CDDP+5-FU+Radiation 20 pathological CR 1-7 pathological CR pathological PR NC PD follow up T4 106 rec CT MRI CT 1989 2000 69 / 62/7 40-75 CDDP 5-FU 3550.7 1 4 44 44 6 CR PR NC 35 106 rec RT-PCR 1 PD NC Induction chemoradiotherapy:crt 5FU CDDP Liniac 350mg/m2 7mg/m2 2Gy/day 1W 2W 3W 4W Induction chemotherapy:fap day1 day7 day28 5FU CDDP ADR 1000mg/day 70mg/m 2 30mg/m 2
34 3 CT CDDP+5-FU+Radiation 40Gy 66 CT UGI CR2/66 3 PR49/66 74 NC+PD 15/66 23 CR 2 Grade2 1 34 Grade3 7/35 20 Grade2 20/ 35 57 Grade1 8/35 23 T4 20 CR CR+PR 5 40 NC+PD 3 Grade3 5 75Grade2 36Grade1 2 2 Grade3 2 p=0.0007 Grade3 2 Grade1 33 33/68 48.5 3 10 3 3 Grade3 30 grade 3 grade 2 grade 1 CR n=2 0 0 2 100 0 0 PR n=49 14 28.6 24 49.0 11 22.4 NC/PD n=15 2 13.3 5 33.3 8 53.3 p53 p53 SSCP-sequence 67 p53 DO7 Novocastra 1010 p53 44 65.7 23 34.3 5/ 44 11.4 Grade3 SSCP-sequence p53 p53 19 28.8 Grade3 1 2
1 p53 p53 status IHC IHC grade 3 10 43.5 5 11.4 n=15 grade 2 3 13.0 16 36.4 n=19 grade 1 10 43.5 23 52.3 n=33 n=67 23 100 44 100 p=0.071, wild type vs mutant by Mann-Whitney's U test 2 p53 mutation p53 status wild type mutant grade 3 15 31.3 0 0 n=15 grade 2 17 35.4 2 10.5 n=19 grade 1 16 33.3 17 89.5 n=33 n=67 48 100 19 100 p 0.001, wild type vs mutant by Mann-Whitney's U test p-53 CyclinD1 8 s-vgef 9 10Bax 11microvessel density 12 methalothionein 13CDC25B 14 QOL CR 2 Grade2 PR 49 Grade3 14 28.6 Grade2 24 49.0 Grade1 11 22.4 NC/PD 15 Grade3 2 15 16 1 CT MRI 18 F-FDG PET 18 F-FDG SUVmax SUVmax 2.5 PET - 1211 92 Grade2, 3 PET + 11 9 82 Grade0,1 3 SUVmax 2.5 PET - 18 F- FDG PET PETSUVmax 2.5 range:72.0 676.0mm 2 median:180.0mm 2 Grade 0 1b 9/11 (82%) PETSUVmax 2.5 range:0 32.6mm 2 median:7.0mm 2 Grade 2/3 : 11/12 (92%)
76 Grade3 22 Grade2 31 23 74 Grade1 23 22 4 QOL QOL Grade3 4 CT FDG-PET CT PET
T4 pathological CR T4 CR pathological CR neoadjuvant adjuvant therapy CDDP+5-FU 4 5 20 5 4 3 CDDP+5-FU+ADR FAP 1 T3 4 23 FAP 3 78.3 55.5 1 80 6 LN CR 1 PR 13 NC 4 PD 0 77.8 LN CR 27 PR 49 NC 60 PD 1 55.5 n=0 8 1 n 3 6 4 n 7 2 8 n 2
2 1 Ultrafulex Covered Stent QOL Stent Stent Stent Stent T2 T2 T2 7 20 5 Ce M(-)&low risk sm2-t3 Th T4 M(+)&high risk N 3 N 4 N(+) N(-) CR CR PR NC CR follow Salvage Salvage Salvage follow
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