文献詳細
特集 これだけは押さえたい!—大腸癌取扱い規約・治療ガイドライン—改訂のポイント
大腸癌治療ガイドライン2019
文献概要
【ポイント】
◆オキサリプラチン(OX)併用療法は,最も再発抑制・予後改善効果の高いレジメンある.
◆OXによる末梢神経障害の出現頻度は用量依存的に増加し,補助療法終了3年後も約20%の症例で症状が残存する.
◆再発高リスクでは6か月のOX併用療法が推奨され,再発低リスクでは3か月のCAPOX療法か6か月のFP単独療法がオプションとなる.
◆オキサリプラチン(OX)併用療法は,最も再発抑制・予後改善効果の高いレジメンある.
◆OXによる末梢神経障害の出現頻度は用量依存的に増加し,補助療法終了3年後も約20%の症例で症状が残存する.
◆再発高リスクでは6か月のOX併用療法が推奨され,再発低リスクでは3か月のCAPOX療法か6か月のFP単独療法がオプションとなる.
参考文献
1)André T, Boni C, Navarro M, et al:Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage Ⅱ or Ⅲ colon cancer in the MOSAIC trial. J Clin Oncol 27:3109-3116, 2009
2)Schmoll HJ, Tabernero J, Maroun J, et al:Capecitabine Plus Oxaliplatin Compared With Fluorouracil/Folinic Acid As Adjuvant Therapy for Stage Ⅲ Colon Cancer:Final Results of the NO16968 Randomized Controlled Phase Ⅲ Trial. J Clin Oncol 33:3733-3740, 2015
3)de Gramont A, Chibaudel B, Bachet JB, et al:From chemotherapy to targeted therapy in adjuvant treatment for Stage Ⅲ colon cancer. Semin Oncol 38:521-532, 2011
4)McCleary NJ, Meyerhardt JA, Green E, et al:Impact of age on the efficacy of newer adjuvant therapies in patients with stage Ⅱ/Ⅲ colon cancer:findings from the ACCENT database. J Clin Oncol 31:2600-2606, 2013
5)Haller DG, O'Connell MJ, Cartwright TH, et al:Impact of age and medical comorbidity on adjuvant treatment outcomes for Stage Ⅲ colon cancer:a pooled analysis of individual patient data from four randomized, controlled trials. Ann Oncol 26:715-724, 2015
6)Kotaka M, Yoshino T, Oba K, et al:Initial safety report on the tolerability of modified FOLFOX6 as adjuvant therapy in patients with curatively resected stage Ⅱ or Ⅲ colon cancer(JFMC41-1001-C2:JOIN trial). Cancer Chemother Pharmacol 76:75-84, 2015
7)Grothey A, Sobrero AF, Shields AF, et al:Duration of Adjuvant Chemotherapy for Stage Ⅲ Colon Cancer. N Engl J Med 378:1177-1188, 2018
8)Sadahiro S, Tsuchiya T, Sasaki K, et al:Randomized phase Ⅲ trial of treatment duration for oral uracil and tegafur plus leucovorin as adjuvant chemotherapy for patients with stage ⅡB/Ⅲ colon cancer:final results of JFMC33-0502. Ann Oncol 26:2274-2280, 2015
9)Tomita N, Kunieda K, Maeda A, et al:Phase Ⅲ randomised trial comparing 6 vs. 12-month of capecitabine as adjuvant chemotherapy for patients with Stage Ⅲ colon cancer:final results of the JFMC37-0801 study. Br J Cancer 120:689-696, 2019
10)Kusumoto T, Ishiguro M, Nakatani E, et al:Updated 5-year survival and exploratory T x N subset analyses of ACTS-CC trial:a randomised controlled trial of S-1 versus tegafur-uracil/leucovorin as adjuvant chemotherapy for Stage Ⅲ colon cancer. ESMO Open 3:e000428, 2018
11)Yamanaka T, Oki E, Yamazaki K, et al:12-Gene Recurrence Score Assay Stratifies the Recurrence Risk in Stage Ⅱ/Ⅲ Colon Cancer With Surgery Alone:The SUNRISE Study. J Clin Oncol 34:2906-2913, 2016
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