Journal Article 肝細胞癌に対する内科治療の足跡 : 革新的治療法の開発
From tracing the history of medical therapies to the development of novel therapies for hepatocellular carcinoma
カンサイボウガン ニ タイスル ナイカ チリョウ ノ ソクセキ : カクシンテキ チリョウホウ ノ カイハツ

山﨑, 隆弘

65 ( 1 )  , pp.15 - 22 , 2016-02-01 , 山口大学医学会
Recent advances in medical therapies, including percutaneous local therapy, transcatheter arterial therapy, and chemotherapy, have improved the prognosis of hepatocellular carcinoma(HCC). Percutaneous local therapy started with percutaneous ethanol injection in the 1980s in Japan, and radiofrequency ablation(RFA)is now the norm. We designed balloon-occluded RFA to increase the area of coagulation necrosis compared to standard RFA. In transcatheter arterial therapy, transcatheter arterial chemoembolization, which was developed in the 1970s in Japan, has assumed a prominent role. Recently, drug-eluting beads-transcatheter arterial chemoembolization, which is used in Western countries, has been performed in Japan, and its efficacy must be investigated. In chemotherapy, although the multikinase inhibitor sorafenib is currently recommended as the standard of care worldwide, the response rate for sorafenib therapy is low, at approximately 2-3%. In contrast, the response rate for hepatic arterial infusion chemotherapy, which is used in Japan and Asia, is approximately 30-40%. However, there are no established criteria for the selection of hepatic arterial infusion chemotherapy or sorafenib. We have shown the efficacy of an alternative drug, the iron chelator deferoxamine, in advanced HCC patients, and a clinical trial investigating the efficacy of the oral iron chelator, deferasirox, for advanced HCC is now ongoing.

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