http://long-life.cocolog-nifty.com/blog/ がん治療の選択肢を増やすために読む新聞 ja-JP 2011-12-12T23:21:10+09:00 http://long-life.cocolog-nifty.com/blog/2011/12/abvd-12d1.html 限局期ホジキンリンパ腫の治療がまた一歩進歩した。11日に発表されたNEJM誌オンライン速報版によると、限局期ホジキンリンパ腫において放射線療法を施行せず、ABVDレジメン単独でも、放射線療法を生存率が得られることが明らかになった。 ■対象 　巨大腫瘤がないステージI... <div style="font-family: ;"><span style="list-style-type: disc;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;"><span style="color: #000000;list-style-type: disc;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;">限局期ホジキンリンパ腫の治療がまた一歩進歩した。11日に発表されたNEJM誌オンライン速報版によると、<span style="list-style-type: disc;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;"><span style="list-style-type: disc;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;">限局期ホジキンリンパ腫</span></span></span></span></span>において放射線療法を施行せず、ABVDレジメン単独でも、放射線療法を生存率が得られることが明らかになった。</span></span></span></span></span></div> <div style="font-family: ;"></div> <div style="font-family: ;"><span style="color: #000000;">&nbsp;</span></div> <div style="font-family: ;"><strong><u><span style="color: #000000;">■対象</span></u></strong></div> <div style="font-family: ;"> <ul> <li> <div style="font-family: ;"><span style="color: #000000;">　巨大腫瘤がないステージIAまたはIIAのホジキンリンパ腫　405例</span></div></li></ul></div> <div style="font-family: ;"><strong><u><span style="color: #000000;">■比較</span></u></strong></div> <div style="font-family: ;"> <ol dir="ltr" style="margin-right: 0px;"> <li><span style="color: #000000;">ABVDレジメン単独</span> <div style="font-family: ; list-style-type: disc;"></div> </li> <li><span style="color: #000000;list-style-type: decimal;">STLI（全リンパ領域から骨盤部を除いた部分に照射する方法）±ABVDレジメン</span></li></ol></div> <blockquote dir="ltr"> <div dir="ltr"><span style="color: #000000;">※ABVD：ドキソルビシン、ブレオマイシン、ビンブラスチン、ダカルバジン</span></div></blockquote> <div style="font-family: ;"><strong><u><span style="color: #000000;">■試験デザイン</span></u></strong></div> <div dir="ltr" style="font-family: ; margin-right: 0px;"> <ul> <li><span style="color: #000000;">無作為化比較試験 </span> </li> <li><span style="color: #000000;">[主要評価項目]　12年生存率 </span></li></ul></div> <div style="font-family: ;"><strong><u><span style="color: #000000;">■結果</span></u></strong></div> <div style="font-family: ;"> <ul> <li><span style="color: #000000;"><strong>12年生存率</strong> </span></li> <ol> <li dir="ltr"> <div><span style="color: #000000;">ABVD療法単独</span><span style="list-style-type: disc;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;">：</span></span></span><span style="color: #000000;">94%</span></div> <div style="font-family: ; list-style-type: disc;"></div> </li> <li dir="ltr"><span style="color: #000000;list-style-type: decimal;">放射線療法</span><span style="color: #000000;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;">：87%</span></span></span><span style="color: #000000;">&nbsp;</span></li></ol> <ul> <li><span style="color: #000000;">HR=0.50; 95%CI＝ 0.25 to 0.99; P=0.04 </span></li></ul> <li><span style="color: #000000;"><strong>非進行生存率</strong> </span></li> <ol> <li><span style="color: #000000;">ABVD療法単独</span><span style="list-style-type: disc;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;">：</span></span></span><span style="color: #000000;">87%</span> </li> <li><span style="color: #000000;list-style-type: decimal;">放射線療法</span><span style="color: #000000;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;">：92%</span></span></span><span style="color: #000000;">&nbsp;</span></li></ol> <ul> <li><span style="color: #000000;">HR=1.91; 95%CI＝ 0.99 to 3.69; P=0.05</span></li></ul> <li><span style="color: #000000;"><strong>無イベント生存率</strong> </span></li> <ol> <li><span style="color: #000000;">ABVD療法単独</span><span style="list-style-type: disc;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;">：</span></span></span><span style="color: #000000;">85% </span> </li> <li><span style="color: #000000;list-style-type: decimal;">放射線療法</span><span style="color: #000000;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;"><span class="Apple-style-span" style="text-transform: none; line-height: 16px; text-indent: 0px; letter-spacing: normal; font-family: ; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;">：80%</span></span></span><span style="color: #000000;">&nbsp;</span></li></ol> <ul> <li><span style="color: #000000;">HR=0.88; 95%CI＝ 0.54 to 1.43; P=0.05</span></li></ul></ul></div> <div><a href="http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(11)70336-9/abstract?rss=yes"><span style="color: #000000;">N Engl J Med, ONLINE FIRST, December 11, 2011</span></a><span class="Apple-style-span" style="text-align: justify; text-transform: none; 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