国内における過去12年間の筋萎縮性側索硬化症とがんの併存症例報告の検討

Abstract

Purpose:The number of elderly patients with multiple coexisting diseases is increasing. While ALS is a designated intractable disease and characterized by rarity, the number of ALS patients with cancer is also increasing. In order to consider support for ALS and cancer coexisting cases, we aimed to organize existing case reports from literature review and obtain basic data. Method: We searched the literature from 2010 to 2021 using the Japan Central Revuo Medicina Web (ver. 5) electronic database, with a combination of 'amyotrophic lateral sclerosis' and 'cancer' . We extracted a total of 26 cases from 23 articles.Results: Out of the 23 articles, the first authors were physicians in 18 articles. In our analysis of 26 cases, 54％ of the patients were in their 70s or over; 18 (69％) cases were diagnosed with ALS before cancer, 3 (12％) with cancer first, and 5 (19％) with both at about the same time. The literature included 9 cases related to surgery, 5 cases for anesthesia for surgery, and 4 cases related to either chemotherapy or radiotherapy. Nine patients were under respiratory management with TPPV. In all but three reports of ALS patients treated for cancer, the cancer treatments were described as successful. Conclusion: Although multidisciplinary, interdisciplinary, and comprehensive consideration for each case is necessary, recent advances in treatment technology have revealed that aggressive cancer treatment is being used for ALS, which is an incurable disease. This study presented a reference material in decision-making support for ALS patients.