| Project/Area Number |
18K09086
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Multi-year Fund |
|---|
| Section | 一般 |
|---|
| Review Section |
Basic Section 56020:Orthopedics-related
|
|---|
| Research Institution | National Center for Geriatrics and Gerontology |
|---|
Principal Investigator |
Wakao Norimitsu 国立研究開発法人国立長寿医療研究センター, 病院, 医長 (80528802)
|
|---|
| Project Period (FY) |
2018-04-01 – 2023-03-31
|
| Project Status |
Completed (Fiscal Year 2022)
|
| Budget Amount *help |
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2018: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
|
|---|
| Keywords | 癌骨転移 / 分子標的薬 / 骨修飾薬 / 放射線治療 / 長期生命予後 / 分子機構 / 生命予後 / 有限要素解析 / 骨関連有害事象 / 転移性骨腫瘍 / Runx2 / NFAT1c / IL-11 / MMP-9 / 転移性脊椎腫瘍 / 多変量解析 / 放射線治療効果 / 骨修復剤治療効果 / 骨修復薬治療 / 治療不応性 |
|---|
| Outline of Final Research Achievements |
The authors designed and carried out a clinical study to establish a database of patients with bone metastases of cancer and to identify factors related to the refractoriness of bone-modifying drugs and radiotherapy for metastatic bone metastases through long-term follow-up. Analysis was performed on 222 enrolled patients. Multivariate analysis showed that the survival rate was superior in the group with good response to radiotherapy compared to the group with poor response. Among primary cancers, gastric cancer, pancreatic cancer, and gall bladder cancer had significantly poorer life prognoses. With regard to the long-term effects of bone-modifying agents, the factors that significantly contributed to the osteosclerotic change of metastatic bone findings after radiotherapy were the primary cancer (prostate, breast, and lung cancers were more responsive). These carcinomas had increased bone strength of metastatic bone and a significantly lower incidence of bone-related adverse events.
|
| Academic Significance and Societal Importance of the Research Achievements |
近年癌治療は劇的に進化・発展し分子標的薬の登場によってこれまでの5年生存率が改善しつつある。しかし、骨転移を認める癌患者では根治を目指すことは難しい。今回骨転移データベースを構築し、治療介入法およびその反応性を網羅し、長期追跡を行う臨床研究を立案し遂行した。その結果、やはり癌骨転移症例の予後は癌腫に大きく左右される結果となり、転移骨の骨強度が上昇し骨折などの有害事象が生じなくても、原発癌による影響がより有意であった。今後は終末期のQOL維持など、生命予後では推し量れない尺度での治療介入法の標準化、妥当性の評価を継続することで癌治療の発展に寄与したい。
|
