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

胆道癌に対するneoadjuvant therapy

著者： 加藤厚¹ 清水宏明¹ 大塚将之¹ 吉富秀幸¹ 古川勝規¹ 高屋敷吏¹ 久保木知¹ 高野重紹¹ 岡村大樹¹ 鈴木大亮¹ 酒井望¹ 賀川真吾¹ 宮崎勝¹

所属機関： ¹千葉大学大学院医学研究院臓器制御外科学

ページ範囲：P.844 - P.849

文献概要

【ポイント】
◆胆道癌に対するエビデンスのあるneoadjuvant therapyの報告は乏しい．
◆切除不能局所進行胆道癌に対するdownsizing resectionを目的とした術前化学療法は根治切除が可能となる症例があり，集学的治療の一環として有用である可能性がある．
◆胆道癌においては，質の高い臨床試験により有効なneoadjuvant therapyを確立することが今後の課題である．

参考文献

1）Miyakawa S, Ishihara S, Horiguchi A, et al：Biliary tract cancer treatment：5,548 results from the biliary tract cancer statistics registry from 1998 to 2004 in Japan. J Hepatobiliary Pancreat Surg 16：1-7, 2009

2）日本肝胆膵外科学会（編）：臨床・病理　胆道癌取扱い規約，第6版．金原出版，2013

3）Okusaka T, Ishii H, Funakoshi A, et al：Phase Ⅱ study of single-agent gemcitabine in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol 57：647-653, 2006

4）Ueno H, Okusaka T, Ikeda M, et al：Phase Ⅱ study of S-1 in patients with advanced biliary tract cancer. Br J Cancer 91：1769-1774, 2001

5）Valle J, Wasan H, Palmer DH, et al；ABC-02 Trial Investigators：Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med 362：1273-1281, 2010

6）Okusaka T, Nakachi K, Fukutomi A, et al：Gemcitabine alone or in combination with cisplatin in patients with biliary tract cancer：a comparative multicentre study in Japan. Br J Cancer 103：469-474, 2010

7）日本肝胆膵外科学会，胆道癌診療ガイドライン作成委員会（編）：エビデンスに基づいた胆道癌診療ガイドライン，改訂第2版．医学図書出版，2014

8）有馬純孝：消化器癌のNeoadjuvant Chemotherapyの日本の現状．Therapeutic Research 17：290-294, 1996

9）Kaufmann M, von Minckwitz G, Smith R, et al：International expert panel on the use of primary （preoperative） systemic treatment of operable breast cancer：review and recommendations. J Clin Oncol 21：2600-2608, 2003

10）Bismuth H, Adam R, Levi F, et al：Resection of nonresectable liver metastases from colorectal cancer after neoadjuvant chemotherapy. Ann Surg 224：509-522, 1996

11）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

12）Nuzzo G, Giuliante F, Ardito F, et al：Liver resection for primarily unresectable colorectal metastases downsized by chemotherapy. J Gastrointest Surg 11：318-324, 2007

13）Kim SH, Kim IH, Kim SW, et al：Repetitive response to gemcitabine that led to curative resection in cholangiocarcinoma. World J Gastroenterol 15：4593-4595, 2009

14）McMasters KM, Tuttle TM, Leach SD, et al：Neoadjuvant chemoradiation for extrahepatic cholangiocarcinoma. Am J Surg 174：605-608, 1997

15）Wiedmann M, Caca K, Berr F, et al：Neoadjuvant photodynamic therapy as a new approach to treating hilar cholangiocarcinoma：a phase Ⅱ pilot study. Cancer 97：2783-2790, 2003.

16）Oshiro Y, Takahashi K, Sasaki R, et al：Adjuvant surgery for advanced extrahepatic cholangiocarcinoma. World J Gastroenterol 19：6934-6938, 2013

17）Kato A, Shimizu H, Ohtsuka M, et al：Surgical resection after downsizing chemotherapy for initially unresectable locally advanced biliary tract cancer：A retrospective single center study. Ann Surg Oncol 20：318-324, 2013

18）Katayose Y, Rikiyama T, Motoi F, et al：Phase I trial of neoadjuvant chemoradiation with gemcitabine and surgical resection for cholangiocarcinoma patients（NACRAC study）. Hepatogastroenterology 58：1866-1872, 2011

19）Rea DJ, Heimbach JK, Rosen CB, et al：Liver transplantation with neoadjuvant chemoradiation is more effective than resection for hilar cholangiocarcinoma. Ann Surg 242：451-458, 2005

20）Sudan D, DeRoover A, Chinnakotla S, et al：Radiochemotherapy and transplantation allow long-term survival for nonresectable hilar cholangiocarcinoma. Am J Transplant 2：774-779, 2002

21）Rosen CB, Darwish Murad S, et al：Neoadjuvant therapy and liver transplantation for hilar cholangiocarcinoma：is pretreatment pathological confirmation of diagnosis necessary? J Am Coll Surg 215：31-38, 2012

22）Darwish Murad S, Kim WR, Harnois DM, et al：Efficacy of neoadjuvant chemoradiation, followed by liver transplantation, for perihilar cholangiocarcinoma at 12 US centers. Gastroenterology 143：88-98, 2012

23）Hong JC, Jones CM, Duffy JP, et al：Comparative analysis of resection and liver transplantation for intrahepatic and hilar cholangiocarcinoma：a 24-year experience in a single center. Arch Surg 146：683-689, 2011

24）Saif MW：Secondary hepatic resection as a therapeutic goal in advanced colorectal cancer. World J Gastroenterol 15：3855-3864, 2009

25）Min BS, Kim NK, Ahn JB, et al：Cetuximab in combination with 5-fluorouracil, leucovorin and irinotecan as a neoadjuvant chemotherapy in patients with initially unresctable colorectal liver metastases. Onkologie 30：637-643, 2007