{"id":111,"date":"2012-04-17T22:43:08","date_gmt":"2012-04-17T13:43:08","guid":{"rendered":"\/sawamura\/wp\/?p=111"},"modified":"2023-05-15T17:49:21","modified_gmt":"2023-05-15T08:49:21","slug":"lymphoma","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/braintumors\/lymphoma\/","title":{"rendered":"\u4e2d\u67a2\u795e\u7d4c\u539f\u767a\u30ea\u30f3\u30d1\u816b PCNSL\uff0c\u305d\u306e\u4ed6\u306e\u30ea\u30f3\u30d1\u816b"},"content":{"rendered":"<div class=\"setumei\">\n<h5 align=\"center\">PCNSL (primary central nervous system lymphoma)<\/h5>\n<h4><strong>\u5927\u307e\u304b\u306a\u3053\u3068<\/strong><\/h4>\n<ul>\n<li>\u8133\u306e\u3069\u3053\u306b\u3067\u3082\u3067\u304d\u308b\u60aa\u6027\u816b\u760d\u3067\uff0c\u8133\u816b\u760d\u306e3%\u304f\u3089\u3044\u3067\u3059<\/li>\n<li>60\u304b\u308980\u6b73\u4ee3\u306e<strong><span style=\"color: #ff0000;\">\u9ad8\u9f62\u8005\u306b\u591a\u304f\u767a\u751f<\/span><\/strong>\u3057\u307e\u3059<\/li>\n<li>\u767a\u751f\u7387\u306f\u5897\u52a0\u306e\u50be\u5411\u306b\u3042\u308a\u307e\u3059<\/li>\n<li>\u60aa\u6027\u306eB\u30ea\u30f3\u30d1\u7403\u304c\u8133\u306e\u4e2d\u3067\u52e2\u3044\u3088\u304f\u5897\u3048\u307e\u3059<\/li>\n<li>\u5c02\u9580\u533b\u306fPCNSL\u3068\u547c\u3073\u307e\u3059<\/li>\n<li>\u6b27\u7c73\u3067\u306f\u514d\u75ab\u529b\u304c\u843d\u3061\u305f\u60a3\u8005\u3055\u3093\uff08\u30a8\u30a4\u30ba\u306a\u3069\uff09\u3067\u306e\u8133\u306e\u30ea\u30f3\u30d1\u816b\u306e\u767a\u751f\u304c\u591a\u3044\u306e\u3067\u3059\u304c\uff0c\u65e5\u672c\u3067\u306f\u3068\u3066\u3082\u7a00\u3067\u3059<\/li>\n<li><strong><span style=\"color: #ff0000;\">\u75c7\u72b6\u306f\u77e5\u80fd\u4f4e\u4e0b\uff08\u8a8d\u77e5\u75c7\uff09\u3084\u9ebb\u75fa\u306a\u3069<\/span><\/strong>\u304c\u591a\u3044\u3067\u3059<\/li>\n<li><strong><span style=\"color: #ff0000;\">\u7247\u65b9\u306e\u76ee\u306e\u8996\u529b\u304c\u6025\u306b\u4f4e\u4e0b\u3059\u308b<\/span><\/strong>\u773c\u5185\u30ea\u30f3\u30d1\u816b\uff08\u30d6\u30c9\u30a6\u819c\u708e\uff09\u306f\u521d\u767a\u75c7\u72b6\u3068\u3057\u3066\u591a\u3044\u3082\u306e\u3067\u3059\uff0c\u305d\u306e\u5f8c\u306b\u8133\u306b\u767a\u751f\u3057\u307e\u3059<\/li>\n<li>\u4e9c\u6025\u6027\uff0c\u3064\u307e\u308a<strong><span style=\"color: #ff0000;\">\u6570\u65e5\u304b\u3089\u4f55\u9031\u9593\u5358\u4f4d\u3067\u9032\u884c\u3059\u308b<\/span><\/strong>\u3082\u306e\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u4e00\u5ea6\u75c7\u72b6\u304c\u51fa\u305f\u3089<strong><span style=\"color: #ff0000;\">\u60aa\u5316\u3059\u308b\u306e\u306f\u65e9\u3044<\/span><\/strong>\u3068\u8003\u3048\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u6cbb\u3059\u305f\u3081\u306b\u306f1\u65e5\u3082\u65e9\u304f\u6cbb\u7642\u3092\u958b\u59cb\u3059\u308b\u3053\u3068\u304c\u5927\u5207\u3067\u3059<\/li>\n<li>\u6cbb\u7642\u306e\u57fa\u672c\u306f\u5316\u5b66\u7642\u6cd5\uff08\u5236\u30ac\u30f3\u5264\uff09\u3067\u3059<\/li>\n<\/ul>\n<h5><span style=\"color: #000080;\">\u4e16\u754c\u6a19\u6e96\u306e\u6cbb\u7642\u6cd5\u306f\uff0c<strong>\u751f\u691c\u8853\uff08\u75c5\u7406\u8a3a\u65ad\uff09\uff0c\u30e1\u30bd\u30c8\u30ec\u30ad\u30bb\u30fc\u30c8\u3092\u57fa\u6750\u3068\u3057\u305f\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u3067\u3059<\/strong><\/span><\/h5>\n<ul>\n<li><span style=\"color: #333333;\">\u305d\u306e\u5f8c\u306b\u5168\u8133\u7167\u5c04\u3092\u52a0\u3048\u308b\u304b\uff0c\u3055\u3089\u306b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3046\u304b\u306f\u610f\u898b\u304c\u5206\u304b\u308c\u307e\u3059<\/span><\/li>\n<li>\u3044\u305a\u308c\u306e\u6cbb\u7642\u6cd5\u3092\u9078\u629e\u3057\u3066\u3082<span style=\"color: #000080;\"><strong>\u518d\u767a\u7387\u3084\u6b7b\u4ea1\u7387\u306f\u9ad8\u3044<\/strong><\/span>\u3082\u306e\u3067\u3059<\/li>\n<\/ul>\n<h5>\u4ee5\u4e0b\u306fPCNSL\u306b\u95a2\u3057\u3066\u306e\u8a18\u8ff0\u3067\u3059<\/h5>\n<div align=\"left\">\n<h4><strong>\u691c\u67fb\u3068\u8a3a\u65ad\u306f<\/strong><\/h4>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-9018 size-medium\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike1-256x300.jpg\" alt=\"pcnslike1\" width=\"256\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike1-256x300.jpg 256w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike1-768x899.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike1-513x600.jpg 513w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike1.jpg 850w\" sizes=\"auto, (max-width: 256px) 100vw, 256px\" \/><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike2.jpg\" rel=\"attachment wp-att-9019\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-9019\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike2-262x300.jpg\" alt=\"pcnslike2\" width=\"262\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike2-262x300.jpg 262w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike2-768x881.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike2-523x600.jpg 523w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslike2.jpg 850w\" sizes=\"auto, (max-width: 262px) 100vw, 262px\" \/><\/a><\/p>\n<p><span style=\"color: #000080;\"><strong>\u5358\u7d14CT\uff08\u5de6\u5074\u306e\u753b\u50cf\uff09\u3067\u816b\u760d\u306e\u90e8\u5206\u304c\u5c11\u3057\u3060\u3051\u9ad8\u5438\u53ce\u5024\u57df<\/strong><\/span>\u3092\u793a\u3059\uff08\u3061\u3087\u3063\u3068\u767d\u3063\u307d\u304f\u306a\u308b\uff09\u306e\u304c\u5927\u304d\u306a\u7279\u5fb4\u3067\uff0c\u3053\u306e\u6240\u898b\u3092\u3082\u3063\u3066\u30b0\u30ea\u30aa\u30fc\u30de\u3068\u306e\u533a\u5225\u3092\u3057\u307e\u3059\u3002\u5468\u56f2\u306b\u9ed2\u3063\u307d\u3044\u90e8\u5206\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u3053\u308c\u306f\u8133\u306e\u816b\u308c\u3067\u8133\u6d6e\u816b\u3068\u8a00\u3044\u307e\u3059\u3002\u53f3\u5074\u306eCT\u306f\u9020\u5f71\u5264\u3092\u5165\u308c\u305f\u3082\u306e\u3067\u3088\u308a\u306f\u3063\u304d\u308a\u5199\u308a\u307e\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkgd.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20330\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkgd-300x290.jpg\" alt=\"\" width=\"300\" height=\"290\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkgd-300x290.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkgd-550x533.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkgd-768x744.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkgd.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkt2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20331\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkt2-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkt2-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkt2-550x552.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkt2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkt2-768x771.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnkt2.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><span style=\"color: #000080;\"><strong>MRI\u691c\u67fb\u3067\uff0c\u306f\u3063\u304d\u308a\u308f\u304b\u308a\u307e\u3059<\/strong><\/span>\u3002MRI\u9020\u5f71\u5264\u3092\u5165\u308c\u308b\u3068\u5747\u4e00\u307e\u305f\u306f\u6591\u3089\u306b\u5897\u5f37\uff08\u771f\u3063\u767d\u306b\u306a\u308b\uff09\u3055\u308c\u3066\uff08\u5de6\u5074\uff09\uff0c\u5468\u56f2\u306b\u306f\u8133\u306e\u816b\u308c\uff08\u8133\u6d6e\u816b\uff09\u304c\u307f\u3089\u308c\u307e\u3059\uff08\u53f3\u5074\uff09\u3002\u3067\u304d\u3084\u3059\u3044\u5834\u6240\u306f<span style=\"color: #000080;\"><strong>\u5074\u8133\u5ba4\u306e\u5468\u56f2<\/strong><\/span>\u30fb<span style=\"color: #000080;\"><strong>\u5927\u8133\u8133\u57fa\u5e95\u6838<\/strong><\/span>\u30fb\u5c0f\u8133\u30fb\u8133\u5e79\u90e8\u306a\u3069<span style=\"color: #000080;\"><strong>\u8133\u306e\u6df1\u3044\u3068\u3053\u308d\uff08\u6df1\u90e8\u767d\u8cea\uff09<\/strong><\/span>\u3067\u3059\u3002\u8133\u306e\u4e2d\u306b\uff12\u500b\u4ee5\u4e0a\u306e\u30ea\u30f3\u30d1\u816b\u304c\u540c\u6642\u306b\u3067\u304d\u308b<span style=\"color: #333333;\"><strong><span style=\"color: #000080;\">\u591a\u767a\u4f8b<\/span><\/strong>\u3068\u3044\u3046\u306e\u3082\u3057\u3070\u3057\u3070<\/span>\u3042\u308a\u307e\u3059<\/p>\n<ul>\n<li>\u8133\u3067\u306f\u306a\u3044<span style=\"color: #000080;\"><strong>\u4f53\u306e\u3069\u3053\u304b\u306b\u767a\u751f\u3057\u305f\u30ea\u30f3\u30d1\u816b\u304c\u8133\u306b\u8ee2\u79fb\u3057\u305f\u3082\u306e\u304b\u3082<\/strong><\/span>\u3057\u308c\u307e\u305b\u3093<\/li>\n<li>\u8133\u306b\u3060\u3051\u3067\u304d\u305f\u306e\u304b\uff0c\u4f53\u306e\u3069\u3053\u304b\u306b\u539f\u767a\u5de3\u304c\u3042\u308b\u306e\u304b\u3092\u533a\u5225\u3059\u308b\u306e\u306f\u3068\u3066\u3082\u96e3\u3057\u3044\u3067\u3059<\/li>\n<li>\u5168\u8eab\u3092\u8abf\u3079\u308b\u306e\u306b\u306f<strong><span style=\"color: #000080;\">\u30ac\u30ea\u30a6\u30e0\u30b7\u30f3\u30c1<\/span><\/strong>\u3068\u3044\u3046\u691c\u67fb\u304c\u7528\u3044\u3089\u308c\u307e\u3059<\/li>\n<li>\u30da\u30c3\u30c8 <span style=\"color: #000080;\"><strong>FDG-PET<\/strong><\/span>\u3068\u3044\u3046\u691c\u67fb\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u81a0\u82bd\u816b\u3084\u8ee2\u79fb\u6027\u8133\u816b\u760d\u3088\u308aFDG-PET\u306e\u53d6\u308a\u8fbc\u307f\u304c\u9ad8\u3044\u306e\u3067\u3059\u304c\uff0c\u78ba\u5b9a\u8a3a\u65ad\u306b\u306f\u81f3\u308a\u307e\u305b\u3093\u3057\uff0c\u3053\u306e\u691c\u67fb\u3092\u4e88\u7d04\u3057\u3066\u3044\u308b\u3068\u6cbb\u7642\u958b\u59cb\u307e\u3067\u306e\u6642\u9593\u304c\u304b\u304b\u3063\u3066\u3057\u307e\u3046\u3068\u3044\u3046\u6b20\u70b9\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u9aa8\u3092\u523a\u3057\u3066\u691c\u67fb\u3059\u308b<span style=\"color: #000080;\"><strong>\u9aa8\u9ac4\u7a7f\u523a<\/strong><\/span>\u3092\u3057\u3066\u5168\u8eab\u306e\u30ea\u30f3\u30d1\u7403\u306b\u7570\u5e38\u304c\u306a\u3044\u304b\u8abf\u3079\u307e\u3059<\/li>\n<li>\u773c\u79d1\u3067\uff0c\u76ee\u306e\u4e2d\u306b\u3082<span style=\"color: #000080;\"><strong>\u773c\u5185\u30ea\u30f3\u30d1\u816b<\/strong><\/span>\u304c\u306a\u3044\u304b\u3069\u3046\u304b\u3092\u8abf\u3079\u307e\u3059<\/li>\n<\/ul>\n<h4>\u624b\u8853\u306b\u3088\u308b\u75c5\u7406\u8a3a\u65ad<\/h4>\n<ul>\n<li>CT\u3068MRI\u304c\u7d42\u308f\u3063\u3066<span style=\"color: #000080;\"><strong>\u30ea\u30f3\u30d1\u816b\u304c\u7591\u308f\u308c\u305f\u3089\uff0c\u6025\u3044\u3067\u3059\u3050\u306b\u300c\u5b9a\u4f4d\u8133\u624b\u8853\u300d\u304b\u300c\u5c0f\u3055\u306a\u958b\u982d\u624b\u8853\u300d<\/strong><span style=\"color: #333333;\">\u3067<\/span><\/span>\u3061\u3087\u3073\u3063\u3068\u3060\u3051\u816b\u760d\u3092\u3068\u308a\u307e\u3059\uff08\u751f\u691c\u8853\uff09<\/li>\n<li>\u8133\u539f\u767a\u306e\u3082\u306e\u306f\u307b\u3068\u3093\u3069\u304cnon-Hodgkin\u30ea\u30f3\u30d1\u816b (NHL)\u3067\uff0c<span style=\"color: #000080;\"><strong>\u3073\u307e\u3093\u6027\u5927\u7d30\u80de\u578b\u00a0<b>B\u7d30\u80de<\/b>\u30ea\u30f3\u30d1\u816b<\/strong><\/span>\u304c\u7d0480\uff5e90\uff05\u3092\u5360\u3081\u307e\u3059<\/li>\n<li>\u75c5\u7406\u7d44\u7e54\u5b66\u7684\u306b\u306f\uff0c\u7570\u578b\u6027\u306e\u9ad8\u3044\u30ea\u30f3\u30d1\u7403\u306e\u816b\u760d\u7d30\u80de\u304c\uff0c\u8840\u7ba1\u5468\u56f2\u306b\u96c6\u307e\u308a\u3055\u3089\u306b\u6df1\u304f\u5468\u56f2\u306e\u8133\u5b9f\u8cea\u5185\u306b\u6d78\u6f64\u3057\u3066\u3044\u307e\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c<strong><span style=\"color: #ff0000;\">\u624b\u8853\u3067\u3068\u308a\u304d\u308c\u308b\u3053\u3068\u306f\u3042\u308a\u307e\u305b\u3093<\/span><\/strong>\u3057\uff0c\u958b\u982d\u624b\u8853\u3060\u3051\u3067\u306f\u518d\u767a\u3057\u307e\u3059<\/li>\n<li>\u8133\u30d8\u30eb\u30cb\u30a2\u3092\u751f\u3058\u308b\u3088\u3046\u306a\u982d\u84cb\u5185\u5727\u4ea2\u9032\u304c\u3042\u308b\u3068\u304d\u3060\u3051\u6e1b\u8377\u624b\u8853 debulking surgery\u3092\u8003\u3048\u307e\u3059\uff0c\u305d\u306e\u4ed6\u306e\u72b6\u6cc1\u3067\u306f\u958b\u982d\u6458\u51fa\u8853\u306b\u5229\u70b9\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u30b9\u30c6\u30ed\u30a4\u30c9\u3068\u3044\u3046\u85ac\u3092\u4f7f\u3046\u3068\u4e00\u6642\u671f\u306b\u75c7\u72b6\u304c\u3088\u304f\u306a\u3063\u3066\uff0cMRI\u3092\u307f\u308b\u3068\u6d88\u3048\u3066\u3057\u307e\u3046\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u305d\u306e\u5834\u5408\u3082\u6570\u9031\u304b\u3089\u6570\u30f6\u6708\u5f8c\u306b\u518d\u767a\u3057\u307e\u3059<\/li>\n<li>\u75c5\u7406\u7d44\u7e54\u3092\u78ba\u8a8d\u3059\u308b\u624b\u8853\u306e\u524d\u306b<strong><span style=\"color: #ff0000;\">\u30b9\u30c6\u30ed\u30a4\u30c9\u3092\u4f7f\u3046\u3068\u75c5\u6c17\u304c\u5224\u3089\u306a\u304f\u306a\u3063\u3066\u3057\u307e\u3046\u306e\u3067\uff0c\u751f\u691c\u8853\u306e\u524d\u306b\u30b9\u30c6\u30ed\u30a4\u30c9\u3092\u4f7f\u7528\u3057\u3066\u306f\u3044\u3051\u307e\u305b\u3093<\/span><\/strong><\/li>\n<li>\u305d\u306e\u4ed6\u306e\u3044\u308d\u3044\u308d\u306a\u30ea\u30f3\u30d1\u816b\u306f\u5f8c\u8ff0\u3057\u3066\u3044\u307e\u3059\uff0c\u4f8b\u3048\u3070\u786c\u819c\uff08\u9ac4\u819c\uff09\u304b\u3089\u767a\u751f\u3059\u308b\u30e2\u30eb\u30c8\u30fb\u30ea\u30f3\u30d1\u816b\u306f\u9ac4\u819c\u816b\u3068\u9593\u9055\u3048\u3084\u3059\u3044\u3067\u3059<\/li>\n<\/ul>\n<\/div>\n<h4><strong>\u6cbb\u7642<\/strong><\/h4>\n<\/div>\n<h5><span style=\"color: #000080;\">2023\u5e74\u6642\u70b9\u306e\u6a19\u6e96\u6cbb\u7642\u306f\uff0c<\/span><br \/>\n<span style=\"color: #000080;\"> <strong>MTX<span class=\"setumei style1\">(\u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8) \u3092\u57fa\u6750\u3068\u3057\u305f<\/span>\u5316\u5b66\u7642\u6cd5<br \/>\n<\/strong><strong>\u5168\u8133\u7167\u5c0430\u30b0\u30ec\u30a4\uff0f15\u5206\u5272\u3092\u52a0\u3048\u308b\u304b\u3069\u3046\u304b\u306f\u500b\u5225\u5224\u65ad<\/strong><\/span><\/h5>\n<div class=\"setumei\">\n<ul>\n<li><strong><span style=\"color: #ff0000;\">\u9032\u884c\u304c\u65e9\u3044\u306e\u3067\u6cbb\u7642\u306f\u3068\u3066\u3082\u6025\u304c\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/span><\/strong><\/li>\n<li>\u958b\u982d\u624b\u8853\u3067\u305f\u304f\u3055\u3093\u816b\u760d\u7d44\u7e54\u3092\u3068\u308b\u306e\u306f\u610f\u5473\u304c\u3042\u308a\u307e\u305b\u3093\uff0c\u6642\u9593\u3092\u5931\u3046\u306e\u3068\uff0c\u6458\u51fa\u3057\u3066\u3082\u307e\u305f\u3059\u3050\u306b\u5927\u304d\u304f\u306a\u3063\u3066\u3057\u307e\u3046\u304b\u3089\u3067\u3059<\/li>\n<li>\u305d\u3046\u3057\u306a\u3044\u3068\u6cbb\u3089\u306a\u304b\u3063\u305f\u308a\uff0c\u6cbb\u3063\u3066\u3082\u5f8c\u907a\u75c7\u304c\u5927\u304d\u304f\u306a\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u304b\u3089\u6cbb\u7642\u3092\u958b\u59cb\u3057\u307e\u3059<\/strong><\/span><\/li>\n<li>\u5168\u8eab\u72b6\u614b\u3068\u814e\u6a5f\u80fd\u304c\u826f\u3051\u308c\u3070\u9ad8\u9f62\u8005\u306b\u3082MTX\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306f\u4f7f\u7528\u3055\u308c\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u653e\u5c04\u7dda\u7642\u6cd5\uff08\u5168\u8133\u7167\u5c04\uff09\u306f\u6709\u52b9<\/strong><\/span>\u3067\uff0c\u7167\u5c04\u3060\u3051\u3067\u6d88\u5931\u3057\u3066\u6cbb\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u65e5\u672c\u3067\u306f1\u65e5\u7dda\u91cf2.0\u30b0\u30ec\u30a4\u3067\u3059\u304c\uff0c1.8\u30b0\u30ec\u30a4\u306b\u3057\u305f\u65b9\u304c\u3044\u3044\u3068\u3044\u3046\u610f\u898b\u3082\u591a\u3044\u3067\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u9ad8\u9f62\u8005\u306e\u8133\u306b\u5e83\u304f<span style=\"color: #333333;\">\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u3068\u8133\u306e\u840e\u7e2e\u304c\u304d\u3066\u4f55\u30f6\u6708\u304b\u5f8c\u306b\u306f\u8a8d\u77e5\u969c\u5bb3<\/span>\u306b\u306a\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u5168\u8133\u7167\u5c04\u3092\u52a0\u3048\u308b\u304b\u3069\u3046\u304b\u306b\u306f\u8b70\u8ad6\u304c\u3042\u308a\uff0c\u60a3\u8005\u3055\u3093\u3082\u8ff7\u3044\u307e\u3059<\/li>\n<li>\u3067\u3082\u9006\u306b\uff0c<span style=\"color: #000080;\"><strong>\u5168\u8133\u7167\u5c04\u3057\u306a\u3044\u3067\uff0c\u3053\u306e\u6cbb\u7642\u304c\u826f\u3044\u3068\u3044\u3046\u78ba\u304b\u306a\u9078\u629e\u80a2\u3082\u3042\u308a\u307e\u305b\u3093<\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>\u85ac\u7269\u7642\u6cd5\uff08\u5316\u5b66\u7642\u6cd5\uff0c\u5236\u304c\u3093\u5264\uff09\u306f\u6709\u52b9\u306a\u3053\u3068\u304c\u591a\u3044<\/strong><\/span>\u3067\u3059\u304c\uff0c20-30%\u304f\u3089\u3044\u306e\u9ad8\u60aa\u6027\u5ea6\u7fa4\u306e\u30ea\u30f3\u30d1\u816b\u306b\u306f\u52b9\u304d\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #333333;\">\u4ed6\u306b\u81e8\u5e8a\u8a66\u9a13\u304c\u9032\u3093\u3067\u3044\u308b\u306e\u306f\uff0c\u30ea\u30c4\u30ad\u30b5\u30f3\u3092\u4f75\u7528\u3059\u308b\uff0c\u5168\u8133\u7167\u5c04\u306e\u7dda\u91cf\u3092\u843d\u3068\u3059\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u65b9\u6cd5\u3092\u5909\u3048\u308b\uff0c\u7dad\u6301\u5316\u5b66\u7642\u6cd5\u3092\u3059\u308b\uff0c\u306a\u3069\u306e\u65b9\u5411\u6027\u304c\u3042\u308a\u307e\u3059<\/span><\/li>\n<li><span style=\"color: #333333;\">\u7d50\u8ad6\u306f\u51fa\u3066\u3044\u307e\u305b\u3093<\/span><\/li>\n<li>70\u6b73\u4ee5\u4e0a\u306e\u72b6\u614b\u306e\u60aa\u3044\u9ad8\u9f62\u8005\u3067\u306f\uff0c\u958b\u982d\u624b\u8853\u3092\u3057\u306a\u3044\uff0c\u5316\u5b66\u7642\u6cd5\u3092\u3057\u306a\u3044\uff0c\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u307f\u306b\u6b62\u3081\u308b\u306a\u3069\uff0c\u4f53\u306b\u8ca0\u62c5\u306e\u5927\u304d\u3044\u7121\u7406\u306a\u6cbb\u7642\u3092\u9078\u629e\u3057\u306a\u3044\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<h4><strong>\u6cbb\u7642\u306e\u9806\u756a\uff08\u5730\u56fa\u3081\u7642\u6cd5\u307e\u3067\u3092\u884c\u3046\u3053\u3068\u304c\u591a\u3044\u3067\u3059\uff09<\/strong><\/h4>\n<h5>1 \u5c0e\u5165\u5316\u5b66\u7642\u6cd5\uff1a\u3069\u308c\u304b\u4e00\u3064<\/h5>\n<ul>\n<li><span style=\"color: #000080;\"><strong>MTX\u5927\u91cf\u5316\u5b66\u7642\u6cd5<br \/>\n(MTX at HD (\u22653 g\/m<sup>2<\/sup>, 2-3 h iv infusion, 4-6 injections, 2-3 weeks interval)\u00a0<\/strong><\/span><\/li>\n<li>\u305d\u308c\u306b\u30ea\u30c4\u30ad\u30b5\u30f3\u3092\u52a0\u3048\u308b\uff082022\u5e74\u6642\u70b9\u3067\u30b3\u30f3\u30bb\u30f3\u30b5\u30b9\u306f\u3042\u308a\u307e\u305b\u3093\uff09<\/li>\n<li>\u3055\u3089\u306b\u30a2\u30eb\u30ad\u30eb\u5316\u5264\u00a0(procarbazine, carmustine, \u00a0thiotepa) \u306a\u3069\u3092\u52a0\u3048\u308b\u5f37\u5316\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3046\uff0c\u6709\u52b9\u6027\u306f\u65ad\u5b9a\u3067\u304d\u307e\u305b\u3093\u304c\uff0c\u594f\u529f\u5272\u5408\u3084\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593 PFS \u304c\u9ad8\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059\uff0c\u5f53\u7136\uff0c\u6709\u5bb3\u4e8b\u8c61\u306f\u304d\u3064\u304f\u306a\u308a\u307e\u3059<\/li>\n<li>cytarabine\u5927\u91cf\u7642\u6cd5\u3092\u52a0\u3048\u308b\u5316\u5b66\u7642\u6cd5\u306f\u65e5\u672c\u3067\u306f\u3042\u307e\u308a\u4f7f\u7528\u3055\u308c\u307e\u305b\u3093<\/li>\n<\/ul>\n<h5>2-1 \u5730\u56fa\u3081\u7642\u6cd5\uff1a\u653e\u5c04\u7dda\u6cbb\u7642\u304b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3069\u308c\u304b\u4e00\u3064<\/h5>\n<ul>\n<li><span style=\"color: #000080;\"><strong>30\u30b0\u30ec\u30a415\u5206\u5272\u306e\u5168\u8133\u7167\u5c04<\/strong><\/span> WBRT\uff08\u6cbb\u7642\u5f8c\u306e\u8a8d\u77e5\u6a5f\u80fd\u306e\u4f4e\u4e0b\u304c\u554f\u984c\uff09<\/li>\n<li>CR\uff08\u5316\u5b66\u7642\u6cd5\u3067\u816b\u760d\u6d88\u5931\uff09\u60a3\u8005\u3055\u3093\u3078\u306e\uff0c\u5168\u8133\u7167\u5c04\u306e\u6e1b\u91cf (23.4\u201330 Gy in 1.8\u20132.0 Gy fractions)\uff0c\u81e8\u5e8a\u8a66\u9a13\u306e\u7d50\u8ad6\u306f\u51fa\u3066\u3044\u307e\u305b\u3093<\/li>\n<li>\u6b8b\u5b58\u816b\u760d\u3042\u308b\u3044\u306f\u816b\u760d\u5e8a\u3078\u306e\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u8ffd\u52a0 (<span style=\"color: #000080;\"><strong>boost<\/strong><\/span>)<\/li>\n<li>\u9006\u306b\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u4e2d\u306b\uff0c\u9032\u884c\u3042\u308b\u3044\u306f\u660e\u3089\u304b\u306a\u6b8b\u5b58\u816b\u760d\u304c\u3042\u308b\u5834\u5408\u306b\u306f\uff0c\u5168\u8133\u7167\u5c04\u306e\u5897\u91cf\uff0836\u201340 Gy with a 1.8\u20132 Gy dose\/fraction\uff09<\/li>\n<li>60\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u3067\u306f\uff0c\u5730\u56fa\u3081\u7642\u6cd5\u306b\u5168\u8133\u7167\u5c04\u3092\u7528\u3044\u308b\u3068\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u3067\u3059<\/li>\n<\/ul>\n<h5>2-2 \u5730\u56fa\u3081\u7642\u6cd5\uff1a\u653e\u5c04\u7dda\u6cbb\u7642\u304b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3069\u308c\u304b\u4e00\u3064<\/h5>\n<ul>\n<li><span style=\"color: #333333;\"><span style=\"color: #000080;\"><strong>\u81ea\u5df1\u5e79\u7d30\u80de\u79fb\u690d ASCT \u3092\u4f7f\u3046\u5927\u91cf\u5316\u5b66\u7642\u6cd5<\/strong><\/span>\u306f\uff0c65-70\u6b73\u304f\u3089\u3044\u307e\u3067\u3067\u3042\u308c\u3070\u6709\u52b9\u6027\u304c\u8a8d\u3081\u3089\u308c\u307e\u3059<\/span><\/li>\n<li>\u5168\u8133\u7167\u5c04\u306b\u5339\u6575\u3059\u308b\u52b9\u679c\u306f\u671f\u5f85\u3067\u304d\u307e\u3059<\/li>\n<li>thiotepa\u3092\u57fa\u5264\u3068\u3057\u305f\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u304c\u7528\u3044\u3089\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<\/ul>\n<h5>3 \u7dad\u6301\u7642\u6cd5<\/h5>\n<ul>\n<li>\u00a0\u7d4c\u904e\u89b3\u5bdf\u306e\u307f\u3067\u4f55\u3082\u3057\u306a\u3044\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u30a2\u30eb\u30ad\u30eb\u5316\u5264\u306b\u3088\u308b\u9577\u671f\u5916\u6765\u5316\u5b66\u7642\u6cd5<\/li>\n<li>\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306f\u6709\u52b9\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u304b\u3089\u9664\u5916\u3057\u307e\u3059<\/li>\n<\/ul>\n<h4><strong>\u5316\u5b66\u7642\u6cd5 \uff08\u5236\u304c\u3093\u5264\u6cbb\u7642\uff09<\/strong><\/h4>\n<ul>\n<li><span style=\"color: #000080;\"><span class=\"setumei style1\" style=\"color: #333333;\">\u3053\u306e20\u5e74\u304f\u3089\u3044\u306f\uff0c<\/span><strong><span class=\"setumei style1\">MTX (\u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8) \u306e\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u304c\u57fa\u672c\u3067\u3057\u305f<\/span><\/strong><\/span><\/li>\n<li>\u4f75\u305b\u3066<strong style=\"color: #000080;\">30\u30b0\u30ec\u30a4\u304f\u3089\u3044\u306e\u5168\u8133\u7167\u5c04<\/strong>\u304c\u751f\u5b58\u7387\u306b\u304a\u3044\u3066\u306f\u3088\u3044\u6210\u7e3e\u3092\u3042\u3052\u3066\u304d\u307e\u3057\u305f<\/li>\n<li>\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f\uff13\u5e74\u4ee5\u4e0a\u306b\u306a\u308b\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u65b0\u3057\u3044\u6cbb\u7642\u306e\u65b9\u5411\u6027\u306f<strong>\uff0c<span style=\"color: #ff0000;\">\u5316\u5b66\u7642\u6cd5\u3092\u4e3b\u4f53\u306b\u3057\u3066\u6cbb\u3059<\/span><\/strong>\u3053\u3068\u3067\u3059<\/li>\n<li>\u5168\u8eab\u306e\u30ea\u30f3\u30d1\u816b\u3068\u540c\u3058\u6cbb\u7642\u3068\u306a\u308a\uff0c\u5f37\u529b\u306a\u5316\u5b66\u7642\u6cd5\u3092\u4f7f\u3046\u306e\u3067\u5c02\u9580\u65bd\u8a2d\uff08\u304c\u3093\u5316\u5b66\u7642\u6cd5\u306e\u5c02\u9580\u5bb6\u304c\u3044\u308b\u3068\u3053\u308d\uff09\u3067\u3057\u304b\u884c\u306a\u3048\u307e\u305b\u3093<\/li>\n<li>\u8133\u306e\u30ea\u30f3\u30d1\u816b\u3060\u3068\u8a3a\u65ad\u3055\u308c\u305f\u3089<span style=\"color: #000080;\"><strong>\u8840\u6db2\u816b\u760d\u5185\u79d1<\/strong><\/span>\uff08\u767d\u8840\u75c5\u3084\u30ea\u30f3\u30d1\u816b\u3092\u5c02\u9580\u306b\u6cbb\u7642\u3059\u308b\u5185\u79d1\uff09\u306b\u79fb\u3057\u3066\u3044\u305f\u3060\u304d\u307e\u3057\u3087\u3046<\/li>\n<li>\u8133\u795e\u7d4c\u5916\u79d1\u533b\u304c\u884c\u3046\u6cbb\u7642\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u7279\u306b\uff0c60\u6b73\u4ee5\u4e0a\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u3088\u308b\u8a8d\u77e5\u969c\u5bb3\u304c\u5f37\u304f\u51fa\u308b\u306e\u3067\u5316\u5b66\u7642\u6cd5\u3060\u3051\u306b\u3059\u308b\u65b9\u5411\u6027\u3067\u3059<\/li>\n<\/ul>\n<\/div>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-9023\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx1-200x200.jpg\" alt=\"pcnslmtx1\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx1-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-9024\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx2-200x200.jpg\" alt=\"pcnslmtx2\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx2-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-9025\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx3-200x200.jpg\" alt=\"pcnslmtx3\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx3-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslmtx3-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/p>\n<p>\u82e5\u3044\u60a3\u8005\u3055\u3093\u306e\u30ea\u30f3\u30d1\u816b\u3067\u3059\u3002\u5de6\u304c\u8a3a\u65ad\u6642MRI\u3067\uff0c\u9ec4\u8272\u306e\u77e2\u5370\u3067\u307f\u308c\u308b\uff13\u30f6\u6240\u306b\u540c\u6642\u306b\u30ea\u30f3\u30d1\u816b\u304c\u767a\u751f\u3057\u3066\u3044\u307e\u3059\u3002\u5b9a\u4f4d\u751f\u691c\u8853\u5f8c\u306b\u3059\u3050\u306bMTX\u5316\u5b66\u7642\u6cd5\u30923\u30b3\u30fc\u30b9\u3057\u305f\u3089\uff0c\u771f\u3093\u4e2d\u306e\u753b\u50cf\u306b\u306a\u308a\u307e\u3057\u305f\u3002\u307b\u3068\u3093\u3069\u6d88\u5931\u3057\u3066\u3044\u308b\u306e\u3067\u3059\u304c\uff0c\u77e2\u5370\u306e\u5148\u306b\u307c\u30fc\u3063\u3068\u5c11\u3057\u6b8b\u3063\u3066\u3044\u308b\u306e\u3067CR\uff08\u6d88\u5931\uff09\u3068\u306f\u3044\u3044\u307e\u305b\u3093\u3002\u5316\u5b66\u7642\u6cd5\u3092\u7d42\u3048\u305f\u5f8c\u306b\u5168\u8133\u7167\u5c0430\u30b0\u30ec\u30a4\u3092\u3057\u305f\u3089\u53f3\u306e\u753b\u50cf\u306b\u306a\u308a\u6cbb\u308a\u307e\u3057\u305f\u3002\u3053\u308c\u306f\u9806\u8abf\u306a\u6cbb\u7642\u7d4c\u904e\u306e\u4f8b\u3067\u3059\u3002<\/p>\n<div class=\"setumei\">\n<ul>\n<li>2010\u5e74\u4ee5\u964d\u306f\uff0c\u3055\u307e\u3056\u307e\u306a\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u304c\u63d0\u6848\u3055\u308c\u3066\u3044\u3066\uff0c\u7d50\u8ad6\u306f\u51fa\u3066\u3044\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #000080;\"><strong>CD20\u967d\u6027\u306eB\u7d30\u80de\u30ea\u30f3\u30d1\u816b\u306b\u5bfe\u3059\u308b\u30ea\u30c4\u30ad\u30b7\u30de\u30d6 rituximab\uff08\u5546\u54c1\u540d\u30ea\u30c4\u30ad\u30b5\u30f3\uff09<\/strong><\/span>\u3068\u3044\u3046\u6297\u4f53\u304c\u5316\u5b66\u7642\u6cd5\u3068\u4f75\u7528\u3067\u304d\u308b\u3088\u3046\u306b\u306a\u308a\u307e\u3057\u305f<\/li>\n<li>\u6b27\u7c73\u3067\u306f\u30ea\u30c4\u30ad\u30b7\u30de\u30d6\u3092\u4f7f\u7528\u3059\u308b\u5831\u544a\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u30b7\u30af\u30ed\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30c9\u30ad\u30bd\u30eb\u30d3\u30b7\u30f3\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\uff0c\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u3092\u4f7f\u3046CHOP\u7642\u6cd5\u306a\u3069\u306b\u4f75\u7528\u3055\u308c\u3066\u3044\u307e\u3059\uff08R-CHOP\uff09<\/li>\n<li>\u9ac4\u6db2\u5185\u3078\u306e\u6297\u304c\u3093\u5264\u306e\u6ce8\u5165\u306f\u4e00\u822c\u7684\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>MTX\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u5f8c\u3067\uff0c\u8840\u6db2\u5e79\u7d30\u80de\u79fb\u690d\u3092\u7528\u3044\u305f<span style=\"color: #000080;\"><strong>\u5730\u56fa\u3081\u5316\u5b66\u7642\u6cd5\u3084\u7dad\u6301\u5316\u5b66\u7642\u6cd5<\/strong><\/span>\u3092\u884c\u3063\u305f\u65b9\u304c\u518d\u767a\u7387\u304c\u4f4e\u3044\u3068\u306e\u5831\u544a\u304c\u5897\u3048\u3066\u3044\u307e\u3059<\/li>\n<li>\u3053\u306e\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u5e79\u7d30\u80de\u79fb\u690d\u3092\u7528\u3044\u3066\u30ea\u30f3\u30d1\u816b\u304c\u6d88\u5931\u3057\u305f\u5834\u5408\u306b\u306f\uff0c\u5168\u8133\u7167\u5c04\u3092\u884c\u308f\u306a\u3044\u3068\u3044\u3046\u53d6\u308a\u7d44\u307f\u3082\u3042\u308a\u307e\u3059\u304c\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u6cbb\u7642\u304c\u78ba\u7acb\u3055\u308c\u3066\u3044\u308b\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u306e\u6700\u65b0\u306e\u3082\u306e\u306b\u95a2\u3057\u3066\u306f\uff0c\u4e0b\u306e\u65b9\u306e\u6587\u732e\u60c5\u5831\u306b\u66f8\u3044\u3066\u3044\u307e\u3059<\/li>\n<\/ul>\n<h4>\u4e88\u5f8c<\/h4>\n<\/div>\n<ul>\n<li>\u6700\u521d\u306b\u3067\u304d\u305f\u5834\u6240\u3068\u306f\u9055\u3046\u8133\u306e\u90e8\u5206\u306b\u518d\u767a\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u518d\u767a\u7387\u306f\u9ad8\u304f\uff0c\u6cbb\u7642\u5f8c\u306b<span style=\"color: #000080;\"><strong>\u3042\u308b\u7a0b\u5ea6\u306e\u5bdb\u89e3\u671f\u304c\u5f97\u3089\u308c\u308b\u306e\u306f\u534a\u6570\u304f\u3089\u3044\u306e\u60a3\u8005\u3055\u3093<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u518d\u6cbb\u7642\u306f\u3082\u3061\u308d\u3093\u96e3\u3057\u304f\u306a\u308a\u307e\u3059\u304c\uff0c\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3063\u305f\u308a\u5c40\u6240\u7167\u5c04\u3092\u8ffd\u52a0\u3057\u305f\u308a\u3057\u3066\u6291\u3048\u308b\u3053\u3068\u3082\u53ef\u80fd\u3067\u3059<\/li>\n<li>\u60a3\u8005\u3055\u3093\u306ePS \u4e00\u822c\u72b6\u614b\u304c\u60aa\u304f\u306a\u3063\u305f\u6642\u306b\u306f\uff0c\u7de9\u548c\u30b1\u30a2\u3092\u9078\u629e\u3057\u307e\u3059<\/li>\n<li>\u6587\u732e\u4e0a\u3067\u306f\uff0c\u81e8\u5e8a\u8a66\u9a13\u3055\u308c\u305f\u60a3\u8005\u3055\u3093\u306e\u6bcd\u96c6\u56e3\u306b\u3088\u3063\u3066\u751f\u547d\u4e88\u5f8c\u304c\u5168\u304f\u9055\u3063\u3066\u304d\u307e\u3059<\/li>\n<li>\u304d\u3061\u3093\u3068\u6cbb\u7642\u3092\u53d7\u3051\u308b\u3053\u3068\u304c\u3067\u304d\u305f\u60a3\u8005\u3055\u3093\u3067\uff0c<span style=\"color: #000080;\"><strong>5\u5e74\u751f\u5b58\u5272\u5408\u306f40%<\/strong><\/span>\u304f\u3089\u3044\u3068\u8003\u3048\u308b\u306e\u304c\u59a5\u5f53\u3067\u3057\u3087\u3046<\/li>\n<\/ul>\n<ul>\n<li>\u904e\u53bb\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3060\u3051\u3092\u884c\u306a\u3063\u305f\u5834\u5408\u3067\uff0c\u751f\u5b58\u671f\u9593\u306f15\u304b\u6708\u524d\u5f8c\u3067\u3057\u305f<\/li>\n<li><strong><span style=\"color: #000080;\">\u6700\u8fd1\u306e\u5316\u5b66\u7642\u6cd5\u3092\u52a0\u3048\u305f\u6cbb\u7642\u6cd5\u3067\u306f\u3082\u3063\u3068\u4f38\u3073\u3066\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f40\u30f6\u6708\u4ee5\u4e0a<\/span><\/strong>\u306b\u306a\u3063\u3066\u3044\u307e\u3059<\/li>\n<li>\u660e\u3089\u304b\u306b\u751f\u5b58\u7387\u304c\u3088\u3044\u306e\u306f50\u6b73\u4ee5\u4e0b\u306e\u82e5\u3044\u60a3\u8005\u3055\u3093\uff0cPS70%\u4ee5\u4e0a\uff08\u81ea\u5206\u306e\u3053\u3068\u306f\u3067\u304d\u308b\u72b6\u614b\u304f\u3089\u3044\uff09\u306e\u60a3\u8005\u3055\u3093\u3067\u3059<\/li>\n<li>70\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u3067\u306f\uff0c\u5168\u8133\u7167\u5c04\u3082\u3064\u3089\u304f\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3082\u5236\u9650\u3055\u308c\u308b\u306e\u30675\u5e74\u751f\u5b58\u5272\u5408\u306f2\u5272\u4ee5\u4e0b\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>70\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u306e\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f\uff0c1970\u5e74\u4ee3\u30676\u30f6\u6708\uff0c2010\u5e74\u4ee3\u30677\u30f6\u6708\u3068\u3082\u8a00\u308f\u308c\u307e\u3059<\/li>\n<li>\u30ea\u30f3\u30d1\u816b\u306f\u9ad8\u9f62\u8005\u306b\u5897\u3048\u3066\u3044\u308b\u306e\u3067\u3059\u304c\uff0c\u5b8c\u5168\u306b\u6cbb\u305b\u308b\u78ba\u7387\u306f\u4f4e\u304f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u3082\u5316\u5b66\u7642\u6cd5\u3067\u3082\u7121\u7406\u306a\u6cbb\u7642\u306f\u3057\u306a\u3044\u307b\u3046\u304c\u3044\u3044\u3067\u3057\u3087\u3046<\/li>\n<\/ul>\n<h4>\u518d\u767a\u6642\u306e\u6cbb\u7642<\/h4>\n<ul>\n<li><span style=\"color: #333333;\">\u521d\u56de\u6cbb\u7642\u3067\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u3066\u3044\u306a\u3044\u60a3\u8005\u3055\u3093\u306f\uff0c\u81ea\u5df1\u5e79\u7d30\u80de\u79fb\u690d ASCT \u3092\u4f7f\u3046\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u304c\u5019\u88dc\u3068\u3057\u3066\u3042\u304c\u308a\u307e\u3059<\/span><\/li>\n<li>\u540c\u69d8\u306b\uff0c\u521d\u56de\u6cbb\u7642\u3067\u5168\u8133\u7167\u5c04\u3092\u53d7\u3051\u3066\u3044\u306a\u3044\u60a3\u8005\u3055\u3093\u306f\uff0c\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u3068\u5168\u8133\u7167\u5c04\u3092\u7528\u3044\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059<\/li>\n<li>\u521d\u56de\u6cbb\u7642\u3067MTX\u306b\u826f\u3044\u53cd\u5fdc\u3092\u793a\u3057\u305f\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\u3082\u3046\u4e00\u5ea6\uff0cMTX\u3092\u4f7f\u7528\u3059\u308b\u3068\u3044\u3046\u9078\u629e\u80a2\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u305d\u306e\u4ed6\uff0c\u69d8\u3005\u306a\u6cbb\u9a13\u3084\u6cbb\u7642\u6cd5\u304c\u8840\u6db2\u5185\u79d1\u306e\u9818\u57df\u3067\u8a66\u3055\u308c\u3066\u3044\u307e\u3059\uff08\u8133\u5916\u79d1\u533b\u306e\u8003\u3048\u308b\u3053\u3068\u3067\u306f\u306a\u3044\u3088\u3046\u3067\u3059\uff09<\/li>\n<\/ul>\n<div class=\"setumei\">\n<div class=\"setumei\">\n<hr \/>\n<h5>\u30ea\u30f3\u30d1\u816b\u306e\u7279\u5fb4<\/h5>\n<h4><b>\u816b\u760d\u5897\u5927\u304c\u65e9\u3044<\/b><\/h4>\n<\/div>\n<div class=\"setumei\">\n<p class=\"imgCenter\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph4.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph4.png\" alt=\"\u30ea\u30f3\u30d1\u816b\u306e\u5897\u5927\u304c\u65e9\u3044\" width=\"480\" height=\"196\" \/><\/a><\/p>\n<p>\u3053\u308c\u306f1990\u5e74\u4ee3\u306e\u53e4\u3044\u4f8b\u3067\u3059\u304c<strong><span style=\"color: #ff0000;\">\u30ea\u30f3\u30d1\u816b\u306e\u5897\u5927\u304c\u65e9\u3044<\/span><\/strong>\u3053\u3068\u3092\u304a\u898b\u305b\u3057\u307e\u3059\u3002\u5de6\u5074\u306e\u306fTHP-COP\u3068\u3044\u3046\u5316\u5b66\u7642\u6cd5\u3092\u3059\u308b\u524d\u306e\u3082\u306e\u3067\u3059\u3002\u771f\u3093\u4e2d\u306e\u306f\u5316\u5b66\u7642\u6cd5\u304b\u3089\uff14\u65e5\u76ee\u3067\uff0c\u816b\u760d\u306f\u5c0f\u3055\u304f\u306a\u308a\u307e\u3057\u305f\u3002\u3067\u3082\uff0c\uff12\u30b3\u30fc\u30b9\u76ee\u306e\u5316\u5b66\u7642\u6cd5\u306e\u76f4\u524d(\uff14\u9031\u9593\u5f8c)\u306b\u3082\u3046\u4e00\u5ea6MRI\u3092\u3057\u3066\u307f\u305f\u3089\u3059\u3054\u304f\u5927\u304d\u304f\u306a\u3063\u3066\u3044\u307e\u3057\u305f\u3002\u3053\u306e\u5316\u5b66\u7642\u6cd5\u306f\u52b9\u3044\u3066\u3044\u308b\u306e\u3060\u304b\u52b9\u3044\u3066\u3044\u306a\u3044\u306e\u3060\u304b\u5224\u3089\u306a\u3044\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u5316\u5b66\u7642\u6cd5\u3092\u884c\u306a\u3046\u306a\u3089\u3068\u3066\u3082\u5f37\u3044\u85ac\u5264\u3092\u4f7f\u308f\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3057\u6025\u304c\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002<\/p>\n<\/div>\n<h4><strong>\u9055\u3046\u90e8\u4f4d\u306b\u518d\u767a\u3059\u308b<\/strong><\/h4>\n<\/div>\n<div class=\"setumei\">\n<div class=\"Wrapper clearFix\">\n<p>\u30ea\u30f3\u30d1\u816b\u3092\u7591\u3063\u305f\u3089\u6570\u65e5\u4e2d\u306b\u306f\u5b9a\u4f4d\u8133\u624b\u8853\uff08\u3061\u3087\u3063\u3068\u3060\u3051\u816b\u760d\u3092\u3064\u307e\u3093\u3067\u75c5\u7406\u691c\u67fb\u3092\u3059\u308b\uff09\u3092\u3057\u307e\u3059\u3002\u305d\u3057\u3066\u75c5\u7406\u3067\u78ba\u8a8d\u3057\u305f\u3089\u3059\u3050\u306b\u5316\u5b66\u7642\u6cd5\u3092\u958b\u59cb\u3057\u307e\u3059\u3002\u60a3\u8005\u3055\u3093\u304c\u5916\u6765\u306b\u521d\u3081\u3066\u8a2a\u308c\u3066\u304b\u3089\uff0c\u3059\u3050\u306b\u751f\u691c\u624b\u8853\u3057\u3066\uff0c\u30b9\u30c6\u30ed\u30a4\u30c9\u6cbb\u7642\u3042\u308b\u3044\u306f\u5316\u5b66\u7642\u6cd5\u958b\u59cb\u307e\u3067\u3092\u624b\u8853\u5f8c\uff11\u9031\u9593\u304f\u3089\u3044\u306b\u3057\u305f\u65b9\u304c\u3044\u3044\u3068\u8003\u3048\u3066\u3044\u307e\u3059<\/p>\n<\/div>\n<p class=\"imgCenter\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph2.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph2.png\" alt=\"MRI\" width=\"425\" height=\"244\" \/><\/a><\/p>\n<p>\u77e2\u5370\u306e\u6240\u3092\u5b9a\u4f4d\u8133\u624b\u8853\u3067\u53d6\u308a\u307e\u3057\u305f\u3002\u75c5\u7406\u306e\u7d50\u679c\u304c\u30ea\u30f3\u30d1\u816b\u3068\u78ba\u5b9a\u3055\u308c\u307e\u3057\u305f\u304b\u3089\uff0cMTX\u5316\u5b66\u7642\u6cd5\u3092\u3057\u3066\u304b\u3089\u653e\u5c04\u7dda\u3092\u3042\u3066\u305f\u3089\uff0c\u53f3\u5074\u306eMRI\u306e\u3088\u3046\u306b\u816b\u760d\u306f\u6d88\u3048\u307e\u3057\u305f\u3002\u60a3\u8005\u3055\u3093\u306e\u75c7\u72b6\u306f\u826f\u304f\u306a\u3063\u3066\u9000\u9662\u3057\u305f\u306e\u3067\u3059\u304c\u30fc\u30fc\u3002<\/p>\n<p class=\"imgCenter\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph3.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph3.png\" alt=\"\u518d\u767a\" width=\"480\" height=\"190\" \/><\/a><\/p>\n<p>\u5de6\u304b\u3089\uff0c\uff11\u56de\u76ee\u306e\u518d\u767a\uff0c\uff12\u56de\u76ee\u306e\u518d\u767a\uff0c\uff13\u56de\u76ee\u306e\u518d\u767a\u3067\u3059\u3002\u518d\u767a\u3059\u308b\u305f\u3073\u306b\u306a\u3093\u3068\u304b\u6cbb\u7642\u306f\u3067\u304d\u308b\u306e\u3067\u3059\u304c\uff0c<span style=\"color: #000080;\"><strong>\u9055\u3063\u305f\u5834\u6240\u306b\u518d\u767a\u3057\u3066\u304d\u3066\u3060\u3093\u3060\u3093\u6cbb\u7642\u304c\u52b9\u304b\u306a\u304f\u306a\u3063\u3066\u304f\u308b<\/strong><\/span>\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002\u3053\u306e\u3088\u3046\u306a\u73fe\u8c61\u304b\u3089\uff0c\u8133\u306e\u30ea\u30f3\u30d1\u816b\u306f\u8133\u306b\u767a\u751f\u3059\u308b\u306e\u3067\u306f\u306a\u304f\u3066\uff0c\u4f53\u306e\u3069\u3053\u304b\u306b\u539f\u767a\u5de3\u304c\u3042\u308b\u306e\u3067\u306f\u306a\u3044\u304b\u3068\u3044\u3046\u8003\u3048\u3082\u3042\u308a\u307e\u3059\u3002\u3082\u3061\u308d\u3093\u3001\u3053\u3093\u306a\u518d\u767a\u3092\u3057\u306a\u3044\u3067\u6cbb\u3063\u3066\u3057\u307e\u3046\u60a3\u8005\u3055\u3093\u3082\u591a\u3044\u3067\u3059\u3002<\/p>\n<\/div>\n<div class=\"setumei\">\n<h4><b>40\u30b0\u30ec\u30a4\u306e\u5168\u8133\u7167\u5c04\u3060\u3051\u3060\u3068\u8133\u840e\u7e2e\u3068\u8a8d\u77e5\u6a5f\u80fd\u4f4e\u4e0b\u304c\u751f\u3058\u308b<\/b><\/h4>\n<p class=\"imgCenter\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph5.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph5.png\" alt=\"\u653e\u5c04\u7dda\u6cbb\u7642\" width=\"425\" height=\"251\" \/><\/a><br \/>\n<a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph6.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph6.png\" alt=\"\u653e\u5c04\u7dda\u6cbb\u7642\" width=\"425\" height=\"250\" \/><\/a><\/p>\n<p>1990\u5e74\u4ee3\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u305f\u53e4\u3044\u4f8b\u3067\u3059\u3002\u5b9a\u4f4d\u751f\u691c\u8853\u306e\u5f8c\u3067\u5168\u90e8\u306e\u8133\u306b40\u30b0\u30ec\u30a4\u3068\u3044\u3046\u7dda\u91cf\u3092\u7167\u5c04\u3057\u307e\u3057\u305f\u3002\u5de6\u304b\u3089\uff12\u756a\u76ee\u306e\u5199\u771f\u3067\u816b\u760d\u306f\u6d88\u3048\u3066\u3044\u307e\u3059\u3002\u3067\u3082\uff0c\uff16\u30f6\u6708\u5f8c\u306e\uff13\u756a\u76ee\u306e\u5199\u771f\u3067\u306f\u8133\u304c\u3084\u305b\u3066\u304d\u3066\u3044\u307e\u3059\uff08<span style=\"color: #000080;\"><strong>\u8133\u840e\u7e2e<\/strong><\/span>\uff09\u3002\u60a3\u8005\u3055\u3093\u306e\u7cbe\u795e\u6a5f\u80fd\u306f\u8457\u3057\u304f\u4f4e\u4e0b\u3057\u307e\u3057\u305f\uff08\u3044\u308f\u3086\u308b\u8a8d\u77e5\u969c\u5bb3\uff09\u3002\uff14\u756a\u76ee\u306e\u5199\u771f\u306f\u6cbb\u7642\u5f8c\uff18\u30f6\u6708\u76ee\u306e\u3082\u306e\u3067\u3059\u304c\uff0c\u3059\u3067\u306b\u5de6\u5074\u306b\u5c0f\u3055\u306a\u518d\u767a\u304c\u898b\u3089\u308c\u307e\u3059\u3002<span style=\"color: #000080;\"><strong>\u5168\u90e8\u306e\u8133\u306b\u3042\u3066\u308b\u653e\u5c04\u7dda\u306e\u91cf\u306f\u3067\u304d\u308b\u9650\u308a\u5c11\u306a\u3044\u65b9\u304c\u3044\u3044<\/strong><\/span>\u306e\u3067\u3059\u30022017\u5e74\u6642\u70b9\u3067\u306f30\u30b0\u30ec\u30a4\u3068\u3044\u3046\u306e\u304c\u6a19\u6e96\u7684\u7dda\u91cf\u3067\u3059\u3002<\/p>\n<h4>\u958b\u982d\u624b\u8853\u3060\u3051\u3067\u306f\u6cbb\u3089\u306a\u3044<\/h4>\n<p class=\"imgCenter\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph8.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/lymph\/lymph8.png\" alt=\"\u958b\u982d\u624b\u8853\u3067\u5168\u90e8\u53d6\u3063\u305f\u3068\u3044\u308f\u308c\u3066\u7d39\u4ecb\u3055\u308c\u305f\u4f8b\" width=\"425\" height=\"233\" \/><\/a><\/p>\n<p>\u958b\u982d\u624b\u8853\u3067\u5168\u90e8\u53d6\u3063\u305f\u3068\u3044\u308f\u308c\u3066\u7d39\u4ecb\u3055\u308c\u305f\u4f8b\u3067\u3059\u3002\u3067\u3082\u53f3\u5074\u306e\u5199\u771f\u3067\u306f\u307b\u3093\u306e\u5c11\u3057\u6b8b\u3063\u3066\u3044\u308b\u3088\u3046\u3067\u3059\u3002\u3053\u306e\u5f8c\u3067\u5316\u5b66\u7642\u6cd5\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3057\u305f\u3002<br \/>\n<strong><span style=\"color: #000080;\">\u958b\u982d\u816b\u760d\u6458\u51fa\u8853\u3092\u3059\u308b\u3068\u5316\u5b66\u7642\u6cd5\u306e\u958b\u59cb\u306e\u6642\u671f\u304c\u9045\u308c\u307e\u3059\u3057\uff0c\u305d\u308c\u3092\u5f85\u3063\u3066\u3044\u308b\u9593\u306b\u3082\u518d\u767a\u3057\u3066\u3057\u307e\u3046<\/span><\/strong>\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u307e\u305f\uff0c\u624b\u8853\u3067\u305f\u304f\u3055\u3093\u3068\u3063\u3066\u3082\u6cbb\u308b\u78ba\u7387\u304c\u9ad8\u304f\u306a\u308b\u75c5\u6c17\u3067\u306f\u306a\u3044\u306e\u3067\uff0c\u5229\u76ca\u306f\u3068\u3066\u3082\u5c11\u306a\u3044\u3068\u8a00\u3048\u307e\u3059\u3002\u5b9a\u4f4d\u8133\u624b\u8853\u3067\u306f\u53d6\u308a\u305d\u3053\u306a\u3046\u3053\u3068\u304c\u3042\u308b\u304b\u3089\uff0c\u5c0f\u3055\u306a\u958b\u982d\u624b\u8853\u3092\u3059\u308b\u306b\u3057\u3066\u3082\uff0c\u751f\u691c\u8853\uff08\u307b\u3093\u306e\u5c11\u3057\u3060\u3051\u816b\u760d\u3092\u3064\u307e\u3093\u3067\u75c5\u7406\u8a3a\u65ad\uff09\u3059\u308b\u3060\u3051\u3067\u3059\u3002\u7a4d\u6975\u7684\u306a\u816b\u760d\u6458\u51fa\u306f\u3057\u307e\u305b\u3093\u3002<\/p>\n<h4>\u304b\u306a\u308a\u5e83\u304c\u3063\u305f\u4f8b\u3067\u3082\u6cbb\u7642\u304c\u3067\u304d\u308b<\/h4>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-13178\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt2-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt2-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-13179\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt3-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt3-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt3-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-13180\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt1-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslnt1-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/p>\n<p>\u304b\u306a\u308a\u5e83\u7bc4\u56f2\u306b\u6025\u901f\u306b\u5e83\u304c\u3063\u305f\u4f8b\u3067\u3059\u3002\u8133\u306e\u4ed6\u306e\u60aa\u6027\u816b\u760d\uff0c\u4f8b\u3048\u3070\u81a0\u82bd\u816b\u3084\u8ee2\u79fb\u6027\u8133\u816b\u760d\u3067\u3059\u3068\u3053\u308c\u3060\u3051\u5e83\u304c\u308c\u3070\u6cbb\u308b\u898b\u8fbc\u307f\u304c\u3042\u308a\u307e\u305b\u3093\u3002\u3067\u3082\u30ea\u30f3\u30d1\u816b\u306f\u5316\u5b66\u7642\u6cd5\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u6cbb\u308b\u898b\u8fbc\u307f\u304c\u3042\u308b\u6cbb\u7642\u3092\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002\u8ae6\u3081\u306a\u3044\u3067\u6025\u3044\u3067\u6cbb\u7642\u3092\u958b\u59cb\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/p>\n<\/div>\n<h4 align=\"left\"><span style=\"color: #000080;\"><strong>2021 WHO\u5206\u985e<\/strong> lymphomas<\/span><\/h4>\n<p><span style=\"color: #000080;\"><strong>CNS lymphomas<br \/>\nPrimary diffuse large B-cell lymphoma of the CNS: \u00a0<\/strong><\/span><span style=\"color: #000080;\"><strong>PCNSL\u00a0\u00a0\u4e2d\u67a2\u795e\u7d4c\u539f\u767a\u3073\u307e\u3093\u6027\u5927\u7d30\u80de\u578b<b>B\u7d30\u80de<\/b>\u30ea\u30f3\u30d1\u816b<\/strong><\/span><br \/>\nImmunodefficiency-associated CNS lymphoma<br \/>\n<span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/braintumors\/miscellaneouscnslymphoma\/\"><strong>lymphomatoid granulomatosis (LYG)<\/strong><\/a><\/span><br \/>\n<span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/braintumors\/miscellaneouscnslymphoma\/\"><span style=\"color: #000080;\">Intravasclar large B-cell lymphoma (IVL)<\/span><\/a><\/strong><\/span><\/p>\n<p><span style=\"color: #000080;\"><strong>Micellaneous rare lymphomas in the CNS<\/strong><\/span><br \/>\n<span style=\"color: #000080;\"><strong>\u00a0 \u00a0<a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/braintumors\/miscellaneouscnslymphoma\/\"><span style=\"color: #000080;\">MALT lymphoma of the dura\u3000\u786c\u819c\u30e2\u30eb\u30c8\u30ea\u30f3\u30d1\u816b<\/span><\/a><br \/>\n<\/strong><\/span>\u00a0 \u00a0Other low-grade B-cell lymphoma of the CNS<br \/>\nAnaplastic large cell lymphoma (<em>ALK+\/ALK-<\/em>)<br \/>\nT-cell and NK\/T-cell lymphomas<\/p>\n<p>PCNSL\u3092\u9664\u3051\u3070\u305d\u308c\u305e\u308c\u81e8\u5e8a\u7684\u306a\u7279\u5fb4\u3082\u3042\u308a\u307e\u3059\u3002\u4f8b\u3048\u3070\uff0c\u8840\u7ba1\u5185\u5927\u7d30\u80de\u578bB\u7d30\u80de\u6027\u30ea\u30f3\u30d1\u816b <span style=\"color: #000080;\"><strong>IVL \u306f\u8133\u6897\u585e\u306e\u3088\u3046\u306a\u75c7\u72b6<\/strong><\/span>\u3067\u767a\u75c7\u3057\u307e\u3059\u3002LYG\u306f\u786c\u3044\u8089\u82bd\u7a2e\u3084\u8133\u816b\u760d\u306e\u3088\u3046\u306a\u584a\u3092\u5f62\u6210\u3057\u307e\u3059\u3002\u307e\u305f\u4e00\u65b9\u3067\uff0c<span style=\"color: #000080;\"><strong>\u786c\u819c\u30e2\u30eb\u30c8\u30ea\u30f3\u30d1\u816b\u306fMRI\u8a3a\u65ad\u3067\u306f\u9ac4\u819c\u816b\u3068\u9593\u9055\u3048\u3089\u308c\u308b<\/strong><\/span>\u3082\u306e\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>\u539f\u767a\u6027\u773c\u5185\u30ea\u30f3\u30d1\u816b PIOL primary intraocular lymphoma \u306fPCNSL\u306e\u4e00\u90e8\u5206\u75c7<\/strong><\/span>\u3068\u3057\u3066\u8a8d\u77e5\u3055\u308c\u3066\u3044\u308b\u306e\u3067\uff0c\u5168\u8eab\u306e\u30ea\u30f3\u30d1\u816b\u3068\u306f\u305b\u305aPCNSL\u3068\u8a3a\u65ad\u3057\u307e\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-16068\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya1-300x281.jpg\" alt=\"\" width=\"300\" height=\"281\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya1-300x281.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya1-550x516.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya1.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-16069\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya2-300x278.jpg\" alt=\"\" width=\"300\" height=\"278\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya2-300x278.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya2-550x509.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya2.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u5186\u5f62\u304b\u3089\u6955\u5186\u5f62\u306e\u6838\u816b\u5927\u3092\u4f34\u3046\u7570\u578b\u7d30\u80de\u304c\u3073\u307e\u3093\u6027\u306b\u5897\u6b96\u3057\u3066\u3044\u307e\u3059\u3002\u6838\u306f\u6c34\u6ce1\u72b6\u306e\u3082\u306e\u304c\u76ee\u7acb\u3061\u307e\u3059\u3002\u9ec4\u8272\u306e\u77e2\u5370\u306f\u6838\u5206\u88c2\u50cf\u3092\u793a\u3057\u307e\u3059\u3002\u5927\u7d30\u80de\u6027\u30ea\u30f3\u30d1\u816b large B cell lymphoma \u306e\u7279\u5fb4\u7684\u306aHE\u67d3\u8272\u50cf\u3067\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-16070\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya3-300x292.jpg\" alt=\"\" width=\"300\" height=\"292\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya3-300x292.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya3-550x534.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pcnslya3.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Ki-67\u67d3\u8272\u306b\u3088\u308bMIB-1\u67d3\u8272\u7387\u306f80%\u3092\u8d85\u3048\uff0c\u7d30\u80de\u306e\u5206\u88c2\u5897\u6b96\u304c\u6fc0\u3057\u3044\u3053\u3068\u3092\u793a\u3057\u307e\u3059\u3002\u30ea\u30f3\u30d1\u816b\u5897\u6b96\u306f\u3068\u3066\u3082\u65e9\u304f\uff0c\uff11\u9031\u9593\u5358\u4f4d\u3067MRI\u4e0a\u306e\u816b\u760d\u5897\u5927\u304c\u8a8d\u3081\u3089\u308c\u307e\u3059\u3002<br \/>\nCD20\u967d\u6027\u306eB\u7d30\u80de\u30ea\u30f3\u30d1\u816b\u3067\u3057\u305f\u3002<\/p>\n<h1>\u4e2d\u67a2\u795e\u7d4c\u306e\u7279\u6b8a\u306a\u30ea\u30f3\u30d1\u816b<br \/>\nmiscellaneous rare lymphomas of the CNS<\/h1>\n<ul>\n<li><strong><span style=\"color: #000080;\"><span class=\"style1\">\u773c\u5185\u30ea\u30f3\u30d1\u816b\u306e\u5408\u4f75 : IOL\u00a0<\/span>intraocular lymphoma<\/span><\/strong><\/li>\n<li><strong><span style=\"color: #000080;\">\u786c\u819c\u306e\u30ea\u30f3\u30d1\u816b\uff1aMALT lymphoma of the dura\u3000\u30e2\u30eb\u30c8\u30fb\u30ea\u30f3\u30d1\u816b<\/span><\/strong><\/li>\n<li><strong><span style=\"color: #000080;\">\u8840\u7ba1\u5185\u30ea\u30f3\u30d1\u816b :\u00a0IVL intravasclar large B-cell lymphoma<\/span><\/strong><\/li>\n<li><strong><span style=\"color: #000080;\">\u30ea\u30f3\u30d1\u816b\u69d8\u8089\u82bd\u816b\u75c7 :\u00a0LYG lymphomatoid granulomatosis<\/span><\/strong><\/li>\n<\/ul>\n<h5>\u8133\u795e\u7d4c\u306b\u3067\u304d\u308b\u30ea\u30f3\u30d1\u816b\u3067\u3059\u304c\uff0c\u901a\u5e38\u306ePCNSL\u3068\u306fMRI\u753b\u50cf\u3082\u7570\u306a\u308a\uff0c\u6cbb\u7642\u6cd5\u3082\u7570\u306a\u308b\u3082\u306e\u3067\u3059<\/h5>\n<h3><strong><span class=\"style1\">\u773c\u5185\u30ea\u30f3\u30d1\u816b<\/span><\/strong>\uff08intraocular lymphoma, IOL)<\/h3>\n<ul>\n<li>\u3053\u308c\u306f\u901a\u5e38\u306elarge B-cell lymphoma\u3067\u3059<\/li>\n<li>\u7247\u773c\u306e\u6bd4\u8f03\u7684\u306b\u6025\u901f\u306a\u8996\u529b\u4f4e\u4e0b\u3067\u767a\u75c7\u3057\uff0c<span style=\"color: #ff0000;\"><strong>\u3076\u3069\u3046\u819c\u708e<\/strong> <\/span>uveitis\u3068\u985e\u4f3c\u3057\u305f\u75c7\u72b6\u3067\u3042\u308b\u306e\u3067\uff0c\u3076\u3069\u3046\u819c\u708e\u3068\u8a3a\u65ad\u3055\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u539f\u767a\u6027\u773c\u5185\u30ea\u30f3\u30d1\u816b PIOL primary intraocular lymphoma \u306fPCNSL\u306e\u4e00\u90e8\u5206\u75c7\u3068\u3057\u3066\u8a8d\u77e5\u3055\u308c\u3066\u3044\u308b\u306e\u3067\uff0c\u773c\u5185\u30ea\u30f3\u30d1\u816b\u304c\u3042\u3063\u3066\u3082\u5168\u8eab\u306e\u30ea\u30f3\u30d1\u816b\u3068\u306f\u305b\u305a\uff0cPCNSL\u3068\u8a3a\u65ad\u3057\u307e\u3059<\/li>\n<li>\u30b9\u30c6\u30ed\u30a4\u30c9\u6cbb\u7642\u3067\u5bdb\u89e3\u304c\u5f97\u3089\u308c\u308b\u3053\u3068\u304c\u3042\u308a\uff0c\u773c\u5185\u751f\u691c\u624b\u8853\u3092\u3055\u308c\u3066\u3044\u306a\u3044\u5834\u5408\u306b\u306f\u78ba\u5b9a\u8a3a\u65ad\u304c\u3064\u304b\u306a\u3044\u307e\u307e\uff0c\u3076\u3069\u3046\u819c\u708e\u306e\u65e2\u5f80\u3068\u3057\u3066\u6b8b\u308b\u306e\u307f\u3067\u3042\u308b\u306e\u3067\uff0cPCNSL\u306e\u60a3\u8005\u3055\u3093\u306e\u75c5\u6b74\u3092\u3068\u3063\u3066\u3044\u308b\u3068\uff0c\u3076\u3069\u3046\u819c\u708e\u3068\u8a00\u308f\u308c\u305f\u3068\u3044\u3046\u3088\u3046\u306a\u8a34\u3048\u3092\u805e\u304f\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u307e\u305f\u8133\u75c5\u5909\u3068\u540c\u6642\u306b\u9032\u884c\u3059\u308b\u3053\u3068\u3082\u591a\u3044\u3057\uff0c\u5408\u4f75\u983b\u5ea6\u304c\u9ad8\u3044\u306e\u3067PCNSL\u3092\u7591\u3046\u5834\u5408\u306b\u306f\u773c\u79d1\u3067\u306e\u691c\u67fb\u3082\u5fc5\u8981\u3067\u3059<\/li>\n<li>\u5b64\u767a\u6027\u306ePIOL\u306a\u3089\u3070\u773c\u5185\u5c40\u6240\u7642\u6cd5\uff08\u5236\u304c\u3093\u5264\u6ce8\u5165 intravitreal methotrexate\uff0c\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642 ocular radiotherapy\uff09\u306a\u3069\u7279\u6709\u306e\u6cbb\u7642\u6cd5\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u8133\u75c5\u5909\u3068\u5408\u4f75\u3059\u308b\u5834\u5408\u306b\u306f\u307e\u305a\u306fPCNSL\u306b\u6e96\u3058\u305f\u6cbb\u7642\u6cd5\u3092\u3057\u307e\u3059<\/li>\n<li>Grimm\u3089\u306e\u773c\u5185\u75c5\u5909\u3092\u5408\u4f75\u3057\u305f221\u4f8b\u306ePCNSL\u306e\u5831\u544a\u3067\u306f\uff0c\u773c\u5185\u5358\u72ec\u3067\u518d\u767a\u304c\u751f\u3058\u308b\u5834\u5408\u306f20%\u3067\uff0c\u773c\u5185\u75c5\u5909\u3078\u306e\u5c40\u6240\u6cbb\u7642\u3092\u52a0\u3048\u305f\u5834\u5408\u306b\u5c40\u6240\u5236\u5fa1\u7387\u306f\u3088\u3044\u304c\uff0c\u5168\u751f\u5b58\u5272\u5408 OS \u306f\u5c40\u6240\u6cbb\u7642\u3092\u52a0\u3048\u306a\u3044\u7fa4\u3068\u306e\u5dee\u304c\u306a\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<\/ul>\n<h3>\u786c\u819c\u306e\u30ea\u30f3\u30d1\u816b\uff1a<span style=\"color: #333333;\">MALT lymphoma of the dura\u3000\u30e2\u30eb\u30c8\u30fb<\/span><span style=\"color: #333333;\">\u30ea\u30f3\u30d1\u816b<\/span><\/h3>\n<ul>\n<li>\u786c\u819c\u304b\u3089\u767a\u751f\u3059\u308b\u30ea\u30f3\u30d1\u816b\u304c\u77e5\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u6210\u4eba\u5973\u6027\u306b\u591a\u3044\u50be\u5411\u304c\u3042\u308a\u307e\u3059\uff0c\u7537\u6027\u306e\uff15\u500d<\/li>\n<li>\u6d78\u6f64\u6027\u306e<span style=\"color: #000080;\"><strong><span style=\"color: #ff0000;\">\u9ac4\u819c\u816b<\/span><\/strong><span style=\"color: #333333;\">\u3084<\/span><strong>\u30ac\u30f3\u306e\u786c\u819c\u8ee2\u79fb\u3068\u8aa4\u8a3a\u3055\u308c\u308b<\/strong><\/span>\u3088\u3046\u306a\u753b\u50cf\u6240\u898b\u3067\u3059<\/li>\n<li>\u786c\u819c\u306e\u80a5\u539a plaque \u306e\u307f\u304c\u521d\u898b\u306e\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u4e3b\u3068\u3057\u3066\u786c\u819c\u4e0b\u306b\u816b\u7624\u5f62\u6210\u3057\u307e\u3059<\/li>\n<li>\u5468\u8fba\u8133\u7d44\u7e54\u306b\u6d78\u6f64\u3057\u3066\uff0c\u8133\u6d6e\u816b\u6240\u898b\u3092\u4f34\u3044\u307e\u3059<\/li>\n<li>MALT\u30ea\u30f3\u30d1\u816b (marginal zone lymphoma) \u304c\u307b\u3068\u3093\u3069\u3067\uff0cB\u7d30\u80de\u30ea\u30f3\u30d1\u816b\u306f\u307e\u308c\u3067\u3059<\/li>\n<li>\u8133\u306ePCNSL\u3088\u308a\u306f\uff0c\u6bd4\u8f03\u7684\u306b\u3086\u3063\u304f\u308a\u5927\u304d\u304f\u306a\u308b\u30ea\u30f3\u30d1\u816b\u3067\u3059<\/li>\n<li>MIB-1 index\u306f5%\u4ee5\u4e0b\u304c\u591a\u3044\u3067\u3059\uff0c\u975e\u5b9a\u578b\u9ac4\u819c\u816b grade II \u3088\u308a\u4f4e\u3044\u304f\u3089\u3044\u3067\u3059<\/li>\n<li>\u816b\u760d\u90e8\u5206\u6458\u51fa\/\u751f\u691c\u8853\u3068\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u3060\u3051\u3067\uff0c5\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u304c80%\u4ee5\u4e0a\u3068\u306a\u308b\u4e88\u5f8c\u306e\u826f\u3044\u30ea\u30f3\u30d1\u816b\u3067\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u3082\u4f4e\u7dda\u91cf\u3067\u6cbb\u7652\u304c\u671f\u5f85\u3067\u304d\u308b\u3068\u3044\u3046\u5831\u544a\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u4ed6\u306e\u81d3\u5668\u3067\u306e\u518d\u767a\u4f8b\u306f\u3042\u308a\u307e\u3059\u304c\uff0c\u786c\u819c\u30ea\u30f3\u30d1\u816b\u306b\u306f\u7121\u7406\u306a\u5316\u5b66\u7642\u6cd5\u3084\u5168\u8133\u7167\u5c04\u306f\u3057\u307e\u305b\u3093<\/li>\n<\/ul>\n<h3>\u8840\u7ba1\u5185\u30ea\u30f3\u30d1\u816b :\u00a0IVL intravasclar large B-cell lymphoma<\/h3>\n<ul>\n<li>\u30ea\u30f3\u30d1\u816b\u7d30\u80de\u304c\u8840\u7ba1\u306e\u5185\u90e8\u3067\u5897\u3048\u308b\u8840\u6db2\u816b\u760d\u3067\u3059<\/li>\n<li>IVL\u306e\u60a3\u8005\u3055\u3093\u306e\uff18\u5272\u304f\u3089\u3044\u306b\u8133\u75c5\u5909\u304c\u751f\u3058\u307e\u3059<\/li>\n<li>\u305d\u306e\u305f\u3081\uff0c\u8133\u8840\u7ba1\u9589\u585e\u304c\u751f\u3058\u3066\uff0c<span style=\"color: #000080;\"><strong>\u8133\u6897\u585e\u3067\u767a\u75c7\u3057\u307e\u3059<\/strong><\/span><\/li>\n<li>\u62e1\u6563\u5f37\u8abf\u753b\u50cf DWI\u3067\u9ad8\u4fe1\u53f7\u3068\u306a\u308a\u307e\u3059<\/li>\n<li>\u521d\u767a\u3067\u306f<span style=\"color: #000080;\"><strong>\u8133\u6897\u585e\u3068\u8aa4\u8a3a\u3055\u308c\u308b\u3053\u3068\u304c\u307b\u3068\u3093\u3069<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u3082\u3057\u304f\u306f\u6d6e\u816b\u6027\u5909\u5316\u304c\u5f37\u3044\u3082\u306e\u3067\uff0c\u4e9c\u6025\u6027\u8133\u708e subacute encephalopathy\u306b\u985e\u4f3c\u3057\u307e\u3059<\/li>\n<li>\u4e00\u5ea6\u53ce\u7e2e\u3057\u3066\u6cbb\u3063\u3066\u3082\uff0c\u307e\u305f\u9055\u3063\u305f\u90e8\u4f4d\u306b\u518d\u71c3\u3057\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u8133\u6897\u585e\u3067\u5165\u9662\u3057\u3066\uff0c\u307e\u305f\u8133\u6897\u585e\u304c\u518d\u767a\u3057\u305f\u3068\u3044\u3046\u7d4c\u904e\u3092\u305f\u3069\u308b<\/strong><\/span>\u60a3\u8005\u3055\u3093\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u75c5\u7406\u8a3a\u65ad\u306f\uff0c\u30ea\u30f3\u30d1\u816b\u306e\u3044\u308b\u8840\u7ba1\u3092\u63a1\u53d6\u3057\u306a\u3044\u3068\u78ba\u5b9a\u306b\u81f3\u308a\u307e\u305b\u3093<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u751f\u691c\u8853\u3067\u8a3c\u660e\u3067\u304d\u306a\u3044\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u8840\u7ba1\u5185\u306b\uff0clarge atypical B-cells\u304c\u5897\u6b96<\/strong><\/span>\u3057\u307e\u3059<\/li>\n<li>\u6cbb\u7642\u306fPCNSL\u306b\u6e96\u3058\u308b\u3082\u306e\u3067\u3059<\/li>\n<li>R-CHOP \u3068MTX, cytarabine, prednisolone\u306e\u9ac4\u6ce8\uff0c\u8840\u7ba1\u5185\u30d8\u30d1\u30ea\u30f3\u6295\u4e0e\u306e\u4f75\u7528\uff08\u8840\u7ba1\u9589\u585e\u4e88\u9632\uff09\u306a\u3069\u306e\u5831\u544a\u304c\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<h4>\u76ae\u819a\u75c5\u5909\u3067\u8a3a\u65ad\u3055\u308c\u3066\u3044\u305f\u60a3\u8005\u3055\u3093\u306e\u540c\u6642\u591a\u767a\u6027\u8133\u75c5\u5909<\/h4>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-12547\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/ivl1-300x158.jpg\" alt=\"\" width=\"300\" height=\"158\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/ivl1-300x158.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/ivl1-768x405.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/ivl1-550x290.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/ivl1.jpg 1476w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><br \/>\n60\u4ee3\u5973\u6027\u3067\uff0c\u76ae\u819a\u7d50\u7bc0\u304cB cell lymphoma (neoplastic angioendotheliosis)\u304c\u3042\u308a\u307e\u3057\u305f\u3002\uff11\u5e74\u5f8c\u306b\u6025\u6027\u306e\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\u3068\u6b69\u884c\u969c\u5bb3\u304c\u3042\u308aMRI\u3067\u767a\u898b\u3055\u308c\u305f\u3082\u306e\u3067\u3059\u3002SPECT, PET\u691c\u67fb\u3067\u306f\u591a\u767a\u6027\u865a\u8840\u6027\u75c5\u5909\u3067\u3059\u3002\u751f\u691c\u624b\u8853\u3067IVL\u306e\u8a3a\u65ad\u304c\u5f97\u3089\u308c\u307e\u3057\u305f\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-12548\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/ivl12-300x170.jpg\" alt=\"\" width=\"300\" height=\"170\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/ivl12-300x170.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/ivl12-768x436.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/ivl12-550x312.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/ivl12.jpg 1181w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><br \/>\n\u5de6\u306f\u767a\u75c7\u6642\uff0c\u53f3\u306fCHOP\u5316\u5b66\u7642\u6cd51\u30b3\u30fc\u30b9\u5f8c\u306eT2\u5f37\u8abf\u753b\u50cf\u3067\u3059\u3002\u5316\u5b66\u7642\u6cd5\u3067\u5bdb\u89e3\u3057\u307e\u3057\u305f\u3002<\/p>\n<h3>\u30ea\u30f3\u30d1\u816b\u69d8\u8089\u82bd\u816b\u75c7 :\u00a0LYG lymphomatoid granulomatosis<br \/>\nALPD angiocentric lymphoproliferative disorder<\/h3>\n<ul>\n<li>\u6ef2\u3080\u69d8\u306b\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u75c5\u5909\u3067\u3059<\/li>\n<li>\u5468\u56f2\u306b\u8133\u6d6e\u816b\u3092\u4f34\u3044\uff0c\u9ac4\u819c\u6d78\u6f64\u304c\u307f\u3089\u308c\uff0cmass effect\u3092\u6709\u3059\u308b\u69d8\u306a\u75c5\u5909\u3067\u306f\u5185\u90e8\u306b\u58ca\u6b7b\u50cf\u3092\u4f34\u3044\u307e\u3059<\/li>\n<li>\u5358\u767a\u306e\u3053\u3068\u304c\u591a\u3044\u306e\u3067\u3059\u304c\uff0c\u591a\u767a\u6027\u8133\u75c5\u5909\u3068\u306a\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>diffuse large B-cell lymphoma\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u80ba\u306b\u6700\u3082\u591a\u304f\u3066\uff0c\u6b21\u3044\u3067\u4e2d\u67a2\u795e\u7d4c\uff0c\u814e\u81d3\uff0c\u76ae\u819a\uff0c\u809d\u81d3\u306a\u3069\u306b\u591a\u767a\u3057\u307e\u3059<\/li>\n<li>\u4e21\u5074\u306e\u80ba\u306b\u7d50\u7bc0\u3068\u6d78\u6f64\u50cf\u304c\u898b\u3089\u308c\u307e\u3059<\/li>\n<li>\u8840\u7ba1\u4e2d\u5fc3\u6027 angiocentric\uff0c\u8840\u7ba1\u7834\u58ca\u6027 angiodestructive \u306b\u7570\u578b\u7d30\u80de\u304c\u6d78\u6f64\u3057\u307e\u3059<\/li>\n<li>\u514d\u75ab\u4e0d\u5168\u306e\u60a3\u8005\u3055\u3093\u306b\u591a\u3044\u3067\u3059<\/li>\n<li>\u539f\u56e0\u3068\u3057\u3066\uff0cEpstein Bar virus\u611f\u67d3\u304c\u7591\u308f\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u4e88\u5f8c\u304c\u826f\u3044\u3082\u306e\u3068\u4e0d\u826f\u306a\u3082\u306e\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u5358\u767a\u6027\u306e\u3082\u306e\u3067\u306f\u81ea\u7136\u5bdb\u89e3\u3059\u308b\u3082\u306e\u3082\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<h4>\u591a\u767a\u6563\u5728\u6027\u75c5\u5909\u4f8b<\/h4>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lyg1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-12537\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lyg1-300x165.jpg\" alt=\"\" width=\"300\" height=\"165\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lyg1-300x165.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lyg1-768x424.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lyg1-550x303.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lyg1.jpg 1476w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\n50\u4ee3\u7537\u6027\uff0c\u75d9\u6027\u56db\u80a2\u9ebb\u75fa\u306b\u3088\u308b\u6b69\u884c\u969c\u5bb3\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u591a\u6570\u306e\u6563\u8ca1\u6027\u75c5\u5909\u3092\u5448\u3059\u308b\u30bf\u30a4\u30d7\u3067\u3059\u3002<\/p>\n<h4>\u5358\u767a\u30fb\u518d\u767a\u4f8b<\/h4>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-12540\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy1-300x153.jpg\" alt=\"\" width=\"300\" height=\"153\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy1-300x153.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy1-768x391.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy1-550x280.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy1.jpg 1476w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\n\u65e2\u5f80\u306b\u4e21\u80ba\u91ce\uff0c\u76ae\u819a\u75c5\u5909\u304c\u3042\u3063\u305f50\u4ee3\u5973\u6027\u304c\uff0c\u53f3\u7247\u9ebb\u75fa\u3068\u5c0f\u8133\u5931\u8abf\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u78ba\u5b9a\u8a3a\u65ad\u306e\u305f\u3081\u306b\u751f\u691c\u624b\u8853\u3092\u3057\u307e\u3057\u305f\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-12541\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy2-300x237.jpg\" alt=\"\" width=\"300\" height=\"237\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy2-300x237.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy2-768x608.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy2-550x435.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy2.jpg 787w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-12542\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy3-300x215.jpg\" alt=\"\" width=\"300\" height=\"215\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy3-300x215.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy3-768x550.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy3-550x394.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy3.jpg 787w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<p>\u8840\u7ba1\u58c1\u3092\u7834\u58ca\u3057\uff0c\u8133\u5b9f\u8cea\u5185\u306b\u6d78\u6f64\u50cf\u304c\u898b\u3089\u308c\u307e\u3059\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-large wp-image-12543\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy4-550x260.jpg\" alt=\"\" width=\"550\" height=\"260\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy4-550x260.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy4-300x142.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy4-768x362.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy4.jpg 1000w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/p>\n<p>\u5de6\u304b\u3089\u9806\u306b\uff0cL26, UCHL-1, CD69-KP-1\u67d3\u8272\u3067\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-12545\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy5-300x176.jpg\" alt=\"\" width=\"300\" height=\"176\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy5-300x176.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy5-768x450.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy5-550x322.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/02\/lygyy5.jpg 1476w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\n\u8133\u5e79\u90e8\u75c5\u5909\u306f\u5c40\u6240\u7167\u5c04\u3067\u6d88\u5931\u3057\u307e\u3057\u305f\u304c\uff0c\uff12\u5e74\u5f8c\u306b\u53f3\u982d\u9802\u90e8\u306b\u518d\u767a\u3057\u307e\u3057\u305f\u3002<\/p>\n<h4>\u6587\u732e<\/h4>\n<ul>\n<li>de la Fuente MI: Marginal\u00a0zone\u00a0dural\u00a0lymphoma: the\u00a0Memorial\u00a0Sloan\u00a0Kettering\u00a0Cancer\u00a0Center\u00a0and University of Miami experiences.\u00a0Leuk\u00a0Lymphoma.\u00a02017<\/li>\n<li>Grimm SA, et al.: Prmary CNS lymphoma with intraocular ivolvement: International PCNSL Collaborative Group Report. Neurology 71, 2008<\/li>\n<li>Katzenstein AL, et al: Lymphomatoid granulomatosis: insights gained over 4 decades. Am J Surg Pathol. 2010<\/li>\n<li><span class=\"highlight\">Nizamutdinov D, et al.: Intravascular<\/span> <span class=\"highlight\">Lymphoma<\/span> in the CNS: Options for Treatment.\u00a0<span role=\"menubar\">Curr Treat Options Neurol.<\/span> 2017<\/li>\n<li>Puri DR: Low-dose and limited-volume radiotherapy alone for primary\u00a0dural\u00a0marginal\u00a0zone\u00a0lymphoma: treatment approach and review of published data.\u00a0Int J Radiat Oncol Biol Phys.\u00a02008<\/li>\n<\/ul>\n<h5>\u6587\u732e\u60c5\u5831<\/h5>\n<h5>\u3082\u306e\u3059\u3054\u304f\u305f\u304f\u3055\u3093\u306e\u6587\u732e\u304c\u3042\u308b\u306e\u3067\u3059\u304c\uff0c2017\u5e74\u307e\u3067\u306b\u7121\u4f5c\u70ba\u8a66\u9a13\u3068\u3044\u3046\u306e\u306f\uff13\u3064\u3057\u304b\u306a\u304f\u3066\uff0c\u81e8\u5e8a\u7b2c\uff13\u76f8\u8a66\u9a13\u306e\u7d50\u679c\u3068\u3044\u3046\u306e\u306f\uff11\u3064\u3057\u304b\u3042\u308a\u307e\u305b\u3093\u306e\u3067\u60d1\u308f\u3055\u308c\u306a\u3044\u3067\u304f\u3060\u3055\u3044<\/h5>\n<h4>\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e\u52b9\u679c\u306f\u306a\u3044<\/h4>\n<p class=\"heading-title\">Mishima K: Randomized phase III study of high-dose methotrexate and whole-brain radiotherapy with\/without temozolomide for newly diagnosed primary CNS lymphoma: JCOG1114C. Neuro Oncol 2023<br \/>\n\u65e5\u672c\u3067\u884c\u308f\u308c\u305f\u7b2c3\u76f8\u8a66\u9a13\u3067\u3059\u3002\u5927\u91cfMTX\u5316\u5b66\u7642\u6cd5\u3068\u5168\u813330Gy\u3068boost\u306e\u6a19\u6e96\u6cbb\u7642\u306b\u52a0\u3048\u3066\uff0c\u7dad\u6301\u7642\u6cd5\u3068\u3057\u3066\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u30922\u5e74\u9593\u6295\u4e0e\u306e\u6709\u7121\u306e\u52b9\u679c\u304c\u8a66\u9a13\u3055\u308c\u307e\u3057\u305f\u3002\u5bfe\u8c61\u306f122\u4eba\u3067\u3059\u3002\u4e2d\u9593\u89e3\u6790\u3067\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u52a0\u3048\u306a\u3044\u7fa4\u306e\u5168\u751f\u5b58\u5272\u5408OS\u306f86.8%\uff0c\u52a0\u3048\u308b\u306871.4%\u3067\u3057\u305f\u3002\u6cbb\u9a13\u306f\u4e2d\u65ad\u3055\u308c\u307e\u3057\u305f\u3002<\/p>\n<h4><strong>2022\u5e74\u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3<\/strong><\/h4>\n<p class=\"heading-title\">Hoang-Xuan K: European Association of Neuro-Oncology (EANO) guidelines for treatment of primary central nervous system lymphoma (PCNSL) Neuro Oncol 2023<br \/>\n\u524d\u56de\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3068\u306e\u4e3b\u305f\u308b\u5909\u66f4\u306f\uff0c\u521d\u671f\u6cbb\u7642\u306b\u304a\u3044\u3066\u306eASCT \u5e79\u7d30\u80de\u79fb\u690d\u306b\u3088\u308b consolidation\u304c\u78ba\u8a8d\u3055\u308c\u305f\u3053\u3068\uff0c\u82e5\u5e74\u8005\u3068\u9ad8\u9f62\u8005\u3067\u306f\u5316\u5b66\u7642\u6cd5\u3092\u4f7f\u3044\u5206\u3051\u308b\u3053\u3068\uff0c\u30ea\u30c4\u30ad\u30b7\u30de\u30d6\u306e\u6709\u7528\u6027\u304c\u306f\u3063\u304d\u308a\u3057\u3066\u6765\u305f\u3053\u3068\u3067\u3059\u3002<\/p>\n<h4><strong>2021\u5e74\u306e\u7dcf\u8ad6<\/strong><\/h4>\n<p class=\"heading-title\"><span class=\"authors-list-item \">Schaff LR:\u00a0<\/span>Primary Central Nervous System Lymphoma, Blood 2021<br \/>\n5\u5e74\u751f\u5b58\u5272\u5408\u306f\uff0c\u3053\u306e\u6642\u70b9\u3067\u308230-40%\u3068\u3057\u3066\u3044\u307e\u3059\u3002\u65b0\u305f\u306a\u6cbb\u7642\u85ac\u5019\u88dc\u3068\u3057\u3066\uff0c<strong>\u30a4\u30d6\u30eb\u30c1\u30cb\u30d6<\/strong> ibrutinib (the Bruton Tyrosine Kinase (BTK) inhibitor)\u00a0\u3084\u30ec\u30ca\u30ea\u30c9\u30df\u30c9lenalidomide\u3068\u30dd\u30de\u30ea\u30c9\u30de\u30a4\u30c9 pomalidomide (immunomodulatory drugs (IMiDs) \u3092\u6319\u3052\u3066\u3044\u307e\u3059\u3002\u3053\u308c\u3089\u306e\u85ac\u5264\u306f\uff0c\u518d\u767a\u3057\u305fPCNSL\u306b\u5bfe\u3057\u3066\u306e\u5831\u544a\u306f\u3042\u308a\u307e\u3059\u304c\uff0c\u3044\u307e\u3060\u7121\u4f5c\u70ba\u7b2c3\u76f8\u8a66\u9a13\u306e\u7d50\u679c\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<h4><strong>\u4e2d\u67a2\u795e\u7d4c\u3078\u8ee2\u79fb\u3057\u305f secondary CNS lymphoma\u306e\u6cbb\u7642<\/strong><\/h4>\n<p class=\"article-header__title smaller\">Ferreri AJM: MATRix\u2013RICE therapy and autologous haematopoietic stem-cell transplantation in diffuse large B-cell lymphoma with secondary CNS involvement (MARIETTA): an international, single-arm, phase 2 trial. Lancet Haematol 2021<br \/>\n\u5316\u5b66\u514d\u75ab\u7642\u6cd5\u306b\u81ea\u5bb6\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u3092\u52a0\u3048\u305f\u6cbb\u7642\u304c\u8a66\u307f\u3089\u308c\u307e\u3057\u305f\u3002\u4e2d\u67a2\u795e\u7d4c\u306b\u8ee2\u79fb\u3057\u305f\u5927\u7d30\u80deB\u7d30\u80de\u30ea\u30f3\u30d1\u816b\u304c\u5bfe\u8c61\u3067\u3059\u30023\u30b3\u30fc\u30b9\u306erituximab,\u00a0methotrexate,\u00a0cytarabine,\u00a0thiotepa\u5316\u5b66\u7642\u6cd5\uff0c\u6b21\u3044\u30673\u30b3\u30fc\u30b9\u306erituximab,\u00a0etoposide,\u00a0ifosfamide,\u00a0carboplatin\u304c\u6295\u4e0e\u3055\u308c\uff0c\u5730\u56fa\u3081\u7642\u6cd5\u3068\u3057\u3066\u00a0carmustine-thiotepa\u3068autologous HSCT\u304c\u52a0\u3048\u3089\u308c\u307e\u3057\u305f\u300275\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u8a55\u4fa1\u3055\u308c\uff0c1\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f58%\uff0842\u540d\uff09\u3067\u3057\u305f\u3002\u8ee2\u79fb\u6027\u306e\u4e2d\u67a2\u795e\u7d4c\u7cfb\u30ea\u30f3\u30d1\u816b\u306e\u4e88\u5f8c\u306f\u6975\u3081\u3066\u4e0d\u826f\u306a\u306e\u3067\uff0c\u6cbb\u7642\u6210\u7e3e\u3068\u3057\u3066\u306f\u304b\u306a\u308a\u826f\u3044\u6210\u7e3e\u3067\u3042\u308b\u3068\u8a55\u4fa1\u3055\u308c\u307e\u3059\u3002\u3057\u304b\u3057\uff0c\u9aa8\u9ac4\u6291\u5236\u306a\u3069\u306e\u6709\u5bb3\u4e8b\u8c61\u304c\u304b\u306a\u308a\u304d\u3064\u3044\u306e\u3067\uff0c4\u4eba\u304c\u6cbb\u7642\u95a2\u9023\u611f\u67d3\u75c7\u3067\u4ea1\u304f\u306a\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4>\u30c1\u30e9\u30d6\u30eb\u30c1\u30cb\u30d6 Tirabrutinib\u306e\u7b2c1\u22122\u76f8\u8a66\u9a13\u306e\u7d50\u679c<\/h4>\n<p class=\"heading-title\">Narita Y: Phase 1\/2 Study of Tirabrutinib, a Second-Generation Bruton&#8217;s Tyrosine Kinase Inhibitor, in Relapsed\/Refractory Primary Central Nervous System Lymphoma. Neuro Oncol 2020<br \/>\n44\u4eba\u306e\u518d\u767a\u307e\u305f\u306f\u96e3\u6cbb\u6027PCNSL\u306b\u5bfe\u3059\u308b\u8a66\u9a13\u306e\u7d50\u679c\u3067\u3059\u3002\u7b2c\uff12\u76f8\u3068\u3057\u3066\u306f\u30c1\u30e9\u30d6\u30eb\u30c1\u30cb\u30d6 480mg\u304c\u9023\u65e5\u7d4c\u53e3\u6295\u4e0e\u3055\u308c\u307e\u3057\u305f\u3002\u594f\u529f\u5272\u540864%\uff0c\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f2.9\u6708\u3067\u3057\u305f\u3002<\/p>\n<h4>\u30c1\u30aa\u30c6\u30d1 thiotepa \u304c\u60aa\u6027\u30ea\u30f3\u30d1\u816b\u306e\u6cbb\u7642\u306b\u4f7f\u7528\u3067\u304d\u308b\u3088\u3046\u306b\u306a\u308a\u307e\u3057\u305f<\/h4>\n<p>2020\u5e743\u6708\uff0c\u300c\u30ea\u30b5\u30a4\u30aa<sup>\u00ae<\/sup>\u70b9\u6ef4\u9759\u6ce8\u6db2100mg\u300d\uff08\u30c1\u30aa\u30c6\u30d1\uff09\u304c\u300c\u60aa\u6027\u30ea\u30f3\u30d1\u816b\u306b\u304a\u3051\u308b\u81ea\u5bb6\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u306e\u524d\u6cbb\u7642\u300d\u306b\u4f7f\u7528\u3067\u304d\u308b\u3088\u3046\u306b\u306a\u308a\u307e\u3057\u305f\u3002\u30d6\u30b9\u30eb\u30d5\u30a1\u30f3\u3068\u306e\u4f75\u7528\u306b\u304a\u3044\u3066\u8a8d\u3081\u3089\u308c\u307e\u3059\u3002<\/p>\n<h4>60\u6b73\u4ee5\u4e0b\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\u5168\u8133\u7167\u5c04\u3092\u907f\u3051\u3066ASCT\u3067\u6cbb\u7642\u3067\u304d\u308b<\/h4>\n<p class=\"heading-title\">Houillier C: Radiotherapy or Autologous Stem-Cell Transplantation for Primary CNS Lymphoma in Patients 60 Years of Age and Younger: Results of the Intergroup ANOCEF-GOELAMS Randomized Phase II PRECIS Study. J Clin Oncol 2019<br \/>\n60\u6b73\u4ee5\u4e0b\u306e\u60a3\u8005\u3055\u3093\u3067\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\uff0cR-MBVP (rituximab, methotrexate 3 g\/m<sup>2,\u00a0<\/sup>VP16, BCNU, prednisone)\u3068R-AraC (rituximab, cytarabine)\u304c\u7528\u3044\u3089\u308c\uff0c\u305d\u306e\u5f8c\u306eASCT\u306b\u3088\u308b\u5927\u91cf\u5316\u5b66\u7642\u6cd5 (thiotepa, busulfan, cyclophosphamide)\u3068\u5168\u8133\u7167\u5c0440Gy\u306e\u52b9\u679c\u304c\u6bd4\u8f03\u3055\u308c\u307e\u3057\u305f\u30022\u5e74PFS\u306f\uff0c\u5168\u8133\u7167\u5c04\u306763%\uff0cASCT\u306e\u5730\u56fa\u3081\u7642\u6cd5\u306787%\u3067\u3057\u305f\u3002\u4e21\u30a2\u30fc\u30e0\u5171\u306b\u3082\u306e\u3059\u3054\u304f\u6cbb\u7642\u4fb5\u8972\u306e\u9ad8\u3044\u6cbb\u7642\u6cd5\u304c\u6bd4\u8f03\u691c\u8a0e\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u65e5\u672c\u3067\u306f\u96e3\u3057\u3044\u3067\u3057\u3087\u3046\u3002<\/p>\n<h4>\u65e5\u672c\u304b\u3089\u306e\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u5e79\u7d30\u80de\u79fb\u690d\u306e\u5831\u544a<\/h4>\n<p><span class=\"highlight\">Kondo E:\u00a0<\/span>High-Dose Chemotherapy with Autologous Stem Cell Transplantation in Primary Central Nervous System <span class=\"highlight\">Lymphoma<\/span>: Data From the Japan Society for Hematopoietic Cell Transplantation Registry.\u00a0<span role=\"menubar\">Biol Blood Marrow Transplant.<\/span> 2019<br \/>\n102\u4f8b\u306ePCNSL\u306e\u60a3\u8005\u3055\u3093\u304c\u6cbb\u7642\u3055\u308c\uff0cupfront\u3068salvage\u3067\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u304c\u7528\u3044\u3089\u308c\u305f\u306e\u3067\u3059\u304c\uff0cOS, PFS\u306b\u5dee\u306f\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u5168\u4f53\u3067\u306f5\u5e74\u5168\u751f\u5b58\u5272\u540855%\uff0c\u7121\u5897\u60aa\u751f\u5b5838%\u3067\u3057\u305f\u3002Thiotepa\u3092\u542b\u3080\u30ec\u30b8\u30e1\u30f3\u306e\u65b9\u304c\u6709\u7528\u6027\u304c\u9ad8\u3044\u3068\u5f37\u8abf\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4>CAR-T\u304c\u518d\u767aPCNSL\u306b\u6709\u52b9\u3060\u3063\u305f<\/h4>\n<p class=\"heading-title\"><span class=\"authors-list-item \">Abramson JS:\u00a0<\/span>Anti-CD19 CAR T Cells in CNS Diffuse Large-B-Cell Lymphoma. N Engl J Med 2017<br \/>\n<span class=\"docsum-authors full-authors\">Zhou TS:\u00a0<\/span>CD19 and CD70 Dual-Target Chimeric Antigen Receptor T-Cell Therapy for the Treatment of Relapsed and Refractory Primary Central Nervous System Diffuse Large B-Cell Lymphoma. <span class=\"docsum-journal-citation full-journal-citation\">Front Oncol. 2019<br \/>\n<\/span>\u75c7\u4f8b\u5831\u544a\u3067\u3059\u3002\u9ad8\u984d\u533b\u7642\u3067\u8a71\u984c\u3068\u306a\u3063\u305f\u30ad\u30e1\u30e9\u6297\u539f\u53d7\u5bb9\u4f53\u3092\u5229\u7528\u3059\u308b CAR-T\u3068\u3044\u3046\u6cbb\u7642\u6cd5\u3067\u3059\u3002\u518d\u767a\u3057CD-19\u3092\u767a\u73fe\u3057\u3066\u3044\u308bPCNSL\u306b\u5bfe\u3057\u3066CAR-T\u6cbb\u7642\u304c\u306a\u3055\u308c\uff0c\u5bdb\u89e3\u304c\u5f97\u3089\u308c\u305f\u3068\u306e\uff12\u3064\u306e\u5831\u544a\u3067\u3059\u3002CAR-T\u306f\uff0c\u6709\u5bb3\u4e8b\u8c61\u3068\u3057\u3066cytokine release syndrome (CRS) \u3084 CART-related encephalopathy syndrome (CRES)\u304c\u751f\u3058\u308b\u3053\u3068\u304c\u3042\u308a\u8133\u306e\u30ea\u30f3\u30d1\u816b\u6cbb\u7642\u306b\u306f\u9069\u3055\u306a\u3044\u3068\u3055\u308c\u3066\u6765\u307e\u3057\u305f\u3002\u3053\u306e\u6cbb\u7642\u304c\u6709\u52b9\u304b\u3069\u3046\u304b\u306f\u307e\u3060\u4e0d\u660e\u3067\u3059\u3002<\/p>\n<h4>70\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u306e\u751f\u5b58\u671f\u9593\u306f\u3053\u306e40\u5e74\u9593\u3067\u6539\u5584\u3055\u308c\u3066\u3044\u306a\u3044<\/h4>\n<p>Mendez JS:\u00a0The elderly left behind &#8211; changes in survival trends of primary central nervous system\u00a0lymphoma\u00a0over the past four decades. Neuro Oncol.\u00a02017<br \/>\n70\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u306e\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f\uff0c1970\u5e74\u4ee3\u30676\u30f6\u6708\uff0c2010\u5e74\u4ee3\u30677\u30f6\u6708\u3060\u305d\u3046\u3067\u3059<\/p>\n<h4>\u5730\u56fa\u3081\u7642\u6cd5\u3068\u3057\u3066\u306e\u5168\u8133\u7167\u5c04\u3068\u5e79\u7d30\u80de\u79fb\u690d<\/h4>\n<p><span style=\"color: #333333;\">Ferreri AJM, et al.:\u00a0Whole-brain radiotherapy or autologous stem-cell transplantation as consolidation strategies after high-dose methotrexate-based chemoimmunotherapy in patients with primary\u00a0CNS\u00a0lymphoma: results of the second randomisation of the International Extranodal\u00a0Lymphoma\u00a0Study Group-32 phase 2 trial. Lancet Haematol.\u00a02017<br \/>\n<\/span>\uff14\u30b3\u30fc\u30b9\u306e\u30e1\u30bd\u30c8\u30ec\u30ad\u30bb\u30fc\u30c8 (3\u00b75 g\/m2 on day 1)\u3092\u57fa\u76e4\u3068\u3057\uff0cgroup A: cytarabine 2 g\/m2 twice daily on days 2 and 3, group B: the same combination plus two doses of rituximab 375 mg\/m2 on days -5,\u00a0group C: the same methotrexate-cytarabine-rituximab combination plus thiotepa 30 mg\/m2 on day 4\u306e3\u7fa4\u3067\uff0c219\u4eba\u306e\u60a3\u8005\u3055\u3093\u306b\u5c0e\u5165\u6cbb\u7642\u304c\u306a\u3055\u308c\u307e\u3057\u305f\u3002\u5e79\u7d30\u80de\u304c\u63a1\u53d6\u3067\u304d\u305f\u306e\u60a3\u8005\u3055\u3093118\u4eba\u306e\u307f\u304c\uff0c\u7121\u4f5c\u70ba\u306b\u5168\u8133\u7167\u5c04 group D \u3082\u3057\u304f\u306f\u30ab\u30eb\u30e0\u30b9\u30c1\u30f3\/\u30c1\u30aa\u30c6\u30d1\u5316\u5b66\u7642\u6cd5 group E \u306e\uff12\u6b21\u6cbb\u7642\uff08\u5730\u56fa\u3081\u7642\u6cd5\uff09\u3092\u53d7\u3051\u307e\u3057\u305f\u30022\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f\uff0c\u5168\u8133\u7167\u5c04\u306780%\uff0c\u5e79\u7d30\u80de\u79fb\u690d\u306769%\u3067\u3042\u308a\u6709\u610f\u306a\u5dee\u304c\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u5e79\u7d30\u80de\u79fb\u690d\u30672\u4f8b\u306e\u5316\u5b66\u7642\u6cd5\u6b7b\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u3053\u306e\u52b9\u679c\u306f\u307b\u307c\u540c\u7b49\u3067\u3042\u308a\uff0c<strong><span style=\"color: #000080;\">\u5168\u8133\u7167\u5c04\u306b\u3088\u308b\u8a8d\u77e5\u6a5f\u80fd\u4f4e\u4e0b\u3092\u8003\u3048\u3066\u6cbb\u7642\u6cd5\u3092\u9078\u629e\u3059\u308b<\/span><\/strong>\u3079\u304d\u3060\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4><strong>\u8840\u6db2\u5e79\u7d30\u80de\u79fb\u690d\u3092\u7528\u3044\u308b\u5927\u91cf\u5316\u5b66\u7642\u6cd5<\/strong><\/h4>\n<p>Illerhaus G, et al.: High-dose chemotherapy with autologous haemopoietic stem cell transplantation for newly diagnosed primary CNS lymphoma: a prospective, single-arm, phase 2 trial. Lancet Haematol, 2016<br \/>\n\u30c9\u30a4\u30c4\u3067\u884c\u308f\u308c\u305f\u591a\u65bd\u8a2d\u5171\u540c\u7814\u7a76\u3067\u3059\u3002\u5c0e\u5165\u3068\u3057\u3066\uff0c5\u30b3\u30fc\u30b9\u306e\u30ea\u30c4\u30ad\u30b7\u30de\u30d6\u3068\uff14\u30b3\u30fc\u30b9\u306e\u5927\u91cf\u30e1\u30bd\u30c8\u30ec\u30ad\u30bb\u30fc\u30c8\u00a08000 mg\/m2\u3092\u6295\u4e0e\u3057\u307e\u3059\u3002\u305d\u308c\u304b\u3089\uff0c\u30ea\u30c4\u30ad\u30b7\u30de\u30d6\uff0c\u30b7\u30bf\u30e9\u30d3\u30f3\uff0c\u30c1\u30aa\u30c6\u30d1\u3092\uff12\u30b3\u30fc\u30b9\u6295\u4e0e\u3057\u307e\u3059\u30023\u9031\u9593\u5f8c\u306b\uff0c<span style=\"color: #000080;\"><strong>\u81ea\u5df1\u8840\u5e79\u7d30\u80de\u79fb\u690d\u3092\u7528\u3044\u3066\u30ea\u30b9\u30ad\u30b7\u30de\u30d6\uff0c\u30ab\u30eb\u30e0\u30b9\u30c1\u30f3 BCNU\u00a0400 mg\/m2\uff0c\u30c1\u30aa\u30c6\u30fc\u30d1 2x5mg\/kg \u306e\u5927\u91cf\u5316\u5b66\u7642\u6cd5<\/strong><\/span> HCT-ASCT \u3092\u884c\u3044\u307e\u3059\u3002\u816b\u760d\u304c\u6d88\u5931\u3057\u306a\u304b\u3063\u305f\u60a3\u8005\u3055\u3093 non-CR \u306e\u307f\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u52a0\u3048\u3089\u308c\u307e\u3057\u305f\u300279\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e\u3046\u3061\uff0c73\u4eba\u3067HCT-ASCT\u304c\u884c\u308f\u308c\uff0c61\u4eba(77%)\u3067CR\u304c\u5f97\u3089\u308c\u307e\u3057\u305f\u30024\u4eba (5%) \u3067\u6cbb\u7642\u95a2\u9023\u6b7b\u304c\u751f\u3058\u307e\u3057\u305f\u3002\u30c1\u30aa\u30c6\u30fc\u30d1\u3068BCNU\u306e\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306f\u82e5\u3044\u60a3\u8005\u3055\u3093\u306b\u306f\u6709\u52b9\u306a\u9078\u629e\u80a2\u3067\u3042\u308b\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<br \/>\n\u3084\u306f\u308a\u6cbb\u7642\u95a2\u9023\u6b7b\u304c\u6570%\u3067\u308b\u6cbb\u7642\u6cd5\u3067\u3059\u304b\u3089\u65e5\u672c\u3067\u884c\u3046\u3053\u3068\u306f\u96e3\u3057\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u307e\u305fCR\u5b8c\u5168\u5bdb\u89e3\u5c0e\u5165\u304c77\uff05\u3067\u3067\u304d\u3066\u3044\u308b\u306e\u3067\u3059\u304c\uff0c5\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u304c\u307e\u3060\u308f\u304b\u3063\u3066\u3044\u307e\u305b\u3093\u3002\u518d\u767a\u7387\u304c\u4e88\u60f3\u3088\u308a\u9ad8\u3044\u3068\u3044\u3046\u7d50\u679c\u304c\u51fa\u308b\u306e\u304b\u3082\u3057\u308c\u306a\u3044\u3067\u3059\u3002<\/p>\n<h4><strong>MATRix\u30ec\u30b8\u30e1\u30f3\uff1a\u30b7\u30bf\u30e9\u30d3\u30f3\uff0c\u30c1\u30aa\u30c6\u30d1\uff0c\u30ea\u30c4\u30ad\u30b7\u30de\u30d6\u3092\u52a0\u3048\u308b<\/strong><\/h4>\n<p>Ferreri AJ:\u00a0Chemoimmunotherapy with methotrexate, cytarabine, thiotepa, and rituximab (MATRix regimen) in patients with primary <span class=\"highlight\">CNS<\/span> <span class=\"highlight\">lymphoma<\/span>: results of the first randomisation of the International Extranodal <span class=\"highlight\">Lymphoma<\/span> Study Group-32 (IELSG32) phase 2 trial.\u00a0<span role=\"menubar\">Lancet Haematol.<\/span> 2016<br \/>\nMTX\u306b\u30b7\u30bf\u30e9\u30d3\u30f3\u3092\u52a0\u3048\u308b\uff0c\u3055\u3089\u306b\u30ea\u30c4\u30ad\u30b7\u30de\u30d6\u3092\u52a0\u3048\u308b\uff0c\u305d\u3057\u3066\u3055\u3089\u306b\u30c1\u30aa\u30c6\u30d1\u3092\u52a0\u3048\u308b3\u7fa4\u304c\u8a66\u3055\u308c\u307e\u3057\u305f\u3002\u305d\u306e\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3042\u308b\u3044\u306f\u81ea\u5df1\u5e79\u7d30\u80de\u79fb\u690d\u304c\u52a0\u3048\u3089\u308c\u3066\u3044\u307e\u3059\u3002219\u4f8b\u306e\u60a3\u8005\u3055\u3093\u304c\u767b\u9332\u3055\u308cCR\u5272\u5408\u304cprimary endopoint\u3067\u3057\u305f\u300270\u6b73\u307e\u3067\u306e\u60a3\u8005\u3055\u3093\u3067\u306fMATRix\u306f\u6709\u671b\u6027\u306e\u3042\u308b\u6cbb\u7642\u6cd5\u3060\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002\u5316\u5b66\u7642\u6cd5\u6b7b\u304c\u6570%\u3042\u308a\u304d\u3064\u3044\u3082\u306e\u3067\u3059\u3002<\/p>\n<h4><strong>\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u7dad\u6301\u7642\u6cd5\u3068\u3057\u3066\u4f7f\u3046<\/strong><\/h4>\n<p>Glass J: Phase I and II Study of Induction Chemotherapy With Methotrexate, Rituximab, and Temozolomide, Followed By Whole-Brain Radiotherapy and Postirradiation Temozolomide for Primary CNS\u00a0Lymphoma: NRG Oncology RTOG 0227. J Clin Oncol.\u00a02016<br \/>\nMTX\u3068\u30ea\u30c4\u30ad\u30b7\u30de\u30d6\u306b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u52a0\u3048\u305f\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\uff0c\u5168\u8133\u7167\u5c04\u306b\u3088\u308b\u5730\u56fa\u3081\uff0c\u305d\u306e\u5f8c\u306b1\u5e74\u307e\u3067\u304f\u3089\u3044\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u7dad\u6301\u5316\u5b66\u7642\u6cd5\u304c\u884c\u308f\u308c\u307e\u3057\u305f\u30022\u5e74\u751f\u5b58\u5272\u5408\u306f81%\u306b\u9054\u3057\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u300253\u4f8b\u306e\u7b2c2\u76f8\u8a66\u9a13\u3067\u3042\u308a\u4fe1\u983c\u6027\u306f\u9ad8\u304f\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<div class=\"setumei\">\n<h4><strong>\u8840\u6db2\u5e79\u7d30\u80de\u79fb\u690d\u3092\u7528\u3044\u308b\u5927\u91cf\u5316\u5b66\u7642\u6cd5<\/strong><\/h4>\n<p>Omuro A, et al.: R-MPV followed by high-dose chemotherapy with TBC and autologous stem-cell transplant for newly diagnosed primary CNS lymphoma. Blood 125: 1403-1410, 2015<br \/>\nSloan-Kettering\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u30ea\u30c4\u30ad\u30b7\u30de\u30d6\uff0c\u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8 MTX (3.5g\/m2)\uff0c\u30d7\u30ed\u30ab\u30eb\u30d0\u30b8\u30f3\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\u3092\u7528\u3044\u308bR-MPV\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u304c\u6709\u52b9\u3067\u3042\u3063\u305f32\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\uff0c<span style=\"color: #000080;\"><strong>\u5730\u56fa\u3081\u5927\u91cf\u5316\u5b66\u7642\u6cd5\uff08\u30c1\u30aa\u30c6\u30d1\uff0c\u30b7\u30af\u30ed\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30d6\u30b9\u30eb\u30d5\u30a1\u30f3\uff09\u3068\u81ea\u5df1\u8840\u6db2\u5e79\u7d30\u80de\u79fb\u690d<\/strong><\/span>\u3092\u53d7\u3051\u307e\u3057\u305f(HDC-ASCT.)\u3002\u5e74\u9f62\u4e2d\u592e\u502457\u6b73\u3068\u82e5\u304f\uff0cKPS\u306f80\u3068\u826f\u597d\u306a\u6bcd\u96c6\u56e3\u3067\u3059\u3002R-MPV\u306e\u594f\u529f\u5272\u5408\u306f97%\u3067\u3042\u308a\uff0c26 (81%) \u4eba\u306e\u60a3\u8005\u3055\u3093\u304c HDC-ASCT\u3092\u53d7\u3051\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3057\u305f\u3002\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024 PFS \u3068\u5168\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024 OS \u306f45\u30f6\u6708\u3092\u8d8a\u3048\u307e\u3057\u305f\u30022\u5e74PFS\u306f79%\uff0c2\u5e74OS\u306f81%\u3067\u3057\u305f\u3002\u79fb\u690d\u304c\u3067\u304d\u305f\u60a3\u8005\u3055\u3093\u3067\u306fPS\u3082OS\u308281%\u3067\u3059\u3002\u6cbb\u7642\u95a2\u9023\u6b7b\u306f3\u4f8b (9%) \u3067\u3057\u305f\u3002\u8a8d\u77e5\u6a5f\u80fd\u304c\u4fdd\u305f\u308c\u795e\u7d4c\u6bd2\u6027\u306e\u306a\u3044\u6cbb\u7642\u3067\u3042\u308b\u3068\u7d50\u8ad6\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u7c73\u56fd\u3067\u306f\u53ef\u80fd\u3067\u3082\uff0c\u65e5\u672c\u306b\u304a\u3044\u3066\u306f\u6cbb\u7642\u95a2\u9023\u6b7b3\u4f8b 9%\u306f\u53b3\u3057\u3044\u5316\u5b66\u7642\u6cd5\u3060\u3068\u8a00\u3048\u307e\u3059\u3002<\/p>\n<\/div>\n<h4>\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e\u52b9\u679c\uff1a60\u6b73\u4ee5\u4e0a\u306e\u60a3\u8005\u3055\u3093\u3067\u306e\u8a66\u9a13<\/h4>\n<p>Omuro A: Methotrexate and temozolomide versus methotrexate, procarbazine, vincristine, and cytarabine for primary CNS\u00a0lymphoma\u00a0in an elderly population: an intergroup ANOCEF-GOELAMS randomised phase 2 trial. Lancet Haematol.\u00a02015<br \/>\nMTX\u306b\u30d7\u30ed\u30ab\u30eb\u30d0\u30b8\u30f3\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\uff0c\u30b7\u30bf\u30e9\u30d3\u30f3\u3092\u52a0\u3048\u308b\u304b\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u52a0\u3048\u308b\u304b\u304c\uff0c60\u6b73\u4ee5\u4e0a\u306e98\u4f8b\u306e\u60a3\u8005\u3055\u3093\u3067\u8a66\u3055\u308c\u307e\u3057\u305f\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u884c\u308f\u308c\u3066\u3044\u307e\u305b\u3093\u30021\u5e74PFS\u306f\u4e21\u8005\u3068\u3082\u306b36%\u3067\u3057\u305f\u3002FPS\u4e2d\u592e\u5024\u306f\uff13\u5264\u3092\u52a0\u3048\u308b\u30689.5\u30f6\u6708\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3067\u306f6.1\u30f6\u6708\u3067\u3057\u305f\u3002\u591a\u5264\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u3092\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5358\u72ec\u306b\u7f6e\u304d\u63db\u3048\u308b\u3053\u3068\u306f\u3067\u304d\u305a\uff0c\u304a\u305d\u3089\u304f\uff0c\u3044\u305a\u308c\u3082\u518d\u767a\uff08\u518d\u71c3\uff09\u307e\u3067\u6570\u30f6\u6708\u3057\u304b\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n<div class=\"setumei\">\n<h4><strong>\u30e1\u30bd\u30c8\u30ec\u30ad\u30bb\u30fc\u30c8\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306b\u30ea\u30c4\u30ad\u30b5\u30f3\u3092\u52a0\u3048\u305f\u65b9\u304c\u826f\u3044<\/strong><\/h4>\n<p>Gregory G, et al.: Rituximab is associated with improved survival for aggressive B cell CNS lymphoma. Neuro Oncol 15: 1068-1073, 2013<br \/>\n\u30aa\u30fc\u30b9\u30c8\u30e9\u30ea\u30a2\u306e4\u3064\u306e\u5927\u304d\u306a\u65bd\u8a2d\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>120\u4f8b\u306eB\u7d30\u80de\u8133\u30ea\u30f3\u30d1\u816b\u306e\u6cbb\u7642\u3092\u5206\u6790\u3059\u308b\u3068\uff0c\u30e1\u30bd\u30c8\u30ec\u30ad\u30bb\u30fc\u30c8\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306b\u30ea\u30c4\u30ad\u30b5\u30f3 rituximab\u3092\u52a0\u3048\u305f\u4f8b\u3067\u751f\u5b58\u671f\u9593\u304c\u9577\u304b\u3063\u305f<\/strong><\/span>\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n<h4>\u5168\u8133\u7167\u5c04\u306e\u7dda\u91cf\u309223.4 Gy\u306b\u843d\u3068\u3059<\/h4>\n<p>Morris PG, et al: Rituximab, methotrexate, procarbazine, and vincristine followed by consolidation reduced-dose whole-brain radiotherapy and cytarabine in newly diagnosed primary CNS lymphoma: final results and long-term outcome. J Clin Oncol 31:3971-3979, 2013<br \/>\nMTX\uff0c\u30ea\u30c4\u30ad\u30b5\u30f3\uff0c\u30d7\u30ed\u30ab\u30eb\u30d0\u30b8\u30f3\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\u306e\u5316\u5b66\u7642\u6cd5\u5f8c\u306b\uff0c\u816b\u760d\u304c\u6d88\u5931\u3057\u305f\u4f8b CR\u3067\u306f\uff0c\u5730\u56fa\u3081\u3068\u3057\u306623.4\u30b0\u30ec\u30a4\u306e\u5168\u8133\u7167\u5c04\u3068\u66f4\u306b\u30b7\u30bf\u30e9\u30d3\u30f3\u304c\u4f7f\u7528\u3055\u308c\u307e\u3057\u305f\u3002\u816b\u760d\u304c\u6d88\u5931\u3057\u306a\u3044\u5834\u5408\u306b\u306f\uff0c\u6a19\u6e96\u7684\u306a45\u30b0\u30ec\u30a4?\u304c\u63d0\u6848\u3055\u308c\u307e\u3057\u305f\u3002\u4e2d\u592e\u5e74\u9f6260\u6b73\uff0c52\u4eba\u306e\u60a3\u8005\u3055\u3093\u3067\uff0c31\u4eba(60\uff05\uff09\u304cCR\u306b\u306a\u308a\u307e\u3057\u305f\u3002\u3053\u306e\u7fa4\u3067\u306e2\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f77%\uff0c\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f7.7\u5e74\u3067\u3059\u3002\u5168\u4f5352\u4eba\u3067\u306e\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f6.6\u5e74\u3067\u3057\u305f\u3002<br \/>\n\u300c\u89e3\u8aac\u300f45\u30b0\u30ec\u30a4\u3063\u3066\u3069\u3053\u306e\u6a19\u6e96\u306a\u3093\u3067\u3057\u3087\u3046\u306d\u3002\u306f\u3063\u304d\u308a\u8a00\u3048\u308b\u3053\u3068\u306f\uff0c<strong><span style=\"color: #000080;\">\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u3067\u816b\u760d\u304c\u6d88\u5931\u3059\u308b\u4f8b\u3067\u306f\uff0c\u5168\u8133\u7167\u5c04\u306e\u7dda\u91cf\u3092\u843d\u3068\u305b\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b<\/span><\/strong>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u3067\u3082\u3084\u306f\u308a\u5316\u5b66\u7642\u6cd5\u3067\u306f40\uff05\u307b\u3069\u304c\u5b8c\u5168\u5bdb\u89e3\uff08\u816b\u760d\u6d88\u5931\uff09\u306b\u81f3\u308a\u307e\u305b\u3093\u3002<\/p>\n<\/div>\n<h4>\u5168\u8133\u7167\u5c04\u3092\u884c\u308f\u306a\u3044\u3067\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u3059\u308b<\/h4>\n<p>Rubenstein JL, et al.: Intensive chemotherapy and immunotherapy in patients with newly diagnosed primary CNS lymphoma: CALGB 50202 (Alliance 50202). J Clin Oncol 3:3061-3068, 2013<br \/>\n\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u306fMTX, \u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\uff0c\u30ea\u30c4\u30ad\u30b5\u30f3\u3067\u3059\u3002\u305d\u306e\u5f8c\u306b\uff0c\u5730\u56fa\u3081\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u3057\u3066\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\u3068\u30b7\u30bf\u30e9\u30d3\u30f3\u304c\u4f7f\u7528\u3055\u308c\u307e\u3057\u305f\u3002\u5168\u8133\u7167\u5c04\u306f\u3057\u307e\u305b\u3093\u3002\u521d\u671f\u6cbb\u7642\u5f8c\u306eCR\u5272\u5408\u306f66%\u3067\uff0c\uff12\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f0.57\u3067\u3057\u305f\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u63a7\u3048\u3081\u306b\u898b\u308b\u306e\u304c\u5f53\u7136\u3067\u3059\u304b\u3089\uff0c\u534a\u6570\u304f\u3089\u3044\u304c2\u5e74\u4ee5\u5185\u306b\u518d\u767a\u3059\u308b\u3068\u8003\u3048\u305f\u307b\u3046\u304c\u3044\u3044\u3067\u3057\u3087\u3046\u3002<\/p>\n<div class=\"setumei\">\n<h4><span style=\"color: #000080;\"><strong>\u8133\u30ea\u30f3\u30d1\u816b\u306e\u624b\u8853<\/strong><\/span><\/h4>\n<p>\u5916\u79d1\u624b\u8853\u306e\u5f79\u5272\u306f\u78ba\u5b9f\u306a\u75c5\u7406\u8a3a\u65ad\u3092\u5f97\u308b\u305f\u3081\u306b\u7d44\u7e54\u3092\u3068\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3042\u308a\uff0c\u5b9a\u4f4d\u8133\u624b\u8853\u3067\u751f\u691c\u3092\u3059\u308b\u3079\u304d\u3002\u958b\u982d\u624b\u8853\u3067\u816b\u760d\u3092\u305f\u304f\u3055\u3093\u53d6\u308b (debulking) \u3068\u3044\u3046\u624b\u8853\u306e\u30e1\u30ea\u30c3\u30c8\u306f\u8a3c\u660e\u3055\u308c\u3066\u3044\u306a\u3044\u3002\u5185\u7167\u5c04\u3068\u3044\u3046\u8133\u306e\u5185\u90e8\u304b\u3089\u653e\u5c04\u7dda\u3092\u3042\u3066\u308b\u3088\u3046\u306a\u7279\u6b8a\u306a\u72b6\u6cc1\u4e0b\u3067\u306f\u751f\u691c\u8853\u4ee5\u5916\u306e\u624b\u8853\u3082\u3042\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u3002<br \/>\nLiu B-L, et al.\u00a0 Limited role of surgery in the management of primary central nervous system lymphoma (Review), Oncol Rep 22: 439-449, 2009<br \/>\n\u89e3\u8aac\uff1a\u8133\u5916\u79d1\u306e\u5148\u751f\u306f\u5927\u304d\u306a\u816b\u760d\u3092\u898b\u3064\u3051\u308b\u3068\u958b\u982d\u624b\u8853\u3092\u52e7\u3081\u304c\u3061\u3067\u3059\u3002\u7406\u7531\u306f\uff0c\u816b\u760d\u3092\u53d6\u3063\u3066\u307f\u306a\u3044\u3068\u8a3a\u65ad\u304c\u3064\u304b\u306a\u3044\u304b\u3089\u6cbb\u7642\u65b9\u91dd\u304c\u7acb\u305f\u306a\u3044\u3002\u751f\u691c\u8853\u3060\u3068\u75c5\u7406\u8a3a\u65ad\u3092\u9593\u9055\u3046\u3053\u3068\u304c\u3042\u308b\u304b\u3089\u305f\u304f\u3055\u3093\u53d6\u308b\u305f\u3081\u306b\u958b\u982d\u3059\u308b\u3002\u816b\u760d\u304c\u5927\u304d\u3044\u304b\u3089\u8133\u306e\u816b\u308c\u3068\u5727\u8feb\u3092\u3068\u308b\u305f\u3081\u306b\u7dca\u6025\u306e\u958b\u982d\u624b\u8853\u3092\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u3002\u3053\u308c\u3089\u306e\u7406\u7531\u306f\u591a\u304f\u306e\u5834\u5408\uff0c\u672c\u5f53\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u306e\u3067\u5b89\u6613\u306b\u958b\u982d\u624b\u8853\u3092\u53d7\u3051\u3066\u306f\u3044\u3051\u307e\u305b\u3093\u3002<\/p>\n<h4><span style=\"color: #000080;\"><strong><span class=\"style1\">MTX\u3068\u30ea\u30c4\u30ad\u30b5\u30f3\u3092\u4f7f\u3063\u305f\u5316\u5b66\u7642\u6cd5<\/span><\/strong><\/span><\/h4>\n<p>Shah GD, et al. Combined immunochemotherapy with reduced whole-brain radiotherapy for newly diagnosed primary CNS lymphoma. J Clin Oncol 25: 4730-4735, 2007<br \/>\n30\u4eba\uff08\u5e74\u4ee4\u4e2d\u592e\u502457\u6b73\uff09\u306e\u30ea\u30f3\u30d1\u816b\u306e\u60a3\u8005\u3055\u3093\u306b\uff0c5\u30b3\u30fc\u30b9\u304b\u3089\uff17\u30b3\u30fc\u30b9\u306eR-MPV (\u30ea\u30c4\u30ad\u30b7\u30de\u30d6\uff0c\u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8\uff0c\u30d7\u30ed\u30ab\u30eb\u30d0\u30b8\u30f3\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\uff09\u5316\u5b66\u7642\u6cd5\u304c\u6295\u4e0e\u3055\u308c\u307e\u3057\u305f\u30027\u30b3\u30fc\u30b9\u306e\u5316\u5b66\u7642\u6cd5\u306e\u5f8c\u3067\u306f78%\u306e\u60a3\u8005\u3055\u3093\u3067\u816b\u760d\u304c\u6d88\u3048\u307e\u3057\u305f\u3002\u816b\u760d\u306e\u5b8c\u5168\u306b\u6d88\u3048\u305f(CR)\u60a3\u8005\u3055\u3093\u306f23.4\u30b0\u30ec\u30a4\u306e\u5168\u8133\u7167\u5c04\u3092\u53d7\u3051\u3066\uff0c\u816b\u760d\u304c\u5b8c\u5168\u306b\u6d88\u3048\u306a\u304b\u3063\u305f\u60a3\u8005\u3055\u3093\u306f45\u30b0\u30ec\u30a4\u306e\u5168\u8133\u7167\u5c04\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u3042\u3068\u3067\u3055\u3089\u306b\uff12\u30b3\u30fc\u30b9\u306e\u5927\u91cf\u306e\u30b7\u30bf\u30e9\u30d3\u30f3\u304c\u6295\u4e0e\u3055\u308c\u3066\u3044\u307e\u3059\u3002\uff12\u5e74\u306e\u5168\u751f\u5b58\u5272\u5408\u306f67%\u3067\uff0c\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f57%\u3067\u3057\u305f\u3002MPV\u5316\u5b66\u7642\u6cd5\u306b\u30ea\u30c4\u30ad\u30b7\u30de\u30d6\u3092\u52a0\u3048\u308b\u3068\uff0c\u597d\u4e2d\u7403\u6e1b\u5c11\u304c\u9855\u8457\u306b\u306a\u308b\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u3053\u306e23.4\u30b0\u30ec\u30a4\u306e\u5168\u8133\u7167\u5c04\u306f\u8a8d\u77e5\u6a5f\u80fd\u3092\u843d\u3068\u3055\u306a\u304b\u3063\u305f\u305d\u3046\u3067\u3059\u3002<br \/>\n\u7d04\uff16\u5272\u306e\u60a3\u8005\u3055\u3093\u3067\u6cbb\u7642\u5f8c\u306b\u518d\u767a\u306a\u3069\u306a\u304f\u3066\uff12\u5e74\u304c\u7d4c\u904e\u3059\u308b\u3068\u3044\u3046\u826f\u597d\u306a\u7d50\u679c\u3067\u3059\u3002MTX\u3092\u57fa\u5264\u3068\u3057\u305f\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u306b\u30ea\u30c4\u30ad\u30b5\u30f3\u3092\u52a0\u3048\u308b\u3068\u816b\u760d\u304c\u6d88\u5931\u3059\u308b\u5272\u5408\uff08\u594f\u529f\u7387\uff09\u304c\u660e\u3089\u304b\u306b\u4e0a\u304c\u308b\u3088\u3046\u3067\u3059\u3002\u5168\u90e8\u306e\u8133\u306b\u3042\u3066\u308b\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u91cf\u304c\u5f8c\u907a\u75c7\u3068\u3057\u3066\u306e\u8a8d\u77e5\u969c\u5bb3\uff08\u75f4\u5446\uff09\u3092\u6c7a\u3081\u307e\u3059\u304b\u3089\uff0c\u3053\u306e\u5316\u5b66\u7642\u6cd5\u3092\u4f7f\u3048\u3070\u653e\u5c04\u7dda\u306e\u91cf\u3092\u6e1b\u3089\u3059\u3053\u3068\u304c\u3067\u304d\u308b\u3067\u3042\u308d\u3046\u3068\u63a8\u5b9a\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u65e5\u672c\u3067\u306f\u4e00\u822c\u7684\u306bMTX\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u5f8c\u306f\uff0c30\u30b0\u30ec\u30a4\u306e\u5168\u8133\u7167\u5c04\u3067\u3059\u304b\u3089\u305d\u308c\u3088\u308a\u3082\u5c11\u306a\u3044\u3067\u3059\u3002<\/p>\n<h4><span style=\"color: #000080;\"><strong><span class=\"style1\">MTX\u304c\u52b9\u304b\u306a\u3044\u6642\uff0c\u8840\u6db2\u5e79\u7d30\u80de\u6551\u63f4\u3092\u7528\u3044\u305f\u5316\u5b66\u7642\u6cd5<\/span><\/strong><\/span><\/h4>\n<p>Soussain C, et al.: Intensive chemotherapy followed by hematopoietic stem-cell rescue for refractory and recurrent primary CNS lymphoma: Societe Francaise de Greffe de Moelle Osseuse-Therapie Cellulaire. J Clin Oncol 26: 2512-2518, 2008<br \/>\nMTX\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306b\u62b5\u6297\u6027\u306e\u30ea\u30f3\u30d1\u816b\u60a3\u8005\u3055\u309343\u4eba\uff08\u5e74\u4ee423-65\u6b73\uff09\u306b\u306a\u3055\u308c\u305f\u6cbb\u7642\u3067\u3059\u3002\u307e\u305a\uff0c\u30c1\u30aa\u30c6\u30fc\u30d1\u3068\u30b7\u30bf\u30e9\u30d3\u30f3\u3092\uff12\u30b3\u30fc\u30b9\u306e\u5316\u5b66\u7642\u6cd5\u304c\u3055\u308c\u307e\u3059\u3002\u6cbb\u7642\u95a2\u9023\u6b7b\u304c\uff13\u4eba\u3067\u3057\u305f\u300220\u4eba(47%)\u306e\u60a3\u8005\u3055\u3093\u3067\u6cbb\u7642\u52b9\u679c\u304c\u307f\u3089\u308c\u307e\u3057\u305f\u3002\u3055\u3089\u306b27\u4eba\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\u30c1\u30aa\u30c6\u30d1\uff0c\u30d6\u30b9\u30eb\u30d5\u30a1\u30f3\uff0c\u30b7\u30af\u30ed\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\u3092\u4f7f\u3046\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u8840\u6db2\u5e79\u7d30\u80de\u6551\u63f4\u304c\u8ffd\u52a0\u3055\u308c\u307e\u3057\u305f\u3002\u3053\u306e27\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e\u5185\u306e26\u4eba\u3067\u816b\u760d\u304c\u3044\u3063\u305f\u3093\u306f\u6d88\u3048\u307e\u3057\u305f (complete remission)\u3002 \u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u308c\u305f\u60a3\u8005\u3055\u3093\u306758.6\u30f6\u6708\u306b\u3082\u306a\u308a\uff0c\uff12\u5e74\u751f\u5b58\u7387\u306f69%\u3067\u3059\u3002<br \/>\n\u3053\u306e\u7d50\u679c\u306f\uff0c\u8840\u6db2\u5e79\u7d30\u80de\u6551\u63f4\u3068\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u304c\u8133\u306e\u30ea\u30f3\u30d1\u816b\u306b\u304b\u306a\u308a\u6709\u52b9\u3067\u3042\u308b\u3053\u3068\u3092\u793a\u3057\u3066\u307e\u3059\u3002\u3057\u304b\u3057\uff0c\u5bfe\u8c61\u3068\u306a\u3063\u305f\u60a3\u8005\u3055\u3093\u306e\u5e74\u4ee4\u306e\u4e2d\u592e\u5024\u304c52\u6b73\u3067\u3042\u3063\u3066\uff0c\u304b\u306a\u308a\u82e5\u3044\u60a3\u8005\u3055\u3093\u3067\u306e\u6210\u529f\u4f8b\u304c\u591a\u3044\u3068\u7406\u89e3\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u8133\u306e\u30ea\u30f3\u30d1\u816b\u306e\u767a\u751f\u5e74\u4ee4\u306f\u3082\u3063\u3068\u9ad8\u3044\u6240\u306b\u5e73\u5747\u5024\u304c\u3042\u308a\u307e\u3059\u3002MTX\u5316\u5b66\u7642\u6cd5\u304c\u52b9\u304b\u306a\u3044\u60a3\u8005\u3055\u3093\u306b\u306f\u7528\u3044\u308b\u4fa1\u5024\u306e\u3042\u308b\uff0c\u3051\u308c\u3069\u3082\u304d\u3064\u3044\u5316\u5b66\u7642\u6cd5\u3067\u3059\u3002<\/p>\n<h4 class=\"style1\"><strong><span style=\"color: #ff0000;\">\u5927\u962a\u5927\u5b66\u3000\u5e73\u8cc0\u5148\u751f\u306e\u6709\u540d\u306a\u8ad6\u6587<\/span><\/strong><\/h4>\n<p>Hiraga S, Arita N, Ohnishi T, et al.: Rapid infusion of high-dose methotrexate resulting in enhanced penetration into cerebrospinal fluid and intensified tumor response in primary central nervous system lymphomas. J Neurosurg 91: 221-230, 1999<br \/>\n\u53e4\u3044\u6587\u732e\u3067\u3059\u3002\u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8(MTX)\u3068\u3044\u3046\u85ac\u5264\u306e\u5927\u91cf\u7642\u6cd5\u3068\u305d\u306e\u5f8c\u306730Gy\u306e\u5168\u8133\u7167\u5c04\u3092\u3059\u308b\u6cbb\u7642\u6cd5\u304c\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002\u3053\u306e\u8ad6\u6587\u306e\u6cbb\u7642\u6210\u7e3e\u3092\u78ba\u8a8d\u3059\u308b\u305f\u3081\u306b\uff0c\u5175\u5eab\u533b\u5927\u306e\u6709\u7530\u61b2\u751f\u5148\u751f\u304c\u5168\u56fd\u5171\u540c\u7814\u7a76\u3092\u3057\u307e\u3057\u305f\u3002<\/p>\n<h4><span style=\"color: #000080;\"><strong><span class=\"style1\">\u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8\uff08\u30e1\u30bd\u30c8\u30ec\u30ad\u30bb\u30fc\u30c8\uff09\u3060\u3051\u3067\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\u306f\u751f\u3058\u308b\u304b<\/span><\/strong><\/span><\/h4>\n<p>Fliessbach K, et al. Neuropsychological outcome after chemotherapy for primary CNS lymphoma: a prospective study. Neurology 64: 1184-1188, 2005<br \/>\nMTX\u30e1\u30c8\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8\u3092\u57fa\u5264\u3068\u3057\u305f\u5316\u5b66\u7642\u6cd5\u3060\u3051\u3067\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306a\u3057\u3067\u6cbb\u7642\u3092\u53d7\u3051\u3066\uff0c\u751f\u5b58\u3057\u305f23\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e\u8a8d\u77e5\u6a5f\u80fd\uff08\u77e5\u80fd\uff09\u3068\u751f\u5b58\u306e\u8cea(QOL)\u3092\u8abf\u67fb\u3057\u305f\u7814\u7a76\u3067\u3059\u3002\u524d\u5411\u304d\u7814\u7a76prospective study\u3067\u3059\u3002\u6cbb\u7642\u5f8c\u306b22\u4eba\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\u8a8d\u77e5\u6a5f\u80fd\u306f\u540c\u3058\u304b\u6cbb\u7642\u524d\u3088\u308a\u6539\u5584\u3057\u3066\u3044\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u300211\u4eba(43%)\u3067\u8efd\u5ea6\u306e\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\u304c\u3042\u3063\u305f\u306e\u3067\u3059\u304c\uff0c\u3053\u308c\u306f\u6cbb\u7642\u306e\u526f\u4f5c\u7528\u3068\u3044\u3046\u3088\u308a\u3082\u816b\u760d\uff08\u30ea\u30f3\u30d1\u816b\uff09\u306b\u3088\u3063\u3066\u8133\u306e\u6a5f\u80fd\u304c\u843d\u3061\u3066\u3044\u305f\u305f\u3081\u3067\u3057\u305f\u300219\u4eba(83%)\u304c\u826f\u3044\u72b6\u614b\u3067\u751f\u6d3b\u3057\u3066\u3044\u307e\u3057\u305f(good QOL)\u3002\uff18\u4eba\u3067\u8133\u306e\u767d\u8cea\u306b\u7570\u5e38\u304c\u307f\u3089\u308c\u305f\u306e\u3067\u3059\u304c\uff0c\u3053\u308c\u306f\u8a8d\u77e5\u6a5f\u80fd\u306e\u4f4e\u4e0b\u3068\u306e\u95a2\u9023\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002 MTX\u3092\u57fa\u5264\u3068\u3057\u305f\u591a\u5264\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u306e\u307f\u3067\u6cbb\u7642\u3055\u308c\u305f\u5834\u5408\u306b\u306f\uff0c\u9855\u8457\u306a\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\u306f\u8d77\u3053\u3089\u306a\u3044\u3068\u7d50\u8ad6\u3055\u308c\u3066\u3044\u307e\u3059\u3002<br \/>\n\u78ba\u304b\u306b\u6210\u4eba\u3067\u306fMTX\u306e\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u307f\u3067\u306f\u8a8d\u77e5\u6a5f\u80fd\u306f\u843d\u3061\u306a\u3044\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u554f\u984c\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3068MTX\u306e\u4f75\u7528\u304c\u306a\u3055\u308c\u305f\u6642\u3067\u3059\u304c\uff0c\u3053\u306e\u6642\u306f\u8a8d\u77e5\u6a5f\u80fd\u306f\u843d\u3061\u307e\u3059\u3002\u8133\u306e\u30ea\u30f3\u30d1\u816b\u3092\u5316\u5b66\u7642\u6cd5\u5358\u72ec\u3067\u6cbb\u3059\u3053\u3068\u306f\u96e3\u3057\u3044\u306e\u3067\uff0c\u7d50\u5c40\u306e\u3068\u3053\u308d\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u306e\u4f75\u7528\u304c\u3055\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u306e\u3067\u3059\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u5148\u306b\u3057\u3066\uff0c\u5f8c\u3067MTX\u3092\u4f7f\u3046\u3068\u767d\u8cea\u8133\u75c7\u304c\u3088\u308a\u9ad8\u5ea6\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n<h4><span style=\"color: #000080;\"><strong><span class=\"style1\">\u4e2d\u67a2\u795e\u7d4c\u539f\u767a\u30ea\u30f3\u30d1\u816b PCNSL\u306e\u5b9a\u7fa9<\/span><\/strong><\/span><\/h4>\n<p>\u521d\u767a\u6642\u306b\u4e2d\u67a2\u795e\u7d4c\u7cfb\u5916\uff08\u773c\u7aa9\u5185\u3092\u9664\u304f\uff09\u306b\u306f\u30ea\u30f3\u30d1\u816b\u75c5\u5de3\u3092\u8a8d\u3081\u306a\u3044\u3001\u304b\u3064\u4ed6\u81d3\u5668\u30ea\u30f3\u30d1\u816b\u7531\u6765\u306e\u8ee2\u79fb\u6027\u4e2d\u67a2\u795e\u7d4c\u30ea\u30f3\u30d1\u816b\u306f\u542b\u307e\u306a\u3044\u3068\u3055\u308c\u308b\u306e\u3067\uff0c\u30ea\u30f3\u30d1\u816b\u306e\u65e2\u5f80\u6b74\u304c\u306a\u3044\u3053\u3068\uff0c\u3055\u3089\u306b\u5168\u8eab\u691c\u7d22\u3092\u4e00\u5fdc\u3057\u306a\u3044\u3068\u8a3a\u65ad\u306f\u3067\u304d\u306a\u3044\u300260\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u304c3\u5206\u306e2\u3092\u5360\u3081\uff0c\u6b27\u7c73\u3068\u306f\u7570\u306a\u308a\u65e5\u672c\u3067\u306f\u30a8\u30a4\u30ba\u306b\u5408\u4f75\u3059\u308b\u4f8b\u306f\u7a00\u3067\u3042\u308b\u3002\u307b\u3068\u3093\u3069\u306e\u4f8b (&gt;95%) \u304c\u975e\u30db\u30b8\u30ad\u30f3\u30ea\u30f3\u30d1\u816b (non-Hodgkin lymphoma, NHL)\u3067B\u7d30\u80de\u7531\u6765\u306e\u3073\u307e\u3093\u6027\u5927\u578bB\u7d30\u80de\u30ea\u30f3\u30d1\u816b (diffuse large B-cell lymphoma\uff09\u3067\u3042\u308b\u3002\u306a\u305cPCNSL\u304c\u4e2d\u67a2\u795e\u7d4c\u304b\u3089\u5916\u306b\u8ee2\u79fb\u3059\u308b\u3053\u3068\u304c\u7a00\u306a\u306e\u304b\u306e\u7406\u7531\u306f\u4e0d\u660e\u3002<\/p>\n<h4><strong><span class=\"style1\" style=\"color: #ff0000;\">PCNSL\u306e\u9ac4\u6db2\u5185\u64ad\u7a2e<\/span><\/strong>\uff08\u9ac4\u819c\u64ad\u7a2e\uff0cmeningeal dissemination, CSF seeding)<\/h4>\n<p>PCNSL\u306e\u9ac4\u819c\u64ad\u7a2e meningeal dissemination\u306f\uff0c10\uff05\u3068\u308240%\u3068\u3082\u3044\u308f\u308c\u308b\u3002PCNSL\u304c\u518d\u767a\u3057\u3084\u3059\u3044\u306e\u306f\u9ac4\u6db2\u4e2d\u306b\u30ea\u30f3\u30d1\u816b\u7d30\u304c\u80de\u5b58\u5728\u3057\uff0c\u6297\u304c\u3093\u5264\u306e\u9759\u8108\u6295\u4e0e\u3084\u5168\u8133\u7167\u5c04\u3067\u306f\u9ac4\u6db2\u4e2d\u306b\u6d6e\u904a\u3059\u308b\u816b\u760d\u7d30\u80de\u3092\u6839\u7d76\u3067\u304d\u306a\u3044\u305f\u3081\u3068\u3059\u308b\u610f\u898b\u3082\u3042\u308b\u3002\u3057\u304b\u3057\u5b9f\u969b\u306b\uff0cMRI\u3067\u810a\u9ac4\u8868\u9762\u3042\u308b\u3044\u306f\u5927\u8133\u8133\u6e9d\u306b\u64ad\u7a2e\u3092\u307f\u308b\u3053\u3068\u306f\u7a00\u3067\u3042\u308a\uff0c \u305d\u306e\u610f\u5473\u306b\u304a\u3044\u3066\u306f\u983b\u5ea6\u306f\u3068\u3066\u3082\u4f4e\u3044\u3068\u8a00\u3048\u308b\u3002<br \/>\n\u9ac4\u6db2\u7d30\u80de\u8a3a CSF cytomorphology\u3067\u306e\u507d\u967d\u6027\u3084\u507d\u9670\u6027\u306f\u591a\u304f\uff0c\u78ba\u5b9f\u306a\u8a3a\u65ad\u306f\u5fc5\u305a\u3057\u3082\u5bb9\u6613\u3067\u306f\u306a\u3044\u3002\u507d\u967d\u6027\u306b\u306a\u308b\u5834\u5408\u306b\u306f\uff0c\u9ac4\u6db2\u4e2d\u306b\u53cd\u5fdc\u6027\u306b\u51fa\u305f\u30ea\u30f3\u30d1\u7403\u3092\u60aa\u6027\u30ea\u30f3\u30d1\u816b\u7d30\u80de\u3068\u8aa4\u8a8d\u3059\u308b\u3053\u3068\u3067\u3042\u308b\u3002\u4e00\u65b9\uff0c\u507d\u9670\u6027\u3068\u306a\u308b\u5834\u5408\u306b\u306f\uff0c\u63a1\u53d6\u3057\u305f\u9ac4\u6db2\u91cf\u304c\u5c11\u306a\u304f\u3066\u967d\u6027\u306b\u306a\u3089\u306a\u3044\u3053\u3068\uff0c\u7d30\u80de\u8a3a\u306e\u524d\u306b\u30b9\u30c6\u30ed\u30a4\u30c9\u3092\u4f7f\u7528\u3057\u3066\u3057\u307e\u3063\u305f\u5834\u5408\uff08\u4e00\u6642\u7684\u306b\u3082\u816b\u760d\u7d30\u80de\u304c\u6d88\u5931\u3059\u308b\uff09\u3067\u3042\u308b\u3002\u9ac4\u6db2\u304b\u3089\u5341\u5206\u306a\u7d30\u80de\u6570\u304c\u63a1\u53d6\u3067\u304d\u3066\uff0c\u591a\u91cf\u306e\u30ea\u30f3\u30d1\u816b\u7d30\u80de\u304c\u78ba\u8a8d\u3067\u304d\u305f\u5834\u5408\u3068\uff0c\u514d\u75ab\u7d44\u7e54\u67d3\u8272\u3084CDR3 PCR\u304c\u53ef\u80fd\u3067\u3042\u308c\u3070\u78ba\u8a3a\u304c\u3067\u304d\u308b\u3002<br \/>\n\u8a3a\u65ad\u306e\u4e0d\u78ba\u5b9f\u6027\u304b\u3089\u3057\u3066\u3082\uff0c\u9ac4\u6db2\u64ad\u7a2e\u304c\u4e88\u5f8c\u56e0\u5b50\u3068\u306a\u308b\u304b\u5426\u304b\u306b\u95a2\u3057\u3066\u306f\u8b70\u8ad6\u304c\u3042\u308b\u3002\u3057\u304b\u3057\uff0c\u5c11\u306a\u304f\u3068\u3082\u6cbb\u7642\u958b\u59cb\u524d\u306b\uff0c\u9ac4\u6db2\u7d30\u80de\u8a3a\u3068\u810a\u9ac4\u306eMRI\u3092\u884c\u306a\u3046\u52aa\u529b\u306f\u3059\u3079\u304d\u3067\u3042\u308b\u3002\u4e88\u9632\u7684\u306b\u9ac4\u6db2\u5185\u3078MTX\u306e\u6ce8\u5165\u3092\u3059\u308b\u6cbb\u7642\u30d7\u30ed\u30c8\u30b3\u30fc\u30eb\u3082\u3042\u308b\u304c\u4e00\u822c\u7684\u3067\u306f\u306a\u3044\u3002\u8133\u5ba4\u5185\u306b\u30c1\u30e5\u30fc\u30d6\u30fb\u30ea\u30b6\u30fc\u30d1\u30fc\u3092\u7559\u7f6e\u3059\u308b\u304b\u8170\u690e\u7a7f\u523a\u3092\u7e70\u308a\u8fd4\u3057\u884c\u306a\u308f\u306a\u3051\u308c\u3070\u306a\u3089\u3044\u3053\u3068\uff0c\u9ac4\u819c\u708e\u4f75\u767a\u306e\u5371\u967a\u6027\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u4f75\u7528\u3059\u308c\u3070\u767d\u8cea\u8133\u75c7\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u307e\u308b\u305f\u3081\u3067\u3042\u308b\u3002<\/p>\n<h4><strong><span class=\"style1\" style=\"color: #ff0000;\">\u5341\u5206\u306a\u8a3a\u65ad\u3068\u6cbb\u7642\u958b\u59cb\u6642\u671f\u306e\u9045\u308c\u306e\u9593\u306e\u30b8\u30ec\u30f3\u30de<\/span><\/strong><\/h4>\n<p>\u8a3a\u65ad\u4fa1\u5024\u306e\u9ad8\u3044\u5358\u7d14CT\u306b\u59cb\u307e\u308a\uff0cMRI\uff0c\u5897\u5f37MRI\uff0c\u810a\u9ac4MRI\uff0c\u5b9a\u4f4d\u751f\u691c\u8853\uff08\u51cd\u7d50\u6a19\u672cHE\uff0c\u514d\u75ab\u7d44\u7e54\u67d3\u8272\u306b\u3088\u308b\u78ba\u5b9a\u8a3a\u65ad\uff09\uff0c\u773c\u79d1\u8a3a\u65ad\uff0c\u8840\u6db2\u691c\u67fb\uff08LDH, IL2-R)\uff0c\uff0c\u80f8\u8179\u90e8\u5897\u5f37CT\uff0c\u30ac\u30ea\u30a6\u30e0\u30b7\u30f3\u30c1\uff0c\u9ac4\u6db2\u7d30\u80de\u8a3a\uff0c FDG-PET\uff0c\u8840\u6db2\u5185\u79d1\u3067\u306e\u9aa8\u9ac4\u7a7f\u523a\u306a\u3069\u5fc5\u8981\u306a\u6cbb\u7642\u524d\u691c\u67fb\u3092\u3042\u3052\u308c\u3070\u304d\u308a\u304c\u306a\u3044\u306e\u304b\u3082\u3057\u308c\u306a\u3044\u3002\u3055\u3089\u306b\u52a0\u3048\u3066\uff0c\u751f\u547d\u4e88\u5f8c\u304c\u4e0d\u826f\u306a\u60aa\u6027\u75be\u60a3\u3067\u3042\u308a\uff0c\u6cbb\u7642\u4fb5\u8972\u304c\u9ad8\u3044\u5316\u5b66\u7642\u6cd5\u3092\u884c\u306a\u3046\u306e\u3067\uff0c\u60a3\u8005\u3055\u3093\u3068\u5bb6\u65cf\u3078\u306e\u75c5\u614b\u8aac\u660e\u3068\u6cbb\u7642\u6cd5\u9078\u629e\u306e\u30a4\u30f3\u30d5\u30a9\u30fc\u30e0\u30c9\u30b3\u30f3\u30bb\u30f3\u30c8\u306b\u306f\u4e88\u60f3\u4ee5\u4e0a\u306b\u6642\u9593\u3092\u3068\u3089\u308c\u308b\u3002<br \/>\n\u3057\u304b\u3057\uff0cPCNSL\u306e\u75c5\u52e2\u306e\u60aa\u5316\u306f\u6642\u3068\u3057\u3066\u6975\u3081\u3066\u65e9\u3044\u306e\u3067\uff0c\u5341\u5206\u306a\u691c\u67fb\u3092\u884c\u3046\u3053\u3068\u3068\uff0c\u60a3\u8005\u3055\u3093\u306e\u6a5f\u80fd\u4e88\u5f8c\u3092\u5b88\u308b\u3068\u3044\u3046\u3053\u3068\u306f\uff0c\u3057\u3070\u3057\u3070\u80cc\u53cd\u3059\u308b\u3002PCNSL\u3092\u7591\u3063\u305f\u5834\u5408\u306b\u6700\u3082\u5927\u5207\u306a\u3053\u3068\u306f\uff0c\u753b\u50cf\u4e0a\u3067\u985e\u4f3c\u3059\u308b\u81a0\u82bd\u816b\u3084\u8ee2\u79fb\u6027\u8133\u816b\u760d\u3088\u308a\u3082\uff0cPCNSL\u306e\u5897\u5927\u901f\u5ea6\u304c\u901f\u3044\u3053\u3068\u3092\u5ff5\u982d\u306b\u304a\u304f\u3053\u3068\u3067\u3042\u308b\u3002\u81a0\u82bd\u816b\u3068\u540c\u69d8\u306a\u30bf\u30a4\u30e0\u30c6\u30fc\u30d6\u30eb\u3067\u691c\u67fb\u3068\u6cbb\u7642\u8a08\u753b\u3092\u3057\u3066\u306f\u306a\u3089\u306a\u3044\u3002<br \/>\n\u7279\u306b\uff0c\u8133\u5e79\u90e8\uff0c\u8996\u5e8a\uff0c\u5927\u8133\u57fa\u5e95\u6838\uff0c\u8133\u6881\uff0c\u6d77\u99ac\u306a\u3069\u3092\u4fb5\u3059\u30ea\u30f3\u30d1\u816b\u304c\uff0c\u6025\u901f\u306b\u75c7\u72b6\u3092\u60aa\u5316\u3055\u305b\u308b\u5834\u5408\u306b\u306f\uff0c\u305d\u308c\u3089\u306e\u90e8\u4f4d\u306b\u4e0d\u53ef\u9006\u7684\u306a\u8133\u7d44\u7e54\u7834\u58ca\u3092\u3082\u305f\u3089\u3057\u3066\u3044\u308b\u3068\u60f3\u50cf\u3057\u305f\u65b9\u304c\u3088\u3044\u3057\uff0c\u307e\u305f\u4e8b\u5b9f\uff0c\u5316\u5b66\u7642\u6cd5\u304c\u594f\u52b9\u3057\u3066\u3082\u9ad8\u6b21\u8133\u6a5f\u80fd\u969c\u5bb3\u3092\u306f\u3058\u3081\u3068\u3059\u308b\u795e\u7d4c\u8131\u843d\u75c7\u72b6\u3092\u6b8b\u3059\u3053\u3068\u304c\u591a\u3044\u3002<br \/>\n\u958b\u982d\u816b\u760d\u6458\u51fa\u8853 (radical removal) \u3082\u3053\u306e\u610f\u5473\u306b\u304a\u3044\u3066\u306f\u8853\u5f8c\u88dc\u52a9\u7642\u6cd5\u306e\u958b\u59cb\u3092\u9045\u3089\u305b\u308b\u8981\u56e0\u3068\u306a\u308a\uff0c\u816b\u760d\u6458\u51fa\u5272\u5408\u3068\u4e88\u5f8c\u304c\u95a2\u9023\u3057\u306a\u3044\u3053\u3068\u3092\u8003\u3048\u3066\u3082\uff0c\u60a3\u8005\u3055\u3093\u306b\u306f\u4f55\u306e\u5229\u76ca\u3082\u3082\u305f\u3089\u3055\u306a\u3044\u6709\u5bb3\u306a\u624b\u6bb5\u3068\u3044\u3048\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u3002PCNSL\u3092\u7591\u3063\u305f\u5834\u5408\u306b\u306f\uff0c\u3067\u304d\u308c\u3070\u5373\u523b\uff0cCT or MRI guide\u306e\u5b9a\u4f4d\u751f\u691c\u8853\u3092\u3059\u308b\u3079\u304d\u3067\u3042\u308d\u3046\u3057\uff0c\u958b\u982d\u3068\u3057\u3066\u3082\u4f4e\u4fb5\u8972\u306a\u5c0f\u958b\u982d\u306b\u3088\u308bopen biopsy\u304c\u3088\u3044\u3002<br \/>\n\u30b9\u30c6\u30ed\u30a4\u30c9\u306f\u30ea\u30f3\u30d1\u816b\u7d30\u80de\u306b\u5bfe\u3057\u3066cytocidal effect\u304c\u5f37\u3044\u3002\u75c5\u52e2\u306e\u9032\u884c\u304c\u65e9\u3044\u306e\u3067\u75c7\u72b6\u60aa\u5316\u3092\u98df\u3044\u6b62\u3081\u3088\u3046\u3068\uff0c\u30b9\u30c6\u30ed\u30a4\u30c9\u3092\u6295\u4e0e\u3057\u3066\u6642\u9593\u7a3c\u304e\u3092\u3057\u3088\u3046\u3068\u3059\u308c\u3070\uff0c\u4e00\u6642\u7684\u306b\u3067\u306f\u3042\u308b\u304c\u75c5\u5de3\u306e\u58ca\u6b7b\u3092\u62db\u304d\uff0c\u751f\u691c\u8853\u3092\u3057\u3066\u3082\u78ba\u5b9a\u75c5\u7406\u8a3a\u65ad\u3067\u304d\u306a\u3044\u3068\u3044\u3046\u7d50\u679c\u306b\u3082\u306a\u308b\u3002<\/p>\n<p>\u3042\u3048\u3066\u3042\u3052\u308c\u3070\uff0c\u75c5\u7406\u8a3a\u65ad\u306e\u305f\u3081\u306e\u751f\u691c\u8853\uff08\u81e8\u6642\u3042\u308b\u3044\u306f\u7dca\u6025\u624b\u8853\uff09\u3092\u3067\u304d\u308b\u9650\u308a\u65e9\u3044\u65e5\u7a0b\u3067\u6c7a\u5b9a\u3059\u308b\u3053\u3068\uff0c\u305d\u308c\u3068\u540c\u6642\u306bPCNSL\u306e\u4eee\u5b9a\u8a3a\u65ad\u306e\u3082\u3068\u306b\u60a3\u8005\u3055\u3093\u5074\u3078\u306e\u8aac\u660e\u3068\u5316\u5b66\u7642\u6cd5\u306e\u958b\u59cb\u3092\u6e96\u5099\u3057\u306a\u304c\u3089\uff0c\u5fc5\u9808\u306e\u8af8\u691c\u67fb\u3092\u9593\u306b\u7acb\u3066\u3066\u3044\u304f\u3053\u3068\u3067\u3042\u308d\u3046\u3002\u75c7\u72b6\u306e\u5897\u60aa\u304c\u65e9\u3051\u308c\u3070\u751f\u691c\u8853\u306e\u76f4\u5f8c\u304b\u3089\u306e\u30b9\u30c6\u30ed\u30a4\u30c9\u306e\u6295\u4e0e\u958b\u59cb\u306f\u3084\u3080\u3092\u5f97\u306a\u3044\u3002<\/p>\n<\/div>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-large wp-image-10110\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/haboromine-550x413.jpg\" alt=\"\" width=\"550\" height=\"413\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/haboromine-550x413.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/haboromine-300x225.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/haboromine-768x577.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/haboromine.jpg 992w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>PCNSL (primary central nervous system lymphoma) \u5927\u307e\u304b\u306a\u3053\u3068 \u8133\u306e\u3069\u3053\u306b\u3067\u3082\u3067\u304d\u308b\u60aa\u6027\u816b\u760d\u3067\uff0c\u8133\u816b\u760d\u306e3%\u304f\u3089\u3044\u3067\u3059 60\u304b\u308980\u6b73\u4ee3\u306e\u9ad8\u9f62\u8005\u306b\u591a\u304f\u767a\u751f\u3057\u307e\u3059 \u767a\u751f\u7387\u306f\u5897\u52a0 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-111","post","type-post","status-publish","format-standard","hentry","category-braintumors"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/111","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/comments?post=111"}],"version-history":[{"count":75,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/111\/revisions"}],"predecessor-version":[{"id":21533,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/111\/revisions\/21533"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/media?parent=111"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/categories?post=111"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/tags?post=111"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}