胃がんの腹腔内再発に対する炭素吸収ミトミシンによる予防
A Hagiwara1, T Takahashi, O Kojima
1First Department of Surgery, Kyoto Prefectural University of Medicine, Japan.
Lancet (London, England)
|March 14, 1992
まとめ
活性炭 (M-CH) に吸収されたミトマイシンは,腹腔内がんを予防することによって,胃がん患者の生存率を向上させた. この放出遅延剤は,腹腔内における薬剤濃度が高い状態を維持し,有望な予防治療を提供した.
科学分野:
- 腫瘍学 腫瘍学
- 外科腫瘍学外科腫瘍学
- 胃腸内科 胃腸内科
背景:
- 腹腔内癌は,胃がん手術後の大きな課題です.
- イントラペリトニアル化学療法は,薬物の保持が悪いため,限られた成功を収めている.
- 薬剤の有効性を向上させるためには,新薬投与システムが必要である.
研究 の 目的:
- 腹膜癌に対する活性炭 (M-CH) に吸収されたミトマイシンの予防効果を評価する.
- 胃がんのための胃切除術後の患者の生存に対するM-CHの影響を評価する.
主な方法:
- 50人の胃がん患者で血清の浸透を患ったランダム化研究.
- M-CH (50 mgミトミシン) の手術中の腹腔内投与と予防療法なしの投与 (対照群).
- 生存率と腹腔内液と血におけるミトマイシン濃度が3年間にわたってモニタリングされました.
主要な成果:
- M-CH群では,対照群と比較して3年生存率が著しく高いことが観察されました (p <0.01).
- ミトマイシンの濃度は,投与後24時間,ペリトネアル排泄物でプラズマより有意に高かった.
- M-CH治療は軽度でよく耐える副作用と関連していました.
結論:
- 術後の腹腔内M-CH投与は,胃がんのための胃切除術後の生存率を向上させるようです.
- 生存率の改善は,M-CHが腹膜再発に与える予防効果による可能性が高い.
- M-CHは,腹腔内腔における薬物の有効な保持を証明し,以前の腹腔内治療の主要な制限に対処しています.
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