化学放射線療法感受性による食道癌治療の個別化に関する研究

2006 Fiscal Year Annual Research Report

• Project/Area Number: 17591410
• Research Institution: Kumamoto University
• Principal Investigator: 馬場 秀夫 熊本大学, 大学院医学薬学研究部, 教授 (20240905)
• Co-Investigator(Kenkyū-buntansha): 沖 英次 九州大学, 大学病院, 助手 (70380392)
• Keywords: 食道癌 / 化学放射線療法 / 手術 / 3D CT / PET

Research Abstract

食道癌に対しては従来より手術治療法が標準治療とされてきたが、治療法の多様化と進歩に伴い、個々の症例に応じた治療法が選択されるようになってきた。特に化学放射線療法は外科治療に匹敵する程の治療成績が報告されるようになった。一方で効果が不十分であったり、癌が再燃した場合にはsalvage手術の適応となるが、術死が12-15%と大変riskが高いため、治療効果をあらかじめ予測し、個別化治療を確立することが急務である。これまでの検討で、以下の点が明らかとなった。
1)p21(-),(+)のCRT後組織学的Grade3は13.5%vs44%と21(+)で有意に治療効果が高かった。
2)治療前後のPETでの効果予測と組織学的評価の対比では特にPETではリンパ節の効果予測が正確にはできなかった。
3)照射野内外でのリンパ節への治療効果の検討で照射野外では効果が低かった。
4)PETのSV値の変化でCRTの組織学的効果を予測するのは必ずしも十分ではなかった。
5)CRT<40GyまでのA群、50Gy<のB群ではTunnel index 8.8%vs11.6%,MIB-1 index 40.2%vs12.3%、照射野内リンパ節の組織学的効果12% vs 20%であった。
6)3DCTによるvolumetryでの評価は臨床的治療効果を判定する上で有用であり、また組織学的効果判定との相関も認められた。
現時点では種々のBiomarkerや画像診断による食道癌に対するCRTの組織学的効果予測は必ずしも十分ではなく、今後更なる精度の高い効果予測法の確立が重要である。

Research Products

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• [Journal Article] Identification of HLA-A2- or HLA-A24-restricted CTL epitopes possibly useful for glypican-3-specific immunotherapy of hematocellular carcinoma (2006)
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• [Journal Article] The diagnostic efficacy of of FDG-PET in the local recurrence of hilar bile duct cancer (2006)
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  • Journal Title: J Hepatobiliary Pancreat Surg 13 Pages: 403-408
• [Journal Article] MCP-1/CCR2 signalling pathway regulates hyperoxia-induced acute lung injury via nitric oxide production (2006)
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• [Journal Article] Protein C as a predictor of mortality in acute pancreatitis (2006)
  • Author(s): Maeda K, Hirota M, Baba H
  • Journal Title: Pancreas 33 Pages: 107-108
• [Journal Article] Applicability of DIC parameters in the assessment of the severity of acute pancreatitis (2006)
  • Author(s): Maeda K, Hirota M, Ichihara A, Ohmuraya M, Hashimoto D, Sugita H, Takamori H, Kanemitsu K, Baba H
  • Journal Title: Pancreas 32 Pages: 87-92
• [Journal Article] Synthetic small interfering RNA targeting heat shock protein 105 induces apoptosis of various cancer ells both in vitro and in viro (2006)
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• [Journal Article] JPN Guidelines for the arrangement of acute pancreatitis : severity assessment of acute pancreatitis (2006)
  • Author(s): Hirota M, Takada T, Kawarada Y, Hirata K, Mayumi T, Yoshida M, Sekimoto M, Kimura Y, Takeda K, Isaji K, Koizumi M, Otsuki M, Matsuno S
  • Journal Title: J Hepatobiliary Pancreat Surg 13 Pages: 33-41
• [Journal Article] Combined chemotherapy of irinotecan and low-dose cisplatin(I/low-P) againt metastatic biliary tract cancer; report of consecutive three cases (2006)
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• [Journal Article] Significance of elevated serum IL-18 levels in patients with acute pancreatitis (2006)
  • Author(s): Hirota M, Shibata M, Baba H
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• [Journal Article] The role of trypsin inhibitor, and trypsin receptor in the onset and aggravation of pancreatitis (2006)
  • Author(s): Hirota M, Ohmuraya M, Baba H
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• [Journal Article] Genetic background of pancreatitis (2006)
  • Author(s): Hirota M, Ohmuraya M, Baba H
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• [Journal Article] The association between Akt activation and resistance to harmone therapy in metastatic breast cancer (2006)
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• [Journal Article] Phase I study of S-1 and biweekly docetaxel combination chemotherapy for advanced and recurrent gastric cancer (2006)
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• [Journal Article] Loss of protein epression of hHLM1 and hMSH2 with double primary carcinomas of the stomach and colorectum (2006)
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  • Journal Title: ONCOLOGY REPORTS 16 Pages: 41-47
• [Journal Article] Loss of expression of type IV collagen alpha5 and alph6 chains in colorectal cancer associated with the hypermethylation of their promoter region (2006)
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• [Journal Article] Akt is frequently activated in HER2/neu-positive breast cancers and associated with poor prognosis among heromone-treated patients (2006)
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• [Journal Article] Impact of loss of heterozygosity of encoding phosphate nad tensin homolog on the prognosis of gastric cacer (2006)
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• [Journal Article] Prediction of survival from first recurrece of breast carcinoma in Japanese women (2006)
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• [Journal Article] Activation of P13K/Akt signaling and hormane resistance in breast cancer. (2006)
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• [Journal Article] Peritoneal Dissemination of Early Gastric Cancer : Report of a Case (2006)
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• [Journal Article] The detection of tumor cells in the prioneal cavity with early gastric cancer
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