CQ2 化学療法

CQ2-3切除不能膵癌に対して推奨される化学療法の投与期間は何か?

推 奨

切除不能膵癌に対するゲムシタビン塩酸塩は,投与継続困難な有害事象の発現がなければ,病態が明らかに進行するまで投与を継続する(グレードB)

エビデンス

    化学療法は一般的には長期に継続することにより,蓄積毒性が出現し,治療効果が減弱する傾向が認められる。適切な投与期間は,投与する薬剤や癌腫により異なると考えられており,切除不能膵癌に対するゲムシタビン塩酸塩の投与期間について検証した。
     切除不能膵癌に対するゲムシタビン塩酸塩の投与期間を明らかにすることを目的とする研究報告はみられなかった。ゲムシタビン塩酸塩と他の治療を比較した大規模なランダム化比較試験では,これまで全て,病態が明らかに進行するまで,または継続が困難な有害事象が発現するまで治療が継続され,有用性が検証されていることから1)〜23)(レベルⅡ),現時点ではこれらと同様な投与期間を設定することが推奨される。

引用文献

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検索式

(1)
医中誌
CQ2─1 局所進行切除不能膵癌に対し,化学療法単独による治療は推奨されるか?
CQ2─2 遠隔転移を有する膵癌に対して推奨される一次化学療法は何か?
CQ2─3 切除不能膵癌に対して推奨される化学療法の投与期間は何か?
CQ2─4 切除不能膵癌に対して推奨される二次化学療法は何か?
(4つのCQをまとめて検索した)
検索年限 出版年2004/7/4〜2007/4/30
検索日 2007/5/21
検索式
#1
(膵臓腫瘍/TH or 膵臓腫瘍/AL) or (膵囊胞/TH or 膵囊胞/AL) or (膵管癌/TH or 膵管癌/AL) or (膵臓腫瘍/TH or 膵臓癌/AL) and (PT=会議録除く)
#2
(薬物療法/TH or 薬物療法/AL) or (薬物療法/TH or 化学療法/AL) or (抗腫瘍剤/TH or 抗腫瘍剤/AL) or (腫瘍多剤併用療法/TH or 混合抗腫瘍剤/AL) or (抗腫瘍剤/TH or 抗癌剤/AL) and (PT=会議録除く)
#3
#1 and #2
#4
#3 and (PT=原著論文 RD=メタアナリシス,ランダム化比較試験,準ランダム化比較試験,比較研究)
検索件数51件
(2)
PubMed
検索年限 出版年2004/7/4〜2007/4/30
検索日 2007/5/21
検索式
#1
pancreatic neoplasms/dt Limits:Entrez Date from 2004/07/04 to 2007/04/30, Humans, English, Japanese
#2
meta─analysis[pt] or randomized controlled trial[pt] or controlled clinical trial[pt] or clinical trial[pt]
#3
antineoplastic agents or 5─fluorouracil or 5─FU or gemcitabine or cisplatin or leucovorin or mytomycin C or doxorubicin or paclitaxel or cytarabine or cyclophosphamide or docetaxel or irinotecan or S─1 or capecitabine or topotecan or UFT or (tagafur and uracil)
#4
#1 and #2 and #3
#5
administration and dosage
#6
#4 and #5
検索件数107件