臨床外科63巻13号

2008年12月発行

特集 外科におけるadjuvant/neoadjuvant chemotherapy update

胆道癌に対する術前・術後補助療法

著者： 古瀬純司¹

所属機関： ¹杏林大学医学部内科学腫瘍内科

ページ範囲：P.1737 - P.1745

文献概要

要旨：外科的切除術は胆道癌に対する唯一の根治的治療法であるが，根治術後も多くの場合再発を認め，治癒率の向上には有効な補助療法が必要である．これまで胆道癌の術後補助療法として，大規模なランダム化比較試験は行われていない．現在，切除不能進行胆道癌にはゲムシタビンあるいはTS-1が多く用いられており，術後補助療法としても十分有効性が期待されている．胆道癌の補助療法ではいくつかの克服すべき問題がある．つまり，切除例はそれほど多くない，切除率や予後がまったく異なる胆管癌，胆囊癌，乳頭部癌が含まれる，胆管～空腸，消化管バイパスなどによる食事摂取不良や胆管炎が生じやすい状態にある，など補助療法に不利な条件も少なくない．今後，標準的術後補助療法の確立のためには，これらの困難性を克服しながら質の高い臨床試験を実施することが必要である．

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