胃と腸49巻5号

2014年05月発行

増刊号 消化管悪性リンパ腫2014 主題 消化管原発aggressive lymphoma―diffuse large B-cell lymphoma

胃DLBCLの診断と治療―最新の治療

著者： 福原傑¹ 飛内賢正¹

所属機関： ¹国立がん研究センター中央病院血液腫瘍科

ページ範囲：P.729 - P.735

胃原発悪性リンパ腫に対しては，以前は手術療法±術後補助化学療法が選択されていたが，現在では化学療法やRTを主体とした胃温存療法が選択され，出血や穿孔などの合併症があるときに限り手術療法が検討される．限局期に対しては，R-CHOP 3コース＋IFRT，あるいはR-CHOP 6～8コースが標準治療である．進行期に対しては，R-CHOP 6～8コースが標準治療である．予後不良因子は，de novo DLBCL，non-GCB type，LDH高値，PS不良などである．近年では胃原発DLBCLに対するH. pylori除菌療法の有効性が報告されている．

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