臨牀消化器内科 Vol.26 No.6(7)


特集名 消化器癌化学療法2011―最近の話題
題名 胆道癌の化学療法―標準治療と最近の動向
発刊年月 2011年 06月
著者 大川 伸一 神奈川県立がんセンター消化器内科
【 要旨 】 胆道癌の治療において化学療法の役割は大変大きいものがあるが,最近まで大規模な比較試験がなく標準治療が存在しなかった.1997年にゲムシタビンが膵癌に対してその有効性が証明されてから,胆道癌に対してもゲムシタビン単独治療が事実上の標準治療であった.しかし最近英国で行われた第III相試験(ABC-02試験)の結果,ゲムシタビンとシスプラチンの併用療法がゲムシタビンに対する有効性が証明され標準治療となった.日本でも同じレジメンで試験が行われ(BT-22試験),まもなく標準治療となると考えられている.今後はこれをベースとしてさらに新たな比較試験が行われていく可能性が高く,胆道癌の化学療法は新たな展開に入ったといえる.
Theme The State of the Art in Chemotherapy for Gastrointestinal Cancer
Title Trends in Chemotherapy for Advanced Biliary Tract Cancer
Author Shinichi Ohkawa Division of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center Hospital
[ Summary ] While chemotherapy plays a major role in the treatment of biliary tract cancer, a large-scale comparative trial had not been performed until recently. Therefore, no standard therapy has been established. Since the effectiveness of gemcitabine for pancreatic cancer was demonstrated in 1997, gemcitabine monotherapy has been the defacto standard therapy for biliary tract cancer. As a result of a phase III trial (ABC-02 Trial) recently conducted in Britain, however, combination therapy with gemcitabine and cisplatin has been shown to be significantly more effective than gemcitabine alone. This combination therapy has gained recognition there as the standard therapy for this disease. A trial (BT-22 Trial) employing the same treatment regimen has been carried out in Japan, and this therapy is expected to become the standard modality in Japan as well. It is, therefore, highly likely that even more comparative studies will be carried out in the near future based on these findings. This may lead to new procedures for biliary tract cancer chemotherapy treatment.
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