臨床外科79巻9号

2024年09月発行

特集 徹底解説　大腸癌治療ガイドライン2024 詳説

直腸癌に対するTotal Neoadjuvant Therapy（TNT）とNon-Operative Management（NOM）

著者： 金光幸秀¹

所属機関： ¹国立がん研究センター中央病院大腸外科

ページ範囲：P.1028 - P.1033

【ポイント】
◆Total Neoadjuvant Therapy（TNT）に期待される主な利点は，病理学的完全奏効（pCR）率の上昇と遠隔転移の減少であるものの，全生存期間の延長効果は明らかでなく，最適なTNT療法もいまだ定義されていない．
◆術前治療後に臨床的完全奏効（cCR）が達成された場合，手術を行わずに待機的な治療を行う非手術的管理（NOM）が検討されているが，NOMの大きな不確定要素の一つは，腫瘍学上の長期的な治療成績の不足である．
◆安易なTNTおよびNOMの導入は控えるべきであり，両者は適切に計画された臨床試験として行われることが望ましい．

参考文献

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