放射線治療 : 化学療法及び分子標的治療と放射線治療の併用 Current Perspectives of Radiation Therapy Chemotherapy and Molecular Target Therapy Combined with Radiation Therapy

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著者

    • 秋元 哲夫 AKIMOTO Tetsuo
    • 独立行政法人 国立がん研究センター東病院 臨床開発センター 粒子線医学開発部 National Cancer Center Hospital East, Division of Particle Therapy and Department of Radiation Oncology

抄録

放射線治療は頭頸部癌や食道癌などの多くの疾患に対する根治的治療として幅広く行われているが,放射線治療単独では十分な局所制御が得られない場合も少なくない。そのため,放射線治療の効果を増強することを目的に抗がん剤を放射線治療に併用する化学放射線療法が試みられ,局所進行頭頸部癌,食道癌及び肺癌などでは放射線治療単独に比較して化学放射線療法が治療成績向上に有効であることが明らかとなっている。更に近年ではがん細胞の特定の分子やシグナルなどを標的にして腫瘍の増殖や悪性度を低下させる分子標的治療薬が開発され,これまでの抗がん剤よりがん特異性の高い効果が期待されている。本稿では,放射線治療と抗がん剤や分子標的治療薬併用による効果増強の基礎や臨床応用の現状について,文献や臨床試験などの報告を中心に解説を加える。

Combined chemotherapy and radiation therapy has been established as standard treatment approach for locally advanced head and neck cancer, esophageal cancer and so on through randomized clinical trials. However, radiation-related morbidity such as acute toxicity also increased as treatment intensity has increased. In underlining mechanism for enhancement of normal tissue reaction in chemo-radiation therapy, chemotherapy enhanced radiosensitivity of normal tissues in addition to cancer cells. Molecular target-based drugs combined with radiation therapy have been expected as promising approach that makes it possible to achieve cancer-specific enhancement of radiosensitivity, and clinical trials using combined modalities have been performed to evaluate the feasibility and efficacy of this approach. In order to obtain maximum radiotherapeutic gain, a detailed understanding of the mechanism underlying the interaction between radiation and Molecular target-based drugs is indispensable. Among molecular target-based drugs, inhibitors targeting EGFR and its signal transduction pathways have been vigorously investigated, and mechanisms regarding the radiosensitizing effect have been getting clear. In addition, the results of randomized clinical trials demonstrated that radiation therapy combined with cetuximab resulted in improvement of overall and disease-specific survival rate compared with radiation therapy in locally advanced head and neck cancer. In this review, clinical usefulness of chemo-radiation therapy and potential molecular targets for potentiation of radiation-induced cell killing are summarized.

収録刊行物

  • Radioisotopes

    Radioisotopes 61(1), 21-29, 2012-01-15

    公益社団法人 日本アイソトープ協会

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各種コード

  • NII論文ID(NAID)
    10030198440
  • NII書誌ID(NCID)
    AN00351589
  • 本文言語コード
    JPN
  • 資料種別
    REV
  • ISSN
    00338303
  • NDL 記事登録ID
    023399175
  • NDL 請求記号
    Z15-20
  • データ提供元
    CJP書誌  NDL  J-STAGE 
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