悪性中皮腫:

頻度と臨床的アプローチ

抄録

Malignant mesothelioma is a highly lethal and particularly refractory tumor for which treatments have been far from satisfactory in achieving clinical responses. Mesothelioma has a strong etiological relationship with asbestos exposure. The incidence is rising and expected to continue to increase into the next decade in Japan. However, strict prohibitions on the use of asbestos started in the early 1970s lead to a decline in the incidence in Sweden, New Zealand, and in US. In June 2005, several inhabitants of Amagasaki, Hyogo prefecture, lived within one kilometer of the asbestos factory, suffered from mesothelioma, whose environmental exposures to asbestos were clarified to trigger off social and medico-legal problems of asbestos-related diseases in Japan. Japan was one of the greatest consumers of chrysotile asbestos and one of the largest producers of asbestos-containing products. Considering the long latent period of about 40 years and more than 300,000 tons of asbestos used between 1973 and 1977, the incidence can be expected to increase dramatically hereafter, may be from 2010. Mesothelioma is a disease which has been poorly responsive to chemotherapy, and there is as yet no standard chemotherapy regimen. Diffuse nature of mesothelioma makes it difficult for surgeon to perform a radical resection, however, combined modality treatments have been attempted in order to reduce local recurrence and systemic spread. Mesothelioma is no longer considered a rare tumor, the peak incidence of this tumor is not reached in Japan.