臨床外科61巻6号

2006年06月発行

特集 癌の播種性病変の病態と診断・治療

腹膜播種の先進治療

著者： 坂本純一¹ 大庭幸治¹ 小林道也² 弓場健義³

所属機関： ¹京都大学大学院医学研究科疫学研究情報管理学講座 ²高知大学医学部腫瘍局所制御学 ³大阪厚生年金病院外科

ページ範囲：P.769 - P.774

要旨：癌の腹膜播種に対しては，化学療法や手術療法が主として行われているが，いまだ決定的な方法はなく，新しい先進治療の開発や，既存治療法との併用効果の評価が必要である．温熱療法は，高周波数のラジオ波を用いたり閉鎖灌流装置を使用したりして，41℃以上の温度を維持することによって，悪性中皮種の播種性病変に有効である．非特異的免疫療法としては，OK-432によってNK細胞，T細胞マクロファージの活性化をはかる試みやIFN-γ，TNF，IL-2などのBMRを用いる方法が提唱されている．また，in vitroで活性化した自己活性化リンパ球の注入や，ペプチドを用いたワクチン療法なども先進医療として進められている．遺伝子治療としては，Kras RNA発現プラスミドに対するantisenseをtransfectする方法や，アデノウイルス，レトロウイルスをvectorとした方法なども臨床応用が期待されている．

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