北海道大学 · 医学
Akihiro Homma教授の研究室では、頭頸部がんをはじめとする悪性腫瘍の治療において、画像誘導下での超選択的動脈内化学療法と放射線療法の併用療法に注力しています。特に、局所進行がんや切除不能な症例においても根治を実現する「RADPLAT」療法の有効性と安全性を、臨床的・画像的根拠に基づいて検証しています。また、週単位のカルボプラチン投与や、動脈内への局所的薬物送達技術の最適化による治療効果向上にも取り組んでいます。
Figures are computed from collected data and may differ slightly.
Although a single institution experience, the results of the current study suggest that RADPLAT can cure the majority of patients with advanced cancer of the nasal cavity and paranasal sinuses, as well as preserve organs. Late adverse reactions should be monitored in future studies.
Weekly cisplatin could be easier to manage than three-weekly cisplatin, because patients can be monitored more regularly for toxicity allowing the schedule to be altered if required. This regimen appears to be a suitable alternative to three-weekly high-dose cisplatin with concomitant radiotherapy.
UMIN-CTR (UMIN000032600), Clinicaltrials.gov (NCT03569436).
These findings suggest that weekly carboplatin treatment is preferable to daily low-dose cisplatin. This could be because the total dose of cisplatin was too low to be effective.
Intra-arterial chemotherapy has been used to treat localized malignant neoplasms in patients with head and neck cancer for over 50 years as the head and neck region is particularly well suited to regional chemotherapy. Early intra-arterial chemotherapy did not prove its efficacy. In addition, the additional complications associated with establishing and maintaining arterial access have further dampened enthusiasm for this approach. Subsequent significant advances in vascular radiology techniques
We confirmed the efficacy of superselective arterial infusion and concomitant radiotherapy, which can concentrate the attack of supradose cisplatin on locoregional disease. Even patients with unresectable disease can be cured. Further studies are needed to establish the indications, long-term outcome, and possible late side effects of this treatment.
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