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今月の主題 スキルス胃癌—病態と診断・治療の最前線
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文献概要
要旨●近年の胃癌診療における薬物療法の進歩は著しく，分子標的薬をはじめとするさまざまな薬剤が薬事承認され，治療体系が大きく変化した．スキルス胃癌は予後不良な病型であり，病理学的に非充実型の低分化腺癌である症例が多いこと，腹膜播種を高頻度に伴うことが特徴である．腹膜播種による高度腹水や腸管狭窄を合併し，経口摂取困難となり，選択可能なレジメンが制限されることも珍しくない．スキルス胃癌に特化した治療開発は難しいが，サブグループ解析などを参考に既存の臨床試験を慎重に吟味することで有効性の予測は可能であり，各薬剤の性質も考慮し，他の肉眼型・組織型の胃癌と同様にすべての薬剤を使い切る治療戦略が重要である．
参考文献
1）日本胃癌学会（編）．胃癌治療ガイドライン，第5版．金原出版，2018
2）日本胃癌学会（編）．胃癌取扱い規約，第15版．金原出版，2017
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