演題抄録

臓器別シンポジウム

開催概要
開催回
第55回・2017年・横浜
 

直腸癌局所再発の治療戦略

演題番号 : OSY15-5

[筆頭演者]
関本 貢嗣:1 
[共同演者]
加藤 健志:1、三宅 正和:1、植村 守:1、中森 正二:1、平尾 素宏:1、宮本 敦史:1、西川 和宏:1、濱 直樹:1、前田 栄:1、浜川 卓也:1、池田 正孝:2

1:独立行政法人国立病院機構大阪医療センター・外科、2:兵庫医科大学・外科

 

The surgical resection has been seen as the only measure to obtain a long term survival for patients with locally recurrent rectal cancer (LRRC), however the multi-visceral resections are often necessary, such as total pelvic excenteration and composite sacral resection. These are very invasive that cause frequent post-operative morbidities and impaired QOL. Furthermore, there have been scarce evidences of the feasibility and the efficacy of such operations, so even large cancer centers have not performed so aggressively. However, better short/long term operative outcomes have been reported gradually.
The carbon ion radiotherapy has been proven to have a therapeutic effect for LRRC equivalent to surgery, recently. Recurrence within the irradiated area is only 10%. However, high dose irradiation to the bowels causes perforation frequently. This limitation narrows the indication of carbon ion radiotherapy. In order to overcome this problem, the operation to dissect and place a spacer between the lesion and bowels is being developed.
We have performed about 150 operations for the treatment of LRRC during this 15 years. We review the current status of the treatment of LRRC, and report our results.

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