An oblique incision approximately 12 cm long was made in the gluteal region to expose either the superior or inferior gluteal artery, into which a Teflon catheter was inserted and fixed. The distal end of the catheter was taken out from under the skin in the precordial region. Via this catheter, a single dose of 10 mg ADM was injected twice a week. Superior-gluteal-artery infusion chemotherapy was performed in 7 patients; the 5-year survival rate was 14.3%, which was not as high as expected. Inferior-gluteal-artery infusion chemotherapy was performed in 25 patients. Cisplatin (CDDP) was used with ADM in 8 patients. Radiation and/or hyperthermia were used in 11 patients. The 5-year survival rate in these 25 patients was 58.4%, which was considered to be satisfactory. Of these 25 patients, 5 were stage-T4 cases; for these, the treatment was ineffective, and all 5 died within 2 years. Of the 6 patients at stage T2, 1 died, as did 1 patient with carcinoma in situ (CIS). Of the 13 patients with bladder cancer at stage T3, 3 died; lymph-node metastases were found in all 3 of these cases. Of the 25 patients who received inferior-gluteal-artery infusion chemotherapy, 9 died of cancer; all 9 died within 2 years due to distant metastases. There was no evidence of recurrence in any patient who survived for 2 years or more after total cystectomy. Therefore, inferior-gluteal-artery infusion chemotherapy may be effective as a preoperative adjuvant therapy with no serious side effects.
32例膀胱癌患者在全膀胱切除术前进行了阿霉素（ADM）动脉内灌注化疗。在臀部做一个约12厘米长的斜切口，以暴露臀上动脉或臀下动脉，将一根聚四氟乙烯导管插入并固定其中。导管远端从前胸壁皮下引出。通过该导管，每周两次注射单剂量10毫克阿霉素。7例患者进行了臀上动脉灌注化疗；5年生存率为14.3%，未达预期。25例患者进行了臀下动脉灌注化疗。8例患者联合使用顺铂（CDDP）和阿霉素。11例患者采用了放疗和/或热疗。这25例患者的5年生存率为58.4%，被认为是令人满意的。在这25例患者中，有5例为T4期病例；对这些患者治疗无效，5例均在2年内死亡。6例T2期患者中有1例死亡，1例原位癌（CIS）患者死亡。13例T3期膀胱癌患者中有3例死亡；这3例均发现有淋巴结转移。在接受臀下动脉灌注化疗的25例患者中，9例死于癌症；所有9例均因远处转移在2年内死亡。全膀胱切除术后存活2年或更长时间的患者均无复发迹象。因此，臀下动脉灌注化疗作为术前辅助治疗可能有效，且无严重副作用。
