Neurological Surgery 脳神経外科46巻2号

2018年02月発行

研究

再発転移性脳腫瘍に対する低用量ベバシズマブの治療効果

著者： 服部悦子¹ 宮腰明典¹ 呉浩一¹ 青竹利治² 川上義行² 坂本匡人³ 川内豪¹ 尾市雄輝¹ 佐野徳隆¹ 早瀬睦¹ 太田諒⁴ 廣瀬由紀² 戸田弘紀¹

所属機関： ¹福井赤十字病院脳神経外科 ²福井赤十字病院外科 ³福井赤十字病院放射線治療科 ⁴福井赤十字病院病理診断科

ページ範囲：P.107 - P.115

Ⅰ．はじめに
　転移性脳腫瘍は担癌患者の10〜30%に発症し^19,24,27)，脳腫瘍症例全体の17〜20%を占める²²⁾．病期，病型，再帰分割分析などの結果をもとに予後を評価し¹³⁾，集学的治療の対象となれば，外科的治療，放射線治療や化学療法を用いて治療する²³⁾．近年は原発巣に対して分子標的療法を併用することも多い．代表的な分子標的薬の1つであるベバシズマブはvascular endothelial growth factorのモノクローナル抗体で，卵巣癌，治癒切除不能な結腸・直腸癌，進行・再発の非小細胞性肺癌，再発乳癌，また悪性神経膠腫に適応があり，放射線壊死に対する治療効果も知られている^6,14,15,21)．ベバシズマブの承認当初は脳転移を有する患者への投与は原則禁忌であったが，2012年6月に慎重投与が認められた．しかし，これまで転移性脳腫瘍やその再発例に対するベバシズマブの治療報告は少ない^9,28)．そこで本研究では，転移性脳腫瘍再発自験例に対するベバシズマブの治療効果を検討した．ベバシズマブには高血圧，腎機能障害や出血など用量依存性に現れる副作用が知られており，特に低用量のベバシズマブの有用性を検証したので報告する．

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