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The Japanese Journal of Thoracic Surgery Volume 71, Issue 4 （April 2018）

胸部外科 71巻4号（2018年4月発行）

Japanese English

特集肺癌の集学的治療の現況

2. 局所進行肺癌における集学的治療

局所進行非小細胞肺癌に対する術前導入化学放射線療法後手術 Induction Chemoradiotherapy for Locally Advanced Non-small Cell Lung Cancer 三浦章博 ¹ , 宗淳一 ¹ , 枝園和彦 ¹ , 山本寛斉 ¹ , 豊岡伸一 ¹ Akihiro Miura ¹ , Junichi Soh ¹ , Kazuhiko Shien ¹ , Hiromasa Yamamoto ¹ , Shinichi Toyooka ¹ ¹岡山大学呼吸器・乳腺内分泌外科 ¹Department of Thoracic Surgery, Okayama University Hospital キーワード：局所進行非小細胞肺癌 , 術前導入化学放射線療法 , 治療成績 Keyword: induction chemoradiotherapy , locally advanced non-small-cell lung cancer , treatment result pp.270-277

発行日 2018年4月1日 Published Date 2018/4/1

DOI https://doi.org/10.15106/j_kyobu71_270

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参考文献 Reference

縦隔リンパ節転移を伴う非小細胞肺癌（non-small cell lung cancer：NSCLC）や，周囲組織への浸潤を伴う局所進行非小細胞肺癌（locally advanced non-small cell lung cancer：LA-NSCLC）は予後不良な疾患で，さまざまな治療方法が検討されている．肺尖部胸壁浸潤肺癌に対する術前化学放射線療法（induction chemoradiot

The management of locally advanced non-small cell lung cancer （LA-NSCLC） is still controversial, because of complicated patient status and poor prognosis. The purpose of this study was to evaluate the treatment results for induction chemoradiotherapy （iCRT） followed by surgery for LA-NSCLC. From 1999 to 2016, 157 patients were surgically treated after iCRT in our hospital, and their median follow-up was 43 months. Overall survival （OS） was 66.8％， and relapse-free survival （RFS） was 52.0％．The poor prognostic factor in OS by multivariate analysis was lower-lobe origin, incomplete radiotherapy, reoperation, and RFS was lower-lobe origin. The result of our hospital was feasible compared with definitive CRT. The definitive CRT is mainstream for treatment of LA-NSCLC and adjuvant anti-programmed death ligand 1 antibody will influence the treatment strategy, however there are some patients who can get benefit only by iCRT followed by surgery. iCRT followed by surgery is one of the feasible treatment for LA-NSCLC.