表在性膀胱癌に対するBCG膀胱内注入療法の検討

Abstract

Between March 1988 and September 1989, 29 patients with superficial bladder cancer (Stages CIS, Ta and T1) were treated with intravesical bacillus Calmette-Guerin (BCG). The patients (23 males and 6 females) ranged in age from 42 to 83 years (average 67.4 years). A suspension containing 80 mg of BCG (Tokyo-strain 172) was instilled into the bladder once a week for 8 weeks. Six patients were treated after transurethral resection (TUR-Bt) as prophylaxis. After treamtment, all patients indicate no recurrence at this time. The remaining 23 patients with visible bladder tumor were treated as antitumor effect. Of the 11 patients with CIS, 8 patients (72.7%) were proved to be free of disease by random biopsy and urinary cytology. Three patients (27.5%) had no evidence of CIS by random biopsy and cystoscopy but have persistent positive urinary cytology. As for superficial tumor (Ta, T1), 9 patients (75.0%) had a complete response but another 3 patients (25.0%) indicated no response. Regarding side effects, irritable bladder in 75%, gross hematuria in 27.6% and fever (over 38℃) in 27.6% of patients were observed. These results suggest that intravesical BCG may be useful in the therapy of superficial bladder cancer as well as in the prophylaxis for recurrent tumor following TUR-Bt. However, clinical efficacy and total dose of BCG should be clarified by long term observation.