臨床外科76巻2号

2021年02月発行

特集 外科医のための—悪性腫瘍補助療法のすべて 各論

胃癌の術後補助化学療法

著者： 藤谷和正¹ 本告正明¹ 宮崎安弘¹ 岩瀬和裕¹ 後藤満一¹

所属機関： ¹大阪急性期総合医療センター消化器外科

ページ範囲：P.164 - P.168

【ポイント】
◆胃癌の術後補助化学療法には，S-1療法，XELOX療法，DS療法，SOX療法がある．
◆病理学的stage Ⅲ胃癌に対する術後の標準補助化学療法は，S-1療法からDS療法へ変更となった．
◆病理学的stage Ⅱ胃癌に対する術後の標準補助化学療法は，S-1療法1年間もしくはXELOX療法半年間である．

参考文献

1）GASTRIC（Global Advanced/Adjuvant Stomach Tumor Research International Collaboration）Group, Paoletti X, Oba K, Burzykowski T, et al：Benefit of adjuvant chemotherapy for resectable gastric cancer：a meta-analysis. JAMA 303：729-737, 2010

2）Oba K, Paoletti X, Alberts S, et al：Disease-free survival as a surrogate for overall survival in adjuvant trials of gastric cancer：a meta-analysis. J Natl Cancer Inst 105：1600-1607, 2013

3）Sakuramoto S, Sasako M, Yamaguchi T, et al：Adjuvant chemotherapy for gastric cancer with S-1, an oral fuoropyrimidine. N Engl J Med 357：1810-1820, 2007

4）Bang YJ, Kim YW, Yang HK, et al：Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy（CLASSIC）：a phase 3 open-label, randomized controlled trial. Lancet 379：315-321, 2012

5）Japanese Gastric Cancer Association：Japanese gastric cancer treatment guidelines（ver. 4）. Gastric Cancer 20：1-19, 2017

6）Sasako M, Sakuramoto S, Katai H, et al：Five-year outcomes of a randomized phase Ⅲ trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage Ⅱ or Ⅲ gastric cancer. J Clin Oncol 29：4387-4393, 2011

7）Noh SH, Park SR, Yang HK, et al：Adjuvant capecitabine plus oxaliplatin for gastric cancer after D2 gastrectomy（CLASSIC）：5-year follow-up of an open-label, randomised phase 3 trial. Lancet Oncol 15：1389-1396, 2014

8）Yoshida K, Kodera Y, Kochi M, et al：Addition of docetaxel to oral fluoropyrimidine improves efficacy in patients with stage Ⅲ gastric cancer：interim analysis of JACCRO GC-07, a randomized controlled trial. J Clin Oncol 37：1296-1304, 2019

9）Fujitani K, Tamura S, Kimura Y, et al：Five-year outcomes of a phase Ⅱ study of adjuvant chemotherapy with S-1 plus docetaxel for stage Ⅲ gastric cancer after curative D2 gastrectomy（OGSG1002）. Gastric Cancer 23：520-530, 2020

10）Shitara K, Chin K, Yoshikawa T, et al：Phase Ⅱ study of adjuvant chemotherapy of S-1 plus oxaliplatin for patients with stage Ⅲ gastric cancer after D2 gastrectomy. Gastric Cancer 20：175-181, 2017

11）Park SH, Zhang DY, Han B, et al：ARTIST 2：Interim results of a phase Ⅲ trial involving adjuvant chemotherapy and/or chemoradiotherapy after D2-gastrectomy in stage Ⅱ/Ⅲ gastric cancer（GC）. ASCO 2019；Abstract 4001.

12）Fuse N, Bando H, Chin K, et al：Adjuvant capecitabine plus oxaliplatin after D2 gastrectomy in Japanese patients with gastric cancer：a phase Ⅱ study. Gastric Cancer 20：332-340, 2017

13）Nakamura Y, Yamanaka T, Chin K, et al：Survival outcomes of two phase 2 studies of adjuvant chemotherapy with S-1 plus oxaliplatin or capecitabine plus oxaliplatin for patients with gastric cancer after D2 gastrectomy. Ann Surg Oncol 26：465-472, 2019

14）Yoshikawa T, Terashima M, Mizusawa J, et al：Four courses versus eight courses of adjuvant S-1 for patients with stage Ⅱ gastric cancer（JCOG1104［OPAS-1］）：an open-label, phase 3, non-inferiority, randomised trial. Lancet Gastroenterol Hepatol 4：208-216, 2019

15）Fujitani K, Kurokawa Y, Takeno A, et al：Time to initiation or duration of S-1 adjuvant chemotherapy；which really impacts on survival in stage Ⅱ and Ⅲ gastric cancer? Gastric Cancer 21：446-452, 2018

16）Aoyama T, Yoshikawa T, Shirai J, et al：Body weight loss after surgery is an independent risk factor for continuation of S-1 adjuvant chemotherapy for gastric cancer. Ann Surg Oncol 20：2000-2006, 2013

17）Aoyama T, Kawabe T, Fujikawa H, et al：Loss of lean body mass as an independent risk factor for continuation of S-1 adjuvant chemotherapy for gastric cancer. Ann Surg Oncol 22：2560-2566, 2015

18）Yamashita K, Kurokawa Y, Yamamoto K, et al：Risk factors for poor compliance with adjuvant S-1 chemotherapy for gastric cancer：a multicenter retrospective study. Ann Surg Oncol 24：2639-2645, 2017