本邦における中皮腫臨床試験の現状と今後の展望

「はじめに」 アスベスト関連疾患, 特に悪性胸膜中皮腫(malignant pleural mesothelioma, 以下MPM)は従来職業病と位置づけられていたが, 2005年兵庫県尼崎市でのいわゆる「クボタショック」以後アスベスト職歴のない一般市民にも発生しうる公害病的側面を有する疾患へと認識が変わった. 国民の動揺を憂慮した政府は, 平成18年度科学技術振興調整費を投じてアスベスト関連疾患への総括的取り組みを開始した. その一環としてMPMの根治を目指す「切除可能悪性胸膜中皮腫に対する集学的治療プロトコール」と題する臨床試験を行うことになった(1, 2). 「MPMの外科療法」 MPM...

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Published in日本衛生学雑誌 Vol. 66; no. 3; pp. 558 - 561
Main Authors 上紺屋, 憲彦, 山中, 竹春, 田中, 文啓, 辻村, 亨, 中野, 孝司, 長谷川, 誠紀, 福岡, 和也, 岡田, 守人, 副島, 俊典
Format Journal Article
LanguageJapanese
Published 一般社団法人日本衛生学会 2011
日本衛生学会
Subjects
ペメトレキセド
悪性胸膜中皮腫
胸膜肺全摘術
臨床試験
集学的治療
Online AccessGet full text
ISSN0021-5082
1882-6482
DOI10.1265/jjh.66.558

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Abstract 「はじめに」 アスベスト関連疾患, 特に悪性胸膜中皮腫(malignant pleural mesothelioma, 以下MPM)は従来職業病と位置づけられていたが, 2005年兵庫県尼崎市でのいわゆる「クボタショック」以後アスベスト職歴のない一般市民にも発生しうる公害病的側面を有する疾患へと認識が変わった. 国民の動揺を憂慮した政府は, 平成18年度科学技術振興調整費を投じてアスベスト関連疾患への総括的取り組みを開始した. その一環としてMPMの根治を目指す「切除可能悪性胸膜中皮腫に対する集学的治療プロトコール」と題する臨床試験を行うことになった(1, 2). 「MPMの外科療法」 MPMに対する外科療法の第1の問題点は過大な侵襲が必発であることである. MPMは通常の固形癌と異なり, 発生当初から患側胸腔内をびまん性に発育する. このため, 切除可能MPMの基本的な手術の概念は「腫瘍を内包した患側の壁側・臓側胸膜を一塊に摘出する」ことである.
AbstractList 「はじめに」 アスベスト関連疾患, 特に悪性胸膜中皮腫(malignant pleural mesothelioma, 以下MPM)は従来職業病と位置づけられていたが, 2005年兵庫県尼崎市でのいわゆる「クボタショック」以後アスベスト職歴のない一般市民にも発生しうる公害病的側面を有する疾患へと認識が変わった. 国民の動揺を憂慮した政府は, 平成18年度科学技術振興調整費を投じてアスベスト関連疾患への総括的取り組みを開始した. その一環としてMPMの根治を目指す「切除可能悪性胸膜中皮腫に対する集学的治療プロトコール」と題する臨床試験を行うことになった(1, 2). 「MPMの外科療法」 MPMに対する外科療法の第1の問題点は過大な侵襲が必発であることである. MPMは通常の固形癌と異なり, 発生当初から患側胸腔内をびまん性に発育する. このため, 切除可能MPMの基本的な手術の概念は「腫瘍を内包した患側の壁側・臓側胸膜を一塊に摘出する」ことである.
Author 田中, 文啓
副島, 俊典
中野, 孝司
岡田, 守人
辻村, 亨
長谷川, 誠紀
上紺屋, 憲彦
山中, 竹春
福岡, 和也
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References (16) de Perrot M, Feld R, Cho BC, Bezjak A, Anraku M, Burkes R, Roberts H, Tsao MS, Leighl N, Keshavjee S, Johnston MR. Trimodality therapy with induction chemotherapy followed by extrapleural pneumonectomy and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma. J Clin Oncol. 2009;27:1413-1418.
(18) Yamanaka T, Tanaka F, Hasegawa S, Okada M, Soejima T, Kamikonya N, Fukuoka K, Nakano T. A feasibility study of induction pemetrexed plus cisplatin followed by extrapleural pneumonectomy and postoperative hemithoracic radiation for malignant pleural mesothelioma. Jpn J Clin Oncol. 2009;39:186-188.
(6) Cameron RB. Extrapleural pneumonectomy is the preferred surgical management in the multimodality therapy of pleural mesothelioma: con argument. Ann Surg Oncol. 2007;14:1249-1253.
(9) Sugarbaker DJ, Flores RM, Jaklitsch MT, Richards WG, Strauss GM, Corson JM, DeCamp MM, Jr., Swanson SJ, Bueno R, Lukanich JM, Baldini EH, Mentzer SJ. Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients. J Thorac Cardiovasc Surg. 1999;117:54-63; discussion -5.
(11) Flores RM, Krug LM, Rosenzweig KE, Venkatraman E, Vincent A, Heelan R, Akhurst T, Rusch VW. Induction chemotherapy, extrapleural pneumonectomy, and postoperative high-dose radiotherapy for locally advanced malignant pleural mesothelioma: a phase II trial. J Thorac Oncol. 2006;1:289-295.
(10) Rusch VW, Rosenzweig K, Venkatraman E, Leon L, Raben A, Harrison L, Bains MS, Downey RJ, Ginsberg RJ. A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma. J Thorac Cardiovasc Surg. 2001;122:788-795.
(13) Vogelzang NJ, Rusthoven JJ, Symanowski J, Denham C, Kaukel E, Ruffie P, Gatzemeier U, Boyer M, Emri S, Manegold C, Niyikiza C, Paoletti P. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol. 2003;21:2636-2644.
(3) Aziz T, Jilaihawi A, Prakash D. The management of malignant pleural mesothelioma; single centre experience in 10 years. Eur J Cardiothorac Surg. 2002;22:298-305.
(7) Sugarbaker DJ. Macroscopic complete resection: the goal of primary surgery in multimodality therapy for pleural mesothelioma. J Thorac Oncol. 2006;1:175-176.
(12) Weder W, Stahel RA, Bernhard J, Bodis S, Vogt P, Ballabeni P, Lardinois D, Betticher D, Schmid R, Stupp R, Ris HB, Jermann M, Mingrone W, Roth AD, Spiliopoulos A. Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma. Ann Oncol. 2007;18:1196-1202.
(19) Flores RM, Pass HI, Seshan VE, Dycoco J, Zakowski M, Carbone M, Bains MS, Rusch VW. Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: results in 663 patients. J Thorac Cardiovasc Surg. 2008;135:620-626.
(14) Scherpereel A, Astoul P, Baas P, Berghmans T, Clayson H, de Vuyst P, Dienemann H, Galateau-Salle F, Hennequin C, Hillerdal G, Le Pechoux C, Mutti L, Pairon JC, Stahel R, van Houtte P, van Meerbeeck J, Waller D, Weder W. Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma. Eur Respir J. 2010;35:479-495.
(17) Van Schil PE, Baas P, Gaafar R, Maat AP, Van de Pol M, Hasan B, Klomp HM, Abdelrahman AM, Welch J, van Meerbeeck JP. Trimodality therapy for malignant pleural mesothelioma: results from an EORTC phase II multicentre trial. Eur Respir J. 2010;36:1362-1369.
(20) Bolukbas S, Manegold C, Eberlein M, Bergmann T, Fisseler-Eckhoff A, Schirren J. Survival after trimodality therapy for malignant pleural mesothelioma: Radical Pleurectomy, chemotherapy with Cisplatin/Pemetrexed and radiotherapy. Lung Cancer. 2011;71:75-81.
(5) Rice DC, Stevens CW, Correa AM, Vaporciyan AA, Tsao A, Forster KM, Walsh GL, Swisher SG, Hofstetter WL, Mehran RJ, Roth JA, Liao Z, Smythe WR. Outcomes after extrapleural pneumonectomy and intensity-modulated radiation therapy for malignant pleural mesothelioma. Ann Thorac Surg. 2007;84:1685-1692; discussion 92-3.
(2) 長谷川誠紀，田中文啓，岡田守人，中野孝司．我が国における悪性胸膜中皮腫に対する集学的治療の現状．肺癌2008;48:93-96
(15) Krug LM, Pass HI, Rusch VW, Kindler HL, Sugarbaker DJ, Rosenzweig KE, Flores R, Friedberg JS, Pisters K, Monberg M, Obasaju CK, Vogelzang NJ. Multicenter phase II trial of neoadjuvant pemetrexed plus cisplatin followed by extrapleural pneumonectomy and radiation for malignant pleural mesothelioma. J Clin Oncol. 2009;27:3007-3013.
(21) Nakas A, Trousse DS, Martin-Ucar AE, Waller DA. Open lung-sparing surgery for malignant pleural mesothelioma: the benefits of a radical approach within multimodality therapy. Eur J Cardiothorac Surg. 2008;34:886-891.
(4) Martin-Ucar AE, Nakas A, Edwards JG, Waller DA. Case-control study between extrapleural pneumonectomy and radical pleurectomy/decortication for pathological N2 malignant pleural mesothelioma. Eur J Cardiothorac Surg. 2007;31:765-770.
(8) Treasure T, Utley M. Ten traps for the unwary in surgical series: a case study in mesothelioma reports. J Thorac Cardiovasc Surg. 2007;133:1414-1418.
(1) Hasegawa S, Tanaka F. Malignant mesothelioma: Current status and perspective in Japan and the world. Gen Thorac Cardiovasc Surg. 2008;56:317-323.
References_xml – reference: (3) Aziz T, Jilaihawi A, Prakash D. The management of malignant pleural mesothelioma; single centre experience in 10 years. Eur J Cardiothorac Surg. 2002;22:298-305.
– reference: (9) Sugarbaker DJ, Flores RM, Jaklitsch MT, Richards WG, Strauss GM, Corson JM, DeCamp MM, Jr., Swanson SJ, Bueno R, Lukanich JM, Baldini EH, Mentzer SJ. Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients. J Thorac Cardiovasc Surg. 1999;117:54-63; discussion -5.
– reference: (16) de Perrot M, Feld R, Cho BC, Bezjak A, Anraku M, Burkes R, Roberts H, Tsao MS, Leighl N, Keshavjee S, Johnston MR. Trimodality therapy with induction chemotherapy followed by extrapleural pneumonectomy and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma. J Clin Oncol. 2009;27:1413-1418.
– reference: (18) Yamanaka T, Tanaka F, Hasegawa S, Okada M, Soejima T, Kamikonya N, Fukuoka K, Nakano T. A feasibility study of induction pemetrexed plus cisplatin followed by extrapleural pneumonectomy and postoperative hemithoracic radiation for malignant pleural mesothelioma. Jpn J Clin Oncol. 2009;39:186-188.
– reference: (15) Krug LM, Pass HI, Rusch VW, Kindler HL, Sugarbaker DJ, Rosenzweig KE, Flores R, Friedberg JS, Pisters K, Monberg M, Obasaju CK, Vogelzang NJ. Multicenter phase II trial of neoadjuvant pemetrexed plus cisplatin followed by extrapleural pneumonectomy and radiation for malignant pleural mesothelioma. J Clin Oncol. 2009;27:3007-3013.
– reference: (20) Bolukbas S, Manegold C, Eberlein M, Bergmann T, Fisseler-Eckhoff A, Schirren J. Survival after trimodality therapy for malignant pleural mesothelioma: Radical Pleurectomy, chemotherapy with Cisplatin/Pemetrexed and radiotherapy. Lung Cancer. 2011;71:75-81.
– reference: (21) Nakas A, Trousse DS, Martin-Ucar AE, Waller DA. Open lung-sparing surgery for malignant pleural mesothelioma: the benefits of a radical approach within multimodality therapy. Eur J Cardiothorac Surg. 2008;34:886-891.
– reference: (6) Cameron RB. Extrapleural pneumonectomy is the preferred surgical management in the multimodality therapy of pleural mesothelioma: con argument. Ann Surg Oncol. 2007;14:1249-1253.
– reference: (19) Flores RM, Pass HI, Seshan VE, Dycoco J, Zakowski M, Carbone M, Bains MS, Rusch VW. Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: results in 663 patients. J Thorac Cardiovasc Surg. 2008;135:620-626.
– reference: (1) Hasegawa S, Tanaka F. Malignant mesothelioma: Current status and perspective in Japan and the world. Gen Thorac Cardiovasc Surg. 2008;56:317-323.
– reference: (2) 長谷川誠紀，田中文啓，岡田守人，中野孝司．我が国における悪性胸膜中皮腫に対する集学的治療の現状．肺癌2008;48:93-96．
– reference: (10) Rusch VW, Rosenzweig K, Venkatraman E, Leon L, Raben A, Harrison L, Bains MS, Downey RJ, Ginsberg RJ. A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma. J Thorac Cardiovasc Surg. 2001;122:788-795.
– reference: (13) Vogelzang NJ, Rusthoven JJ, Symanowski J, Denham C, Kaukel E, Ruffie P, Gatzemeier U, Boyer M, Emri S, Manegold C, Niyikiza C, Paoletti P. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol. 2003;21:2636-2644.
– reference: (7) Sugarbaker DJ. Macroscopic complete resection: the goal of primary surgery in multimodality therapy for pleural mesothelioma. J Thorac Oncol. 2006;1:175-176.
– reference: (12) Weder W, Stahel RA, Bernhard J, Bodis S, Vogt P, Ballabeni P, Lardinois D, Betticher D, Schmid R, Stupp R, Ris HB, Jermann M, Mingrone W, Roth AD, Spiliopoulos A. Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma. Ann Oncol. 2007;18:1196-1202.
– reference: (8) Treasure T, Utley M. Ten traps for the unwary in surgical series: a case study in mesothelioma reports. J Thorac Cardiovasc Surg. 2007;133:1414-1418.
– reference: (4) Martin-Ucar AE, Nakas A, Edwards JG, Waller DA. Case-control study between extrapleural pneumonectomy and radical pleurectomy/decortication for pathological N2 malignant pleural mesothelioma. Eur J Cardiothorac Surg. 2007;31:765-770.
– reference: (11) Flores RM, Krug LM, Rosenzweig KE, Venkatraman E, Vincent A, Heelan R, Akhurst T, Rusch VW. Induction chemotherapy, extrapleural pneumonectomy, and postoperative high-dose radiotherapy for locally advanced malignant pleural mesothelioma: a phase II trial. J Thorac Oncol. 2006;1:289-295.
– reference: (14) Scherpereel A, Astoul P, Baas P, Berghmans T, Clayson H, de Vuyst P, Dienemann H, Galateau-Salle F, Hennequin C, Hillerdal G, Le Pechoux C, Mutti L, Pairon JC, Stahel R, van Houtte P, van Meerbeeck J, Waller D, Weder W. Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma. Eur Respir J. 2010;35:479-495.
– reference: (5) Rice DC, Stevens CW, Correa AM, Vaporciyan AA, Tsao A, Forster KM, Walsh GL, Swisher SG, Hofstetter WL, Mehran RJ, Roth JA, Liao Z, Smythe WR. Outcomes after extrapleural pneumonectomy and intensity-modulated radiation therapy for malignant pleural mesothelioma. Ann Thorac Surg. 2007;84:1685-1692; discussion 92-3.
– reference: (17) Van Schil PE, Baas P, Gaafar R, Maat AP, Van de Pol M, Hasan B, Klomp HM, Abdelrahman AM, Welch J, van Meerbeeck JP. Trimodality therapy for malignant pleural mesothelioma: results from an EORTC phase II multicentre trial. Eur Respir J. 2010;36:1362-1369.
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Snippet 「はじめに」 アスベスト関連疾患, 特に悪性胸膜中皮腫(malignant pleural mesothelioma, 以下MPM)は従来職業病と位置づけられていたが, 2005年兵庫県尼崎...
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StartPage 558
SubjectTerms ペメトレキセド
悪性胸膜中皮腫
胸膜肺全摘術
臨床試験
集学的治療
Title 本邦における中皮腫臨床試験の現状と今後の展望
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