臨床外科67巻8号

2012年08月発行

特集 知っておきたい放射線・粒子線治療

消化器癌に対する陽子線治療の現況と展望

著者： 有村健¹ 荻野尚¹

所属機関： ¹財団法人メディポリス医学研究財団がん陽子線治療研究センター

ページ範囲：P.1011 - P.1015

【ポイント】

◆消化器癌における陽子線治療の主な対象疾患は，切除不能な肝癌，膵癌および直腸癌の術後再発である．

◆管腔臓器は耐容線量が低く，内容物やガスを含み，固定が困難なため，原則として陽子線治療の対象にならない．

◆陽子線治療の適応は，腫瘍と近接する消化管との距離が離れていることが，最も重要な条件の一つである．

参考文献

1）Emami B, Lyman J, Brown A, et al：Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21：109-122, 1991

2）International Commission on Radiation Units and Measurements（ICRU）Report 50, Prescribing, Recording and Reporting Photon Beam Therapy, ICRU Publications, Bethesda, USA, 1993

3）International Commission on Radiation Units and Measurements（ICRU）Report 62, Prescribing, Recording and Reporting Photon Beam Therapy（Supplement to ICRU Report 50）, ICRU Publications, Bethesda, USA, 1999

4）Oshiro Y, Okumura T, Ishida M, et al：Displacement of hepatic tumor at time to exposure in end-expiratory-triggered-pulse proton therapy. Radiother Oncol 99：124-130, 2011

5）Chiba T, Tokuuye K, Matsuzaki Y, et al：Proton beam therapy for hepatocellular carcinoma：a retrospective review of 162 patients. Clin Cancer Res 11：3799-3805, 2005

6）Kawashima M, Kohno R, Nakachi K, et al：Dose-volume histogram analysis of the safety of proton beam therapy for unresectable hepatocellularcarcinoma. Int J Radiat Oncol Biol Phys 79：1479-1486, 2011

7）Bush DA, Kayali Z, Grove R, et al：The safety and efcacy of high-dose proton beam radiotherapy for hepatocellular carcinoma：a phase 2 prospective trial. Cancer 117：3053-3059, 2011

8）Kawashima M, Furuse J, Nishio T, et al：Phase Ⅱ study of radiotherapy employing proton beam for hepatocellular carcinoma. J Clin Oncol 23：1839-1846, 2005

9）Fukumitsu N, Sugahara S, Nakayama H, et al：A prospective study of hypofractionated proton beam therapy for patients with hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 74：831-836, 2009

10）Komatsu S, Fukumoto T, Demizu Y, et al：Clinical results and risk factors of proton and carbon ion therapy for hepatocellular carcinoma. Cancer 117：4890-4904, 2011

11）Ogino T：Clinical evidence of particle beam therapy（proton）. Int J Clin Oncol 17：79-84, 2012

12）Skinner HD, Hong TS, Krishnan S：Charged-particle therapy for hepatocellular carcinoma. Sem Radiat Oncol 21：278-286, 2011

13）Mizumoto M, Okumura T, Hashimoto T, et al：Proton beam therapy for hepatocellular carcinoma：a comparison of three treatment protocols. Int J Radiat Oncol Biol Phys 81：1039-1045, 2011

14）Mizumoto M, Tokuuye K, Sugahara S, et al：Proton beam therapy for hepatocellular carcinoma adjacent to the porta hepatis. Int J Radiat Oncol Biol Phys 71：462-467, 2008

15）Nakayama H, Sugahara S, Fukuda K, et al：Proton beam therapy for hepatocellular carcinoma located adjacent to the alimentary tract. Int J Radiat Oncol Biol Phys 80：992-995, 2011

16）Komatsu S, Hori Y, Fukumoto T, et al：Surgical spacer placement and proton radiotherapy for unresectable hepatocellular carcinoma. World J Gastroenterol 16：1800-1803, 2010

17）Mizumoto M, Okumura T, Hashimoto T, et al：Evaluation of liver function after proton beam therapy for hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 82：e529-535, 2012

18）Ohara K, Okumura T, Tsuji H, et al：Radiation tolerance of cirrhotic livers in relation to the preserved functional capacity：analysis of patients with hepatocellular carcinoma treated by focused proton beam radiotherapy. Int J Radiat Oncol Biol Phys 38：367-372, 1997

19）Hata M, Tokuuye K, Sugahara S, et al：Proton beam therapy for hepatocellular carcinoma patients with severe cirrhosis. Strahlenther Onkol 182：713-720, 2006

20）Sugahara S, Oshiro Y, Nakayama H, et al：Proton beam therapy for large hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 76：460-466, 2010

21）Hata M, Tokuuye K, Sugahara S, et al：Proton beam therapy for aged patients with hepatocellular carcinoma. Int J Radiat Oncol Biol Phys 69：805-812, 2007

22）Hata M, Tokuuye K, Sugahara S, et al：Proton beam therapy for hepatocellular carcinoma with portal vein tumor thrombus. Cancer 104：794-801, 2005

23）Sugahara S, Nakayama H, Fukuda K, et al：Proton-beam therapy for hepatocellular carcinoma associated with portal vein tumor thrombosis. Strahlenther Onkol 185：782-788, 2009

24）D'Souza MA, Shrikhande SV：Pancreatic resectional surgery：an evidence-based perspective. J Cancer Res Ther 4：77-83, 2008

25）Ishii H, Furuse J, Boku N, et al：Phase Ⅱ study of gemcitabine chemotherapy alone for locally advanced pancreatic carcinoma：JCOG0506. Jpn J Clin Oncol 40：573-579, 2010

26）Li D, Xie K, Wolff R, et al：Pancreatic cancer. Lancet 27：1049-1057, 2004

27）Hidalgo M：Pancreatic cancer. N Engl J Med 29：1605-1617, 2010

28）Vincent A, Herman J, Schulick R, et al：Pancreatic cancer. Lancet 13：607-620, 2011

29）Steel GG, Peacock JH：Why are some human tumours more radiosensitive than others? Radiother Oncol 15：63-72, 1989

30）Terashima K, Demizu Y, Hashimoto N, et al：A phase Ⅰ/Ⅱ study of gemcitabine-concurrent proton radiotherapy for locally advanved pancreatic cancer without distant metastasis. Radiother Oncol 103：25-31, 2012

31）Raut CP, Tseng JF, Sun CC, et al：Impact of resection status on pattern of failure and survival after pancreaticoduodenectomy for pancreatic adenocarcinoma. Ann Surg 246：52-60, 2007

32）Evans DB, Varadhachary GR, Crane CH, et al：Preoperative gemcitabine-based chemoradiation for patients with resectable adenocarcinoma of the pancreatic head. J Clin Oncol 26：3496-3502, 2008

33）Sebag-Montefiore D, Stephens RJ, Steele R, et al：Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer（MRC CR07 and NCIC-CTG C016）：a multicentre, randomised trial. Lancet 373：811-820, 2009