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ネオアジュバント化学放射線治療後の直腸がん患者における顕微鏡内腔拡散
A E Verrijssen1,2, E J Van Limbergen1, M Bellezzo1
1MAASTRO, GROW School of Oncology and Reproduction, University of Maastricht, Maastricht, the Netherlands.
Clinical and translational radiation oncology
|August 25, 2025
まとめ
大半の直腸がん患者 (69%) は,ネオアジュバント治療後に微小な内腔伝播 (MIS) を示していません. 接触ブラキセラピー (CXB) のようなさらなる放射線増強のために患者を選択するには,腫瘍の厚さが重要です.
科学分野:
- 結腸直腸手術
- 腫瘍学
- 放射線腫瘍学
背景:
- ネオアジュバント治療は直腸がんの標準治療です
- ネオアジュバント療法後の残留疾患の評価は極めて重要です.
- 顕微鏡内膜拡散 (MIS) は治療決定に影響する.
研究 の 目的:
- ネオアジュバント治療後の直腸がん患者における顕微鏡内腔伝播 (MIS) を評価する.
- 放射線増強や局所切除のための追加の処理マージンの必要性を決定する.
主な方法:
- 2016年から2022年の間に治療を受けた54人の直腸がん患者の分析.
- ネオアジュヴァント後の画像検査 (MRI,CT,シグモイドスコーピ) に続き,全髄膜切除 (TME) を行う.
- マクロスコーピカル腫瘍とMIS (断片化/連続) のTME標本の病理学的評価
主要な成果:
- 69%の患者 (37/54) はMISが検出されなかった.
- MISは,ycT1-2の22%とycT3-4の36%に存在した.
- 継続的なMISは患者の7%で,断片的なMISは患者の28%で発生し,ypT1-2腫瘍ではMISは発生しなかった.
結論:
- 大半の直腸がん患者は,ネオアジュバント治療後にMISを発症しない.
- 接触ブラキセラピー (CXB) の選択において,腫瘍の厚さは重要な要因である.
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