臨床外科65巻4号

2010年04月発行

特集 消化器癌neoadjuvant chemotherapyの新展開 〔根治性向上〕

膵癌に対するneoadjuvant chemoradiationの適応と意義

著者： 大東弘明¹ 高橋秀典¹ 江口英利² 後藤邦仁¹ 山田晃正¹ 石川治¹ 田中晃司¹ 真貝竜史¹ 本告正明¹ 岸健太郎¹ 能浦真吾¹ 宮代勲¹ 大植雅之¹ 矢野雅彦¹

所属機関： ¹大阪府立成人病センター消化器外科 ²大阪大学大学院医学系研究科消化器外科

ページ範囲：P.502 - P.507

要旨：長期生存を得るにはR0切除が必須であるが，進行例の多い膵癌では手術単独での限界は明らかである．術前化学放射線療法はsurgical marginやリンパ節転移の陰性化など局所制御の向上をもたらした．われわれは3-dimensional conformal radiationによって胃や十二指腸などの消化管を厳密に照射野から外すことを試み，full-doseのgemcitabine併用にもかかわらず消化器系副作用を軽減させ，通院でも施行可能にした．これに加え，術後の肝灌流化学療法の併用は，肝転移再発を抑制し，治療前T3～4でありながら56％の5年生存が得られた．

参考文献

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