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<title>大腸癌薬物療法の要点と盲点 | 株式会社文光堂</title>


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<meta name="description" content="待ちに待った9年ぶりの大改訂！多くの新規抗がん薬や分子標的治療薬が登場した大腸癌薬物療法．医師はそれぞれのレジメンの治療効果・特性，副作用とその対処法などを十分に理解したうえで，患者のQOLを考慮した最適な治療法・レジメンを提供することが求められる．本書では，ガイドラインに記載の大腸癌薬物療法のレジメンを上手に実施するためのコツや，副作用への対策を臨床の現場で役に立つように解説した．">

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		<h1 class="catchCopy">9年ぶりの大改訂！患者のQOLを考慮した大腸癌薬物療法を実施するコツを臨床視点で解説!!</h1>
		

		<h2 class="series">Knack & Pitfalls&nbsp;&nbsp;</h2>
		<h1 class="copy">ガイドラインに沿った</h1>
		<h1 class="title">大腸癌薬物療法の要点と盲点<span class="version">改訂・改題第2版</span></h1>
		

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					監修：杉原健一（光仁会第一病院）
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					編集：島田安博（高知医療センター腫瘍内科）
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				<ul class="property"><li class="disc">B5判・192頁・2色刷</li><li class="disc">ISBN&nbsp;978-4-8306-2265-6</li><li class="disc">2023年11月1日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">待ちに待った9年ぶりの大改訂！多くの新規抗がん薬や分子標的治療薬が登場した大腸癌薬物療法．医師はそれぞれのレジメンの治療効果・特性，副作用とその対処法などを十分に理解したうえで，患者のQOLを考慮した最適な治療法・レジメンを提供することが求められる．本書では，ガイドラインに記載の大腸癌薬物療法のレジメンを上手に実施するためのコツや，副作用への対策を臨床の現場で役に立つように解説した．</section><section class="preface">「大腸癌薬物療法の要点と盲点」<br>改訂・改題第2版序文<br><br>　2014年に「大腸癌化学療法の要点と盲点」の初版が刊行されてから約9年が経ちました．その序文に書きましたが，2000年代に入り大腸癌薬物療法においては新しい殺細胞性抗がん薬や分子標的治療薬が続々と登場してきたことから，それらの薬剤をどのように組み合わせるのが最も効果的なのか，どのような基準でレジメンを選ぶのか，それらのレジメンをどのような順で投与するのが全生存期間を最も延ばすのか，副作用の対策は，などが大腸癌薬物療法の臨床における大きな関心事項でした．それらの問題点の解決策を提示する目的で初版が上梓されました．それ以降は，免疫チェックポイント阻害薬やBRAF遺伝子変異に対する薬剤が開発され臨床応用されるようになりましたが，それらの薬剤が適応される大腸癌患者は1割以下と少ないことから一般臨床では大きな問題にはなりませんでした．<br>　その後の約9年間に大腸癌薬物療法の経験が蓄積されるにつれ，前述した大腸癌の薬物療法における一般臨床での関心事項に対する回答がかなり明らかになってきたように思います．ただ，この場合はこうすべきだ，この薬剤を組み合わせたレジメンを使うべきだ，この時点で次の治療を開始すべきだ，といった断定的な，統一的な答えはありません．医師はそれぞれのレジメンの治療効果，特性，副作用とその対処法，などを十分に理解したうえで，患者に説明・推奨することが肝要だと思います．<br>　それまでの大腸癌治療ガイドラインにおいては薬物療法の効果を優先して記載していましたが，2016年版に患者の身体的状況に応じてレジメンを選択することが初めて推奨されました．大腸癌の薬物療法において効果的な薬剤がなかった2000年以前は切除不能大腸癌患者の50％生存期間は約1 年でした．しかし，その後多くの新規抗がん薬や分子標的治療薬の登場により，現在はそれが3年近くに延びてきました．そのような状況を踏まえ，これまでのように全生存期間を延長させることだけを目的に行われてきた臨床試験に対する考え方を改める必要があると思います．QOL（生活の質）を加えたQALY（質調整生存年）を考慮して，個々の患者にとっての最適な治療法・レジメンを提供することが求められる時代になっていると思います．<br>　本書では，「大腸癌治療ガイドライン2022年版」に準拠しつつ，それらをさらに深く理解し，ガイドラインに記載されているレジメンを上手に実施するうえでのコツやレジメンの長期間投与を阻害する副作用に対する対策を，第一線で活躍している先生方に臨床の現場で役に立つように執筆していただきました．大腸癌の薬物療法に携わっている多くの先生方に本書を活用していただければと思います．<br><br>2023年10月<br>杉原健一</section><section class="indexes">Ⅰ　総論<br>　1　大腸癌薬物療法の目的と治療価値<br>　2　大腸癌治療ガイドライン2022年版アルゴリズムの解説<br>　3　大腸癌薬物療法の治療の継続・変更の基本的考え方<br><br>Ⅱ　各種レジメンの実際<br>　1　FOLFOX＋BEV療法，FOLFIRI＋BEV療法，CapeOX＋BEV療法，SOX＋BEV療法<br>　2　FOLFOX＋CET/PANI療法，FOLFIRI＋CET/PANI療法<br>　　One Point Advice　右側，左側原発部位での分子標的治療薬の使用<br>　3　FOLFOXIRI＋BEV療法<br>　　One Point Advice　術後補助化学療法としてFOLFOX/CapeOX療法施行後の再発症例の治療<br>　　One Point Advice　切除不能肝限局転移に対する治療方針<br>　　One Point Advice　腹膜転移症例の治療方針<br>　　One Point Advice　肝転移切除後の術後補助化学療法は行うべきか─推奨する立場で─<br>　　One Point Advice　肝転移切除後の術後補助化学療法は行うべきか─推奨しない立場で─<br>　4　sLV5FU2＋BEV療法，Cape＋BEV療法<br>　5　レゴラフェニブ（REG）単独療法<br>　6　IRIS＋BEV療法，CapeIRI＋BEV療法<br>　7　イリノテカン抵抗性に対するIRI＋CET/PANI療法<br>　8　FTD/TPI単独療法，FTD/TPI＋BEV併用療法<br>　9　<i>BRAF</i> <sup>V600E</sup> 遺伝子変異陽性大腸癌の二次治療：ENCO＋CET療法，ENCO＋BINI＋CET療法<br>　10　MSI-Hや特定の遺伝子異常をもつ大腸癌に対する治療<br>　11　高齢者の全身化学療法<br>　　One Point Advice　メンテナンス療法の意義<br>　　One Point Advice　大腸癌における抗EGFR抗体薬リチャレンジのエビデンス<br>　　One Point Advice　遺伝性大腸癌診療に必要な病診連携<br>　　One Point Advice　地方の化学療法を取り巻く現状と実践<br><br>Ⅲ　副作用マネジメント<br>　1　白血球減少・好中球減少，血小板減少<br>　2　悪心・嘔吐<br>　3　口腔粘膜炎<br>　4　下痢<br>　5　皮膚障害<br>　6　末梢神経障害<br>　　One Point Advice　がんゲノム医療について<br>　　One Point Advice　腫瘍関連の深部静脈血栓症（DVT）─担がん患者における静脈血栓塞栓症（VTE）の特徴：わが国のレジストリーデータから─<br>　7　アレルギー反応<br>　8　インフュージョンリアクション<br>　9　薬剤性肺障害炎<br>　10　低マグネシウム血症<br>　11　蛋白尿<br>　　One Point Advice　shared decision makingとは─インフォームド・コンセントとの違い─ 　<br>　　One Point Advice　がん患者への「悪い知らせ（bad news）」の伝え方<br><br>索引</section></article>
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