INTESTINE Vol.7 No.3(4-4)

特集名 大腸癌肝転移の画像診断と治療
題名 治療 (4) 全身化学療法
発刊年月 2003年 05月
著者 島田 安博 国立がんセンター中央病院第一領域外来部大腸科
【 要旨 】 要旨はありません。
Theme Recent advances in the diagnostic imaging and the treatment of liver metastates from colorectal cancer
Title Systemic chemotherapy for advanced/metastatic colorectal cancer
Author Yasuhiro Shimada Medical Oncology, National Cancer Center Hospital
[ Summary ] Use of systemic chemotherapy for colorectal cancer has made great strides as seen in several foreign pivotal phase III studies. Irinotecan, in combination with 5-fluorouracil/Leucovorin, demonstrated superior overall survival rates, compared to 5-fuorouracil/Leucovorin alone in European and North American studies. Oxaliplatin in combination with infusional 5-fluorouracil/Leucovorin had significant survival benefits over irinotecan, in combination with bolus 5-fluorouracil/Leucovorin, in a North American Intergroup study N9471. These excellent new treatment regimens brought double or triple the survival rates to patients with minimum adverse events. Oral fluoropyrimidines were evaluated in randomized phase III studies, in relation to intravenous 5-fluorouracil/Leucovorin. Only capecitabine was approved, based on two pivotal studies demonstrating the equivalence of survival and time to progression. S-1, a new oral fluoropyrimidine derivative, is now under evaluation in phase II studies. New active drugs, including oxaliplatin, capecitabine and S-1 have not been approved in Japan. Many Japanese colorectal cancer patients can not receive the clinical benefits of new active combination chemotherapies. Clinical investigators should actively conduct and participate in well-designed clinical studies to evaluate and create new active chemotherapy regimens.