肝oligometastasesに対する定位放射線治療：case based review

Stereotactic body radiotherapy for hepatic oligometastases：case based review

肝臓は，門脈を通して腸間膜血流が灌流するため，消化器癌をはじめ様々な癌腫の転移部位となる。従来，癌の遠隔転移は全身薬物療法が基本であったが，近年の治療法の発達により，広範な転移能を獲得していない遠隔転移病巣を有する長期生存例が増加してきた。そして肝転移に限らず，「根治的に局所治療可能な少数個の転移が存在する状態」としてoligometastases（オリゴ転移）の概念が提唱され^1），転移巣に対する手術や放射線治療などによる積極的な局所治療に注目が集まっている。

The liver is one of the major sites of metastases from a variety of carcinomas because mesenteric blood flow returns through the portal vein. Although distant metastatic diseases have exclusively been treated with systemic chemotherapy, with the recent development of anti-tumor treatment, the number of long-term survivors with distant metastases without extensive metastatic potential has increased. Not necessarily in the case of liver metastases, aggressive local treatment of oligometastases including radiotherapy has been attracting attention. In this article, we present cases with metastatic liver tumors treated with stereotactic body radiation therapy（SBRT）and discuss its problems, precautions, and future perspectives.