臨床外科69巻6号

2014年06月発行

特集 癌の補助療法アップデート

切除可能進行食道癌に対するJCOG臨床試験の変遷と今後の展望

著者： 竹内裕也¹ 川久保博文¹ 中村理恵子¹ 福田和正¹ 高橋常浩¹ 和田則仁¹ 才川義朗¹ 大森泰¹ 安藤暢敏² 北川雄光¹

所属機関： ¹慶應義塾大学医学部外科 ²国際親善総合病院

ページ範囲：P.650 - P.655

文献概要

【ポイント】

◆切除可能進行食道癌は集学的治療の時代を迎え，外科治療成績の向上のために術前補助療法が模索されている．

◆現行よりもさらに強力なレジメンによる術前補助化学療法，あるいは局所制御をより重視した術前補助化学放射線療法による治療成績の向上が期待されている．

◆食道温存治療としての根治的化学放射線療法はさらなる治療成績向上のために，晩期有害事象の軽減とsalvage手術を根治的かつ安全に施行することが求められている．

参考文献

1）日本食道学会（編）：食道癌診断・治療ガイドライン　2007年4月版，金原出版

2）日本食道学会（編）：食道癌診断・治療ガイドライン　2012年4月版，金原出版

3）Japanese Esophageal Oncology Group：A comparison of chemotherapy and radiotherapy as adjuvant treatment to surgery for esophageal carcinoma. Chest 104：203-207, 1993

4）Ando N, Iizuka T, Kakegawa T, et al：A randomized trial of surgery with and without chemotherapy for localized squamous carcinoma of the thoracic esophagus：the Japan Clinical Oncology Group Study. J Thorac Cardiovasc Surg 114：205-209, 1997

5）AndoN, Iizuka T, Ide H, et al：Surgery plus chemotherapy compared with surgery alone for localized squamous cell carcinoma of the thoracic esophagus：a Japan Clinical Oncology Group Study－JCOG9204. J Clin Oncol 21：4592-4596, 2003

6）Malthaner RA, Wong RK, Rumble RB, et al；Members of the Gastrointestinal Canser Disease Site Group of Cancer Care Ontario's Program in Evidence-based Care：Neoadjuvant or adjuvant therapy for resectable esophageal cancer：a systematic review and meta-analysis. BMC Med 2：35, 2004

7）Medical Research Council Oesophageal Cancer Working Group：Surgical Resection with or without preoperative chemotherapy in oesophageal cancer：a randomized controlled trial. Lancet 359：1722-1734, 2002

8）Cunningham D, Allum WH, Stenning SP, et al：Perioperative chemotherapy versus surgery alone for respectable gastroesophageal cancer. N Engl J Med 355：11-20, 2006

9）Gebski V, Burmeister B, Smithers BM, et al：Survival benefits from neoadjuvant chemoradiotherapy or chemotherapy in oesophageal carcinoma：a meta-analysis. Lancet Oncol 8：226-234, 2007

10）Ando N, Kato H, Igaki H, et al：A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus（JCOG9907）Ann Surg Oncol 19：68-74, 2012

11）Hirao M, Ando N, Tsujinaka T, et al；Japan Esophageal Oncology Group/Japan Clinical Oncology Group：Influence of preoperative chemotherapy for advanced thoracic esophageal squamous cell carcinoma on perioperative complications. Br J Surg 98：1735-1741, 2011

12）Iizuka T, Ide H, Kakegawa T, et al：Preoperative radioactive therapy for esophageal caricnoma：Randomized evaluation trial in eight institutions. Chest 93：1054-1058, 1998

13）Walsh T, Noonan N, Hollywood D, et al：A comparison of multimodal therapy and surgery for esophageal adenocarcinoma. N Engl J Med 335：462-467, 1996

14）Tepper J, Krasna MJ, Niedzwiecki D, et al：Phase Ⅲ trial of trimodality therapy with cisplatin, fluorouracil, radiotherapy, and surgery compared with surgery alone for esophageal cancer：CALGB9781. J Clin Oncol 26：1086-1092, 2008

15）van Hagen P, Hulshof MC, van Lanschot JJ, et al；CROSS Group：Preoperative chemoradiotherapy for esophageal or junctional cancer. N Engl J Med 366：2074-2084, 2012

16）Urschel JD, Vasan H：A meta-analysis of randomized controlled trials that compared neoadjuvant chemoradiation and surgery to surgery alone for resectable esophageal cancer. Am J Surg 185：538-543, 2003

17）Nakamura K, Kato K, Igaki H, et al：Three-arm phase Ⅲ trial comparing cisplatin plus 5-FU （CF） versus docetaxel, cisplatin plus 5-FU （DCF） versus radiotherapy with CF（CF-RT） as preoperative therapy for locally advanced esophageal cancer （JCOG1109, NExT Study）. Jpn J Clin Oncol 43：752-755, 2013

18）Stahl M, Stuschke M, Lehmann N, et al：Chemoradiation with and without surgery in patients with localy advanced squamous cell carcinoma of the esophagus. J Clin Oncol 23：2310-2317, 2005

19）Bedenne L, Michel P, Bouché O, et al：Chemoradiation followed by surgery compared with chemoradiation alone in squaomous cancer of the esophagus：FFCD9102. J Clin Oncol 25：1160-1168, 2007

20）Minashi K, Kato M, Ohtsu A, et al：A phase Ⅱ study of chemoradiotherpy in patients with stage Ⅱ, Ⅲ, esophageal squamous cell carcinoma （ESCC）：JCOG trial （JCOG9906）. J Clin Oncol, ASCO Gastrointestinal Cancers Symposium Abstract #114, 2008

21）Minski BD, Pajak TF, Ginsberg RJ, et al：INT0123 （Radiation Therapy Oncology Group 94-05） phase Ⅲ trial of combined-modality therapy for esophageal cancer：high-dose versus standard-dose radiation therapy. J Clin Oncol 20：1167-1174, 2002