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KMID : 0670719990040020009
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Journal of the Korean Society Hyperthermia Oncology
1999 Volume.4 No. 2 p.9 ~ p.17
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Multidisciplinary Treatment for Colorectal Cancer in Japan
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Shingo Kameoka
Akiyoshi Seshimo/Michio Itabashi/Kabuki Aratake/Naohiro Soga
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Abstract
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We have tried some multidisciplinary treatments for colorectal cancer in Japan and haute obtained good results. Two main subjects in this field are pre- and intra-operative radiotherapy for rectal cancer and multidisciplinary therapy for liver metastases. I will lecture on these two themes using our own data and reports from other hospitals in Japan. We began pre- and intra-operative radiotherapy for advanced rectal cancer cases in 1982. The 5-year survival rate in the radiotherapy group had risen to as high as 80%, but there were more complications, and hospitalization was longer, in the radiotherapy group than in the control group. The results of treatments combined with radiotherapy at other hospitals varied. And there were somewhat fewer reports in Japan which mentioned radiotherapy as being statistically effective than those in the United States and Europe. This may indicate that the sensitivity to radiation is different between Occidentals and Orientals. Therefore in our institute we are especially careful in selecting this therapy. There are several combined therapies for liver metastases from colorectal cancer currently being used in Japan. The first choice is hepatectomy for metastatic lesions that can be resected. Our Indication for a hepatectomy is when the tumor is solitary, unilobar and can be rejected with a sufficient and clear surgical margin. The second is hepatic arterial infusion chemotherapy for patients whose tumors cannot be rejected. The results of both treatments have been satisfactory. In our department the post-hepatectomy 5-year survival rate is 38%. And the 5-year survival rate for the combined complete and partial response rate of the patients who underwent hepatic arterial infusion chemotherapy is 48%. Recently we have been treating patients with hepatic arterial infusion adjutant chemotherapy after hepatectomies. We are also performing hepatectomies after treating patients with hepatic arterial infusion chemotherapy in unresectable cases. We have had very good results with both of these approaches.
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KEYWORD
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