第2段階または第3段階の結腸癌患者における全体および結腸癌特異的な死亡率に対する,より頻繁またはより頻繁な追跡検査の効果: COLOFOLランダム化臨床試験
Peer Wille-Jørgensen1, Ingvar Syk2, Kenneth Smedh3
1Abdominal Disease Center, Bispebjerg Hospital and Danish Colorectal Cancer Group, Copenhagen, Denmark.
JAMA
|May 26, 2018
まとめ
頻繁なコンピュータートモグラフィー検査と癌胚抗原検査を用いた大腸がん患者の集中的な追跡は,より頻繁な検査と比較して,死亡率や再発率を有意に低下させなかった.
科学分野:
- 腫瘍学
- 臨床試験
- 癌 の 検診
背景:
- 大腸がんの手術後の集中フォローアップは標準ですが,その生存効果は十分に確立されていません.
- ステージIIまたはIIIの結腸直腸がんの最適のフォローアップスケジュールは,さらなる調査を必要とします.
研究 の 目的:
- 高周波と低周波の追跡スケジュールの有効性を比較する.
- 総死亡率,大腸がん特異的な死亡率,再発率への影響を評価する.
主な方法:
- 非盲検ランダム化試験では,II期またはIII期の大腸がんの患者2,509人が参加した.
- 高頻度 (6, 12, 18, 24, 36ヶ月) または低頻度 (12, 36ヶ月) のCTスキャンとCEA検査によるフォローアップを受けた.
- 追跡期間は5年でした.
主要な成果:
- 5 年の全死亡率 (13. 0% vs 14. 1%) や癌特異的な死亡率 (10. 6% vs 11. 4%) に関して,グループ間では有意な差異はなかった.
- 結腸直腸がんに特異的な再発率も同様の (21. 6% vs 19. 4%) であった.
結論:
- コンピュータトモグラフィーと癌胚抗原によるより頻繁なフォローアップ検査は,ステージIIまたはIIIの結腸直腸がん患者の生存結果を有意に改善しません.
- 現在のフォローアップ戦略は,これらの発見に基づいて再評価を正当化することがあります.
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