臨床外科70巻7号

2015年07月発行

特集 Neoadjuvant therapyの最新の動向—がんの治療戦略はどのように変わっていくのか がん種別：術前補助療法の臨床的意義と今後の方向性

大腸癌肝転移に対するneoadjuvant chemotherapy

著者： 大内繭子¹ 坂本快郎¹ 宮本裕士¹ 林洋光¹ 清住雄希¹ 中村健一¹ 泉大輔¹ 小澄敬祐¹ 徳永竜馬¹ 藏重淳二¹ 馬場祥史¹ 吉田直矢¹ 別府透¹ 馬場秀夫¹

所属機関： ¹熊本大学大学院消化器外科学

ページ範囲：P.833 - P.837

【ポイント】
◆切除可能な大腸癌肝転移に対して術前に行う化学療法をneoadjuvant chemotherapyという．
◆大腸癌肝転移に対するneoadjuvant chemotherapyについて，臨床試験が行われている．
◆neoadjuvant chemotherapyの利点と問題点を理解したうえで適応を決めるべきである．

参考文献

1）がん情報サービス：最新がん統計（http://ganjoho.jp/public/statistics/pub/statistics01.html）

2）大腸癌研究会（編）：大腸癌治療ガイドライン医師用2014年度版．金原出版，2014

3）Alberts SR, Horvath WL, Sternfeld WC, et al：Oxaliplatin, fluorouracil, and leucovorin for patients with unresectable liver-only metastases from colorectal cancer：a North Central Cancer Treatment Group phase II study. J Clin Oncol 23：9243-9249, 2005

4）Van Cutsem E, Nordlinger B, Adam R, et al：Towards a pan-European consensus on the treatment of patients with colorectal liver metastases. Eur J Cancer 42：2212-2221, 2006

5）Ismaili N：Treatment of colorectal liver metastases. World J Surg Oncol 9：154, 2011

6）Poston GJ, Adam R, Alberts S, et al：OncoSurge：a strategy for improving resectability with curative intent in metastatic colorectal cancer. J Clin Oncol 23：7125-7134, 2005

7）NCCN腫瘍学臨床診療ガイドライン（結腸癌），2015年版

8）Nordlinger B, Sorbye H, Glimelius B, et al：Perioperative chemotherapy with FOLFOX4 and surgery versus surgery alone for resectable liver metastases from colorectal cancer （EORTC Intergroup trial 40983）：a randomised controlled trial. Lancet 371：1007-1016, 2008

9）Primrose J, Falk S, Finch-Jones M, et al：Systemic chemotherapy with or without cetuximab in patients with resectable colorectal liver metastasis：the New EPOC randomised controlled trial. Lancet Oncol 15：601-611, 2014

10）KRAS野生型切除可能大腸癌肝転移に対する術後補助化学療法mFOLFOX6と周術期化学療法mFOLFOX6＋セツキシマブの第Ⅲ相ランダム化比較試験—EXPERT試験実施計画書

11）Charnsangavej C, Clary B, Fong Y, et al：Selection of patients for resection of hepatic colorectal metastases：expert consensus statement. Ann Surg Oncol 13：1261-1268, 2006

12）Kato T, Yasui K, Hirai T, et al：Therapeutic results for hepatic metastasis of colorectal cancer with special reference to effectiveness of hepatectomy：analysis of prognostic factors for 763 cases recorded at 18 institutions. Dis Colon Rectum 46 （Suppl）：S22-31, 2003

13）Sauer R, Becker H, Hohenberger W, et al：Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Eng J Med 351：1731-1740, 2004

14）Vauthey JN, Pawlik TM, Ribero D, et al：Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. J Clin Oncol 24：2065-2072, 2006

15）Komori H, Beppu T, Baba Y, et al：Histological liver injury and surgical outcome after FOLFOX followed by a hepatectomy for colorectal liver metastases in Japanese patients. Int J Clin Oncol 15：263-270, 2010

16）Ribero D, Wang H, Donadon M, et al：Bevacizumab improves pathologic response and protects against hepatic injury in patients treated with oxaliplatin-based chemotherapy for colorectal liver metastases. Cancer 110：2761-2767, 2007

17）Imai K, Emi Y, Iyama KI et al：Splenic volume may be a useful indicator of the protective effect of bevacizumab against oxaliplatin-induced hepatic sinusoidal obstruction syndrome. Eur J Surg Oncol 40：559-566, 2014

18）Scappaticci FA, Fehrenbacher L, Cartwright T, et al：Surgical wound healing complications in metastatic colorectal cancer patients treated with bevacizumab. J Surg Oncol 91：173-180, 2005

19）Gruenberger B, Tamandl D, Schueller J, et al：Bevacizumab, capecitabine, and oxaliplatin as neoadjuvant therapy for patients with potentially curable metastatic colorectal cancer. J Clin Oncol 26：1830-1835, 2008

20）Nakano H, Oussoultzoglou E, Rosso E, et al：Sinusoidal injury increases morbidity after major hepatectomy in patients with colorectal liver metastases receiving preoperative chemotherapy. Ann Surg 247：118-124, 2008

21）Tamandl D, Klinger M, Eipeldauer S, et al：Sinusoidal obstruction syndrome impairs long-term outcome of colorectal liver metastases treated with resection after neoadjuvant chemotherapy. Ann Surg Oncol 18：421-430, 2011

22）Benoist S, Brouquet A, Penna C, et al：Complete response of colorectal liver metastases after chemotherapy：does it mean cure? J Clin Oncol 24：3939-3945, 2006