臨床外科63巻1号

2008年01月発行

特集 機能温存手術のメリット・デメリット

下部直腸癌に対する術前化学放射線療法併用の縮小手術のメリット・デメリット

著者： 井上靖浩¹ 三木誓雄¹ 楠正人¹

所属機関： ¹三重大学大学院医学系研究科生命医科学専攻病態修復医学講座消化管・小児外科学

ページ範囲：P.29 - P.34

要旨：下部進行直腸癌の治療においては根治性と機能温存をバランスよく保つことが理想的である．最近では手術技術の進歩で根治性，自然肛門温存率ともに著しく向上した．さらに欧米では，局所再発を抑え予後を向上させる目的で補助療法としての放射線療法が標準治療として確立している．なかでも術前化学放射線療法にはダウンステージングによって自然肛門温存率を向上させる可能性があり，患者QOLの観点からも一段と注目されている．本稿では特に，下部進行直腸癌に対する術前化学放射線療法併用の縮小手術について概説した．直腸癌に対する術前化学放射線療法は放射線スケジュールや，併用する化学療法などの点でいまだ過渡期にあり，今後もさらなる効果ならびに安全性の向上が期待できることから，根治性のみならず機能温存にとっても大きな将来性を担っている．

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