臨床外科71巻4号

2016年04月発行

特集 大腸癌肝転移—最新の治療ストラテジー 総論

化学療法と肝障害

著者： 河地茂行¹ 千葉斉一¹ 高野公徳¹ 富田晃一¹ 佐野達¹ 小澤陽介¹ 疋田康祐¹ 芹澤博美²

所属機関： ¹東京医科大学八王子医療センター消化器外科・移植外科 ²東京医科大学八王子医療センター病理診断科

ページ範囲：P.404 - P.408

【ポイント】
◆化学療法による肝障害として，イリノテカンによるsteatohepatitis（いわゆるyellow liver），オキサリプラチンによるsinusoidal obstructive syndrome（SOS，いわゆるblue liver）は重要であり，肝切除後の死亡率・合併症率に影響を及ぼす．
◆ベバシズマブはオキサリプラチンによるSOSを軽減する効果をもつ．
◆化学療法による肝障害を避けるには漫然と化学療法を継続せず，肝切除前に一定の休薬期間をおくことが重要である．肝予備能へ及ぼす影響を評価するためには，ICG15分値やアシアロシンチなどの従来法を駆使するよりほかはない．

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