臨床外科77巻2号

2022年02月発行

特集 ガイドラインには書いていない 大腸癌外科治療のCQ—妥当な治療と適応を見直そう

高度進行大腸癌への術前治療を分子標的薬別に考える—Total neoadjuvant therapy・triplet時代における術前治療の最新エビデンス

著者： 小倉淳司¹ 上原圭¹ 村田悠記¹ 水野隆史¹ 國料俊男¹ 伊神剛¹ 山口淳平¹ 宮田一志¹ 尾上俊介¹ 砂川真輝¹ 渡辺伸元¹ 杉田静紀¹ 横山幸浩¹ 江畑智希¹

所属機関： ¹名古屋大学腫瘍外科

ページ範囲：P.199 - P.206

【ポイント】
◆局所進行直腸癌に対し，術前CRTへの分子標的薬併用による局所制御・生存率への上乗せ効果は証明されていない．一方，NACやinduction chemotherapyへの分子標的薬併用による局所制御への上乗せ効果の報告は散見される．
◆Stage Ⅳ・再発大腸癌では，分子標的薬を併用することで奏効率・腫瘍縮小率が上昇し，原発巣・遠隔転移巣ともR0切除やconversion手術のチャンスが増加する．
◆“Cure”をめざした術前治療との併用こそが，分子標的薬の真の使いどころかもしれない．

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