Neurological Surgery 脳神経外科38巻11号

2010年11月発行

研究

ICE（イホマイド・シスプラチン・エトポシド）療法の安全性：単一施設の108連続症例の検討から

著者： 金森政之¹ 隈部俊宏¹ 斎藤竜太¹ 山下洋二¹ 園田順彦¹ 冨永悌二¹

所属機関： ¹東北大学大学院医学系研究科神経外科学分野

ページ範囲：P.997 - P.1005

Ⅰ．はじめに

　固形腫瘍に対する化学療法は，膠芽腫に対するテモゾロミド単剤投与²⁹⁾を除き，一般的には多剤併用療法が用いられている．この中でアルキル化剤（イホマイド）・白金製剤（シスプラチン）・トポイソメラーゼⅡ阻害剤（エトポシド）を併用したICE療法は，1986年にGöbelら¹³⁾が精巣外原発の胚細胞腫瘍への有効性を示して以来，頭蓋外胚細胞腫，非小細胞性肺癌，小細胞性肺癌，非ホジキン性悪性リンパ腫，卵巣癌，再発ユーイング肉腫^{1,9-12,15,19)}などで広く有効性が示されてきた．

　一方で頭蓋内腫瘍に対しては，MAKEI 89 Studyにて精巣外胚細胞腫瘍に対するICE療法の有効性が報告されたが，その一部に頭蓋内胚細胞系腫瘍が含まれ¹⁴⁾，その後，髄芽腫^25,31)，原始神経外胚葉性腫瘍³¹⁾，嗅神経芽腫¹⁸⁾，脳幹部膠芽腫^5,26)などで有効性が報告されてきた．

　本報告では当科における1997年以降のICE療法施行症例を後方視的に検討し，有害事象について明らかにすることを目的とした．この中で，2005年5月から骨髄抑制，腎機能障害，聴力障害を参考にした減量基準に従った投与量の調整を行ったが，減量による治療効果，有害事象への影響にも着目した．

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