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<title>胃癌化学療法の要点と盲点（電子版のみ） | 株式会社文光堂</title>


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<meta name="description" content="好評だった「大腸癌化学療法の要点と盲点」に続く，消化器癌の化学療法のテキスト第２弾．大腸化学療法は「大腸癌治療ガイドライン」でスタンダードがかなり明確に示されているのに対し，胃癌化学療法は「胃癌治療ガイドライン」には記述が極めて少なく，日常診療で悩む消化器内科医も多い．本書では，「考える胃癌化学療法」を目標に，治療選択の思考過程を明らかにし，個々の症例にどのように対応するか，担当医が自ら決める指針">

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	<section class="book">

		<h1 class="catchCopy">胃癌治療ガイドラインだけではわからない胃癌化学療法の奥義</h1>
		

		<h1 class="copy">考える胃癌化学療法</h1>
		<h1 class="title">胃癌化学療法の要点と盲点（電子版のみ）<span class="version"></span></h1>
		

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					編集：島田安博（高知医療センター）
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					<span class="transparent">編集</span>　室　圭（愛知県がんセンター）
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					<span class="transparent">編集</span>　朴　成和（国立がん研究センター）
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				<ul class="property"><li class="disc">B5判・164頁・4色刷</li><li class="disc">ISBN&nbsp;978-4-8306-1899-4</li><li class="disc">2017年3月2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">好評だった「大腸癌化学療法の要点と盲点」に続く，消化器癌の化学療法のテキスト第２弾．大腸化学療法は「大腸癌治療ガイドライン」でスタンダードがかなり明確に示されているのに対し，胃癌化学療法は「胃癌治療ガイドライン」には記述が極めて少なく，日常診療で悩む消化器内科医も多い．本書では，「考える胃癌化学療法」を目標に，治療選択の思考過程を明らかにし，個々の症例にどのように対応するか，担当医が自ら決める指針を示した．</section><section class="preface">巻頭言<br><br>　胃癌化学療法は，「日本胃癌学会の胃癌治療ガイドライン第4版」（2014年5月改訂）が発刊され，国内外の臨床試験のエビデンスに基づき治療アルゴリズムが整理されました．また日本胃癌学会WEBでも重要な知見の紹介が行われております．<br>　しかしながら，まだまだ多くの臨床課題（clinical question）が残されており，実臨床の現場では治療方針の選択に迷うこともしばしばです．治療成績は確実に進歩してきていますが，画一的なガイドライン頼みの治療選択では，十分な治療を行うことができないことを実感されていると思います．腹膜転移例，経口摂取低下例，高齢・併存症例などに適切に対応するには，ガイドラインを含めた最善の治療方針を個々の患者ごとに十分に考え，かつ治療方針を患者さんやご家族，そして同僚にきちんと説明することが必要となります．<br>　本書では，上記のような日常診療で遭遇するガイドラインに含まれない症例にどのように対応すればよいか，経験豊かな先生方に最新情報の整理と実際の治療内容について記載していただきました．<br>　特殊な病態での治療選択，有害事象への対応，治療継続の判断など，ガイドラインとともに利用することにより，適切な治療選択，治療判断ができるようになることが本書の目的です．ガイドラインに記載がないからといって治療を行わないことは少ないと思います．またエビデンスがないからといって治療を終了し，すぐに緩和ケアの選択を勧めることも少ないと思います．ところが，ガイドライン時代に育った若手医師の治療方針の判断過程を見ていると残念ながら「自らの思考停止状態での臨床判断」が行われています．これは，治療に期待している患者や家族にとって大きなギャップを生んでいます．<br>　本書では，まさに臨床現場で臨床医が判断に迷う点にフォーカスを当てて，治療選択をどのように考えて選択しているかという内容を記載しています．治療方針に迷うこのような症例は，がんセンターや大学病院では診療科内，あるいはMDT（多職種合同カンファレンス）で討論し，方針決定をしていると思います．一方で，多くの第一線病院では，院内のわずかな経験を共有して不安の中で治療方針を決定しているのが現状です．そのような第一線病院の先生方を本書の読者になると想定して臨床現場でガイドラインを読みながら，目の前の患者に最善の治療選択を提供する努力を惜しまない臨床医にぜひご一読をお勧めしたいと思います．エビデンスに基づきながら，目の前の「患者のために考える臨床医」が増えることを期待しております．<br><br>平成29年2月<br>島田安博，室　　圭，朴　成和</section><section class="indexes">I　胃癌治療ガイドラインの解説<br>　切除不能進行・再発胃癌における薬物療法<br>　付　胃癌化学療法レジメン一覧<br>II　胃癌化学療法の選択のポイント<br>　1． 術後補助化学療法<br>　2． 1次治療<br>　3． 2次治療<br>　4． 3次治療以降<br>III　胃癌特有の病態に応じた治療の選択<br>　1． 高度腹膜播種<br>　2． 播種性血管内凝固症候群（DIC）を合併した胃癌に対する薬物療法<br>　3． 髄膜播種<br>　4． 高齢者の胃癌<br>IV　副作用の予防と対応<br>　1． SP療法，Cape＋CDDP療法<br>　2． SOX療法，CapeOX療法<br>　3． Cape＋CDDP＋Tmab療法，SP＋Tmab療法<br>　4． Weekly PTX＋Ramucirumab療法<br>　5． Weekly PTX療法<br>　6． DTX療法<br>　7． イリノテカン療法<br>　8． Ramucirumab療法<br>　9． S-1単独療法<br>　10． 5-FU＋LV療法<br>　11． DCS療法<br>V　緩和治療<br>VI　Controversy<br>　●肝転移症例の治療─肝切除の適応はあるのか<br>　●ステージIV根治手術後の化学療法<br>　●胃癌術後補助化学療法後の再発症例の治療<br>　●conversion therapyの意義とconversionによる治癒切除後の治療<br>　●術前化学療法の意義<br>　●HER2陽性胃癌の2次化学療法<br><br>ワンポイント・アドバイス<br>　・HER2陽性胃癌の臨床・病理学的特徴<br>　・切除不能・再発胃癌に対する分子標的薬の主な第Ⅲ相試験<br>　・S-1継続投与の意義<br>　・切除不能進行・再発胃癌に伴う出血，狭窄，穿孔への対応<br>　・OXはどれくらい継続可能か？<br>　・味覚・嗅覚の異常<br>　・眼の副作用（流涙など）の原因と対応</section></article>
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