臨床外科60巻6号

2005年06月発行

特集 化学放射線療法―現状とイメージングによる効果判定

直腸癌に対する化学放射線療法

著者： 幸田圭史¹ 軍司祥雄¹ 山田滋² 落合武徳¹

所属機関： ¹千葉大学大学院医学研究院先端応用外科 ²放射線医学総合研究所

ページ範囲：P.743 - P.748

文献概要

要旨：原発直腸癌に対する手術はTME（total mesorectal excision）手技の普及により治療成績が飛躍的に向上したが，特に低位の進行癌に対しては機能温存や局所根治性の向上を目指して放射線治療が従来併用されてきた．しかし放射線治療は局所再発率の低下というコンセンサスは得られたものの，術後の生存率向上にはなかなか結びつかないことが指摘されていた．一方，高度進行大腸癌に対する近年の化学療法の進歩はめざましく，5-FU/LVを中心にoxaliplatinやirinotecanなどの多剤併用療法，さらに経口剤での良好な治療効果も報告されている．このような背景の中，局所の治療効果を向上させ，さらに遠隔成績の向上を期待して，原発直腸癌に対する放射線化学療法が様々なレジメンで行われ，近年その良好な治療成績が発表されつつある．本稿においてはこれらの一部を紹介し，今後の展開について考察を行った．

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