{"id":189,"date":"2012-04-19T02:44:01","date_gmt":"2012-04-18T17:44:01","guid":{"rendered":"\/sawamura\/wp\/?p=189"},"modified":"2020-11-21T15:44:13","modified_gmt":"2020-11-21T06:44:13","slug":"icechemothr","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/icechemothr\/","title":{"rendered":"ICE\u5316\u5b66\u7642\u6cd5\u4f7f\u3044\u65b9"},"content":{"rendered":"
\n

ICE chemotherapy
\nifosfamide, cisplatin, etoposide<\/h1>\n

\u3053\u306e\u6cbb\u7642\u306e\u6700\u521d\u306e\u539f\u8457\u306f\uff0cSawamura Y, et al.: Combined irradiation and chemotherapy using ifosfamide, cisplatin, and etoposide for children with medulloblastoma\/posterior fossa primitive neuroectodermal tumor. \u00a0Neurol Med Chirur (Tokyo) 36: 632-638, 1996\u3068\uff0cSawamura Y, et al.: Induction Chemotherapy followed by reduced-volume radiation therapy for newly diagnosed central nervous system germinoma. J Neurosurg 88: 66-72, 1998\u306b\u3042\u308a\u307e\u3059\u3002\u6700\u3082\u6a29\u5a01\u306e\u9ad8\u3044\u539f\u8457\u3068\u3057\u3066\uff0cAoyama H, Sawamura Y et al. : Induction chemotherapy followed by low-dose involved-field radiotherapy for intracranial germ cell tumors. J Clin Oncol 20: 857-865 2002\u306b\u8a18\u8ff0\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n

ICE\u5316\u5b66\u7642\u6cd5\u306e\u6982\u8981<\/span><\/h5>\n

ICE\u5316\u5b66\u7642\u6cd5\u306fIfosfamide (IFO)\u30fbCisplatin (CDDP)\u30fbEtoposide (VP-16)\u306e\u4e09\u8005\u4f75\u7528\u7642\u6cd5\u3067\u3059\u3002\u901a\u5e38\u306f\u5408\u8a08\u3067\uff16\u30b3\u30fc\u30b9\u3092\u884c\u3044\u307e\u3059\u3002ICE\u7642\u6cd5\u5358\u72ec\u3067\u306f\u4e0a\u8a18\u306e\u816b\u760d\u3092\u6cbb\u7652\u3055\u305b\u308b\u3053\u3068\u306f\u96e3\u3057\u304f\u3001\u307b\u3068\u3093\u3069\u306e\u5834\u5408\u3001<\/span>\u653e\u5c04\u7dda\u6cbb\u7642\uff08\u591a\u304f\u306f\u5168\u8133\u810a\u9ac4\u7167\u5c04\uff09\u3068\u306e\u4f75\u7528\u304c\u5fc5\u8981\u3067\u3059\u3002<\/span><\/p>\n

\u307e\u305a\uff0c\u624b\u8853\u306b\u3088\u308b\u7d44\u7e54\u8a3a\u65ad\u3092\u884c\u3063\u305f\u5f8c\u306b\u3001\u6b8b\u5b58\u816b\u760d\u304c\u3042\u308b\u6642\u306b\u306f\u3001ICE\u7642\u6cd5\u3092\uff11\u56de\u884c\u3063\u3066\u305d\u306e\u6709\u52b9\u6027\uff08\u594f\u529f\u6027\uff09\u3092\u753b\u50cf\u3067\u78ba\u8a8d\u3057\u3066\u304b\u3089\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u79fb\u884c\u3059\u308b\u306e\u304c\u826f\u3044\u3067\u3057\u3087\u3046\u3002\u3053\u306e\u5316\u5b66\u7642\u6cd5\u304c\u6709\u52b9\u304b\u3069\u3046\u304b\u3092\u306f\u3063\u304d\u308a\u628a\u63e1\u3057\u3064\u3064\u884c\u3048\u308b\u304b\u3089\u3067\u3059\u3002\u7b2c\u4e00\u56de\u76ee\u306eICE\u7642\u6cd5\u304c\u5168\u304f\u7121\u52b9\u3067\uff0c\u816b\u760d\u304c\u9032\u884c\u3057\u3066\u3057\u307e\u3046\u5834\u5408\u306b\u306f\uff0c\u4ed6\u306e\u5316\u5b66\u7642\u6cd5\u30d7\u30ed\u30c8\u30b3\u30fc\u30eb\u306b\u5909\u66f4\u3059\u308b\u3053\u3068\u3092\u304a\u52e7\u3081\u3057\u307e\u3059\u3002<\/span><\/p>\n

\u4e73\u5e7c\u5150\u306e\u5834\u5408\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u305b\u305aICE\u7642\u6cd5\u3092\u5358\u72ec\u3067\u7d9a\u3051\u307e\u3059\u3002\u5168\u6458\u51fa\u3067\u304d\u305f\uff0c\u5e74\u9577\u5150\u306e\u816b\u760d\u3067\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u3063\u3066\u304b\u3089ICE\u5316\u5b66\u7642\u6cd5\u30926\u30b3\u30fc\u30b9\u7d99\u7d9a\u3057\u307e\u3059\u3002<\/span>ICE\u7642\u6cd5\u7d42\u4e86\u5f8c\u306b\u306f\u5f37\u3044\u9aa8\u9ac4\u6291\u5236\u304c\u751f\u3058\u308b\u305f\u3081\uff0cICE\u5316\u5b66\u7642\u6cd5\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u3046\u6642\u306f\u3067\u304d\u3046\u308b\u9650\u308a\u65e9\u671f\u306b\u5c40\u6240\u7167\u5c04\u3092\u958b\u59cb\u3057\uff0c\u9aa8\u9ac4\u6291\u5236\u306e\u56de\u5fa9\u3092\u307e\u3063\u3066\u305d\u306e\u5f8c\u306b\u5168\u8133\u810a\u9ac4\u7167\u5c04\u3092\u52a0\u3048\u307e\u3059\u3002<\/p>\n

\u7167\u5c04\u5f8c\u306bICE\u7642\u6cd5\u3092\uff13\u56de\u8ffd\u52a0\u3057\u305f\u3068\u3053\u308d\u3067\u9000\u9662\u3068\u3057\u3066\uff0c\u4ee5\u5f8c\uff0c\u7dad\u6301\u7642\u6cd5\u3068\u3057\u30662\uff5e3\u30f6\u6708\u6bce\u306b\uff0c\uff12\u56de\u306eICE\u7642\u6cd5\u3092\u8ffd\u52a0\u3057\u3066\uff0c\u624b\u8853\u5f8c\u304a\u3088\u305d1\u5e74\u3042\u307e\u308a\u3092\u3082\u3063\u3066\u7d42\u4e86\u3092\u76ee\u6307\u3059\u306e\u304c\u901a\u5e38\u3067\u3059\u3002\u3057\u304b\u3057\uff0c\u5316\u5b66\u7642\u6cd5\u62b5\u6297\u6027\u306e\u816b\u760d\u306b\u306ftime intensity\u3092\u3042\u3052\u3066\uff0c\uff16\u30b3\u30fc\u30b9\u9023\u7d9a\u3057\u307e\u3059\u3002\u521d\u767a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306b\u5fdc\u7528\u3059\u308b\u5834\u5408\u306b\u306f\uff13\u30b3\u30fc\u30b9\u3001\u518d\u767a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f4\u30b3\u30fc\u30b9\u3067\u6b62\u3081\u307e\u3059\u3002<\/p>\n

\u672b\u68a2\u8840\u5e79\u7d30\u80de\u79fb\u690d\u3092\u7528\u3044\u308b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3068\u306e\u7d44\u307f\u5408\u308f\u305b\u3067\u306f\uff0cICE\u5316\u5b66\u7642\u6cd5\uff12\u30b3\u30fc\u30b9\u5f8c\u306b\u5e79\u7d30\u80de\u63a1\u53d6\u3092\u3059\u308b\u3068\u52b9\u7387\u304c\u826f\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002
\n<\/span><\/p>\n

\u653e\u5c04\u7dda\u7167\u5c04\u524d\u5316\u5b66\u7642\u6cd5 preirradiation chemotherapy \u306f\u7d50\u679c\u3068\u3057\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u958b\u59cb\u6642\u671f\u3092\u9045\u3089\u305b\u307e\u3059\u3002\u80ce\u5150\u6027\u816b\u760d\u3067\u660e\u3089\u304b\u306b\u6709\u52b9\u306a\u6cbb\u7642\u3067\u3042\u308b\u3053\u3068\u304c\u8a3c\u660e\u3055\u308c\u3066\u3044\u308b\u653e\u5c04\u7dda\u7642\u6cd5\u306e\u958b\u59cb\u6642\u671f\u306e\u9045\u308c\u306f\uff0c\u305d\u306e\u6cbb\u7642\u52b9\u679c\u3092\u6e1b\u3058\u308b\u3068\u3044\u3046\u5371\u60e7\u304c\u3042\u308b\u305f\u3081\uff0c\u5e74\u9577\u5150\u306b\u304a\u3044\u3066\u306fICE\u7642\u6cd5\u5358\u72ec\u3067\u6cbb\u7642\u3092\u7d99\u7d9a\u3059\u308b\u3053\u3068\u306f\u304a\u52e7\u3081\u3067\u304d\u307e\u305b\u3093\u3002\u3057\u304b\u3057\uff0cgerminoma\u3067\u306fICE\u7642\u6cd5\u5358\u72ec\u3067\uff13\u30b3\u30fc\u30b9\u6cbb\u7642\u3092\u9023\u7d9a\u3057\u305f\u5f8c\u306b\u4f4e\u7dda\u91cf\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u308b\u3053\u3068\u3067\u5b8c\u5168\u6cbb\u7652\u7387\u306f\u6975\u3081\u3066\u9ad8\u3044\u3067\u3059\u3002
\n<\/span><\/p>\n

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\u00a0\u5316\u5b66\u7642\u6cd5\u9069\u5fdc\u6761\u4ef6<\/h4>\n

ICE\u7642\u6cd5\u3092\u884c\u3046\u306b\u3042\u305f\u308a\uff0c\u539f\u5247\u3068\u3057\u3066\u4ee5\u4e0b\u306e\u6761\u4ef6\u3092\u6e80\u305f\u3059\u3053\u3068\u3092\u5fc5\u8981\u3068\u3057\u307e\u3059\u3002\u305f\u3060\u3057\uff0c\u6761\u4ef6\u3092\u6e80\u305f\u3055\u306a\u3044\u5834\u5408\u306b\u306f\uff0c\u5f8c\u8ff0\u306edose-reduction\u00a0criteria\u306b\u5247\u3063\u3066\u5404\u85ac\u5264\u3092\u6e1b\u91cf\u3059\u308b\u3053\u3068\u3082\u3067\u304d\u307e\u3059\u3002<\/span><\/p>\n

    \n
  1. \u8a55\u4fa1\u53ef\u80fd\u306a\u60a3\u8005\u3067\u306f\u8074\u529b\u691c\u67fb\u306b\u3066\uff0c\u4e21\u5074\u6027\u306e\u8457\u660e\u306a\u8074\u529b\u969c\u5bb3\u304c\u306a\u3044<\/li>\n
  2. \u30af\u30ec\u30a2\u30c1\u30cb\u30f3\u30af\u30ea\u30a2\u30e9\u30f3\u30b9(CCr)\uff1a70ml\/min\u4ee5\u4e0a<\/li>\n
  3. \u767d\u8840\u7403\u6570\uff1a3,000\/mm2\u4ee5\u4e0a<\/li>\n
  4. \u8840\u5c0f\u677f\u6570\uff1a7,500\/mm2\u4ee5\u4e0a<\/li>\n
  5. \u4ed6\u81d3\u5668\u306e\u8457\u3057\u3044\u969c\u5bb3\u306e\u306a\u3044\u3053\u3068<\/li>\n<\/ol>\n

    \u00a0\u5316\u5b66\u7642\u6cd5\u524d\u8a55\u4fa1\u3068\u958b\u59cb\u6642\u671f<\/span><\/h4>\n

    ICE\u5316\u5b66\u7642\u6cd5\u306e\u9069\u5fdc\u3068\u306a\u308b\u8133\u816b\u760d\u306f\u9ac4\u6db2\u64ad\u7a2e\u3092\u8d77\u3053\u3059\u53ef\u80fd\u6027\u306e\u3042\u308b\u3082\u306e\u3067\u3059\u3002\u3067\u3059\u304b\u3089\u5fc5\u305aICE\u7642\u6cd5\u76f4\u524d\u306b\uff0cwhole neuraxis MRI (\u5168\u8133\u5168\u810a\u9ac4T1\u5f37\u8abf\u753b\u50cf\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37)\u3067\uff0c\u816b\u760d\u306e\u6458\u51fa\u7a0b\u5ea6\uff0c\u4f38\u5c55\u5ea6\uff0c\u64ad\u7a2e\u306e\u6709\u7121\u306b\u3064\u3044\u3066\u306e\u78ba\u8a8d\u3092\u884c\u3092\u884c\u3063\u3066\u4e0b\u3055\u3044\u3002\u3067\u304d\u308c\u3070\uff0c\u9ac4\u6db2\u7d30\u80de\u8a3a\u3082\u3057\u305f\u65b9\u304c\u826f\u3044\u3067\u3057\u3087\u3046\u3002<\/span><\/p>\n

    \u958b\u59cb\u524d\u65e5\u307e\u3067\u306b\u306f\uff0c\u9577\u671f\u7559\u7f6e\u578b\u306e\u30ab\u30c6\u30fc\u30c6\u30eb\u3042\u308b\u3044\u306f\u30dd\u30fc\u30c8\u3092\u9396\u9aa8\u4e0b\u306b\u7559\u7f6e\u3057\u307e\u3059\u3002\u30d6\u30ed\u30d3\u30a2\u30c3\u30af\u30fb\u30ab\u30c6\u30fc\u30c6\u30eb\u306a\u3069\u306f\u633f\u5165\u5f8c\uff12\u9031\u9593\u304f\u3089\u3044\u306f\u629c\u3051\u3084\u3059\u3044\u306e\u3067\u6ce8\u610f\u3057\u3066\u4e0b\u3055\u3044\u3002\u3053\u306e\u30ab\u30c6\u30fc\u30c6\u30eb\u304b\u3089\u306f\uff0c\u63a1\u8840\u304c\u3067\u304d\u307e\u3059\u3057\uff0c\u60a3\u8005\u3055\u3093\u306f\u30ab\u30c6\u30fc\u30c6\u30eb\u3092\u5165\u308c\u305f\u307e\u307e\u304a\u98a8\u5442\u306b\u5165\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3057\uff0c\u53d6\u5916\u3057\u304c\u3067\u304d\u308b\u305f\u3081\u5916\u6cca\u3084\u4e00\u6642\u9000\u9662\u304c\u53ef\u80fd\u3067\uff0c\u30ab\u30c6\u30fc\u30c6\u30eb\u304c\u539f\u56e0\u3068\u306a\u308b\u611f\u67d3\u75c7\u306e\u78ba\u7acb\u304c\u975e\u5e38\u306b\u4f4e\u3044\u3082\u306e\u3067\u3059\u3002\u6cbb\u7642\u671f\u9593\u304c\u975e\u5e38\u306b\u9577\u671f\u9593\u306b\u53ca\u3073\u307e\u3059\u304c\u6570\u30ab\u6708\u4ee5\u4e0a\u306b\u308f\u305f\u3063\u3066\u7559\u7f6e\u3067\u304d\u308b\u3068\u3044\u3046\u5229\u70b9\u3092\u3082\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n

    ICE\u7642\u6cd5\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u524d\u8a55\u4fa1\u3092\u3057\u305f\u5f8c\uff0c\u53ef\u80fd\u306a\u9650\u308a\u624b\u8853\uff08\u958b\u982d\u3068\u751f\u691c\u3082\u542b\u3081\u3066\uff09\u304b\u3089\u9045\u304f\u3068\u3082\uff11\u9031\u9593\u5f8c\u306b\u306f\u958b\u59cb\u3067\u304d\u307e\u3059\u3002\u624b\u8853\u306b\u3088\u3063\u3066\u5f97\u3089\u308c\u305f\u51cd\u7d50\u6a19\u672c\u3067\u304a\u3088\u305d\u306e\u75c5\u7406\u8a3a\u65ad\u304c\u5f97\u3089\u308c\u3066\uff0c\u8853\u524d\u8a3a\u65ad\u3068\u5927\u304d\u304f\u7570\u306a\u308b\u3053\u3068\u304c\u306a\u3051\u308c\u3070\u53ef\u80fd\u3067\u3059\u3002\u78ba\u5b9a\u7684\u306a\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u3092\u514d\u75ab\u67d3\u8272\u3084\u907a\u4f1d\u5b50\u8a3a\u65ad\u306e\u305f\u3081\u306b\uff12\u304b\u30894\u9031\u9593\u5f85\u3066\u3070\u305d\u306e\u9593\u306b\u9032\u884c\u3057\u3066\u3057\u307e\u3046\u75c7\u4f8b\u3082\u591a\u3044\u3068\u3044\u3046\u7d4c\u9a13\u304b\u3089\u3053\u306e\u3088\u3046\u306a\u65e9\u671f\u6295\u4e0e\u3082\u884c\u3044\u307e\u3057\u305f\u3002<\/span>ICE\u7642\u6cd5\u958b\u59cb\u6642\u671f\u304c\u8853\u5f8c\u65e9\u671f\u3067\u3042\u308b\u3053\u3068\u3067\u7279\u306b\u969c\u5bb3\uff08\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\uff09\u3092\u6765\u3057\u305f\u7d4c\u9a13\u306f\u306a\u304f\uff0c\u6025\u901f\u5897\u5927\u50be\u5411\u304c\u3042\u308b\u9ad8\u5ea6\u60aa\u6027\u816b\u760d\u306b\u3042\u3048\u3066\u5316\u5b66\u7642\u6cd5\u306e\u958b\u59cb\u3092\u9045\u5ef6\u3055\u305b\u308b\u3068\u3044\u3046\u7406\u8ad6\u7684\u6839\u62e0\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/span><\/p>\n

    \u5c3f\u5d29\u75c7(DI)\u306e\u3042\u308b\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\u5c3f\u5d29\u75c7\u3092\u653e\u7f6e\u3057\u305f\u307e\u307e\u306b\u3057\u3066\u3053\u306e\u5316\u5b66\u7642\u6cd5\u3092\u3057\u306a\u3044\u65b9\u304c\u3044\u3044\u3067\u3059\u3002\u5c3f\u6bd4\u91cd\u304c\u4e0b\u304c\u308a\u5c3f\u91cf\u304c\u591a\u304f\u306a\u308a\u904e\u304e\u306a\u3044\u3088\u3046\u306b\uff0cDDAVP\u30c7\u30b9\u30e2\u30d7\u30ec\u30c3\u30b7\u30f3\uff08\u3042\u308b\u3044\u306f\u6c34\u6eb6\u6027\u30d4\u30c8\u30ec\u30c3\u30b7\u30f3\uff09\u3092\u4f7f\u7528\u3057\u3064\u3064ICE\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3044\u307e\u3059\u3002<\/span><\/p>\n

    ICE\u5316\u5b66\u7642\u6cd5\u30d7\u30ed\u30c8\u30b3\u30fc\u30eb<\/span><\/h3>\n

    ICE\u7642\u6cd5\u306b\u304a\u3051\u308b\u5404\u7a2e\u85ac\u5264\u91cf\u306f\u4ee5\u4e0b\u306e\u3068\u304a\u308a\u3067\u3059\u3002<\/span><\/p>\n\n\n\n\n\n
    \n

    Ifosfamide (IFOS)<\/span><\/p>\n<\/td>\n

    		\n

    900mg\/m2<\/span><\/p>\n<\/td>\n

    		\n

    days 1-5<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    Cisplatin (CDDP)<\/span><\/p>\n<\/td>\n

    		\n

    20mg\/m2<\/span><\/p>\n<\/td>\n

    		\n

    days 1-5<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    Etoposide (VP-16)<\/span><\/p>\n<\/td>\n

    		\n

    60mg\/m2<\/span><\/p>\n<\/td>\n

    		\n

    days 1-5<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    \u00a0\u6295\u4e0e\u65b9\u6cd5\u306f\u5404\u85ac\u5264\u3068\u3082\u751f\u7406\u98df\u5869\u6c34\u306b\u6eb6\u89e3\u3057\uff0c\uff12\u6642\u9593\u304b\u3051\u3066\u70b9\u6ef4\u9759\u6ce8\u3057\u307e\u3059\u3002\u5404\u85ac\u5264\u3068\u3082\uff15\u65e5\u9593\u6295\u4e0e\u3067\uff0c\u3053\u308c\u30921 cycle\uff08\u30b3\u30fc\u30b9\uff0928\u65e5\u3068\u3057\u3066\u3044\u307e\u3059\u3002\u9593\u9694\u306f\u304a\u3088\u305d\uff14\u9031\u9593\u306b\uff11\u30b3\u30fc\u30b9\u3067\u884c\u3046\u3053\u3068\u304c\u53ef\u80fd\u3067\u3059\u3002\u6709\u5bb3\u4e8b\u8c61\u304c\u751f\u3058\u305f\u3068\u304d\u306b\u306f\u85ac\u5264\u91cf\u3092\u6e1b\u91cf\u3059\u308b\u3053\u3068\u3067\u5bfe\u5fdc\u3057\u3066\u6295\u4e0e\u6642\u671f\u3092\u9045\u3089\u305b\u306a\u3044\u3088\u3046\u306b\u3057\u307e\u3059\u3002<\/p>\n

    \u305f\u3060\u3057\uff0c1\u6b73\u672a\u6e80\uff08\uff10\u6b73\uff09\u306e\u75c7\u4f8b\u3067\u306f\uff0c\u6295\u4e0e\u91cf\u306e\u6c7a\u5b9a\u306b\u969b\u3057\u3066\u901a\u5e38\u306e\u4f53\u8868\u9762\u7a4d\u306e\u8a08\u7b97\u5f0f\u306e\u5024\u3092\u7528\u3044\u305a\uff0c\u4f53\u91cd30kg\u3042\u305f\u308a\u4f53\u8868\u9762\u7a4d\u3092\uff11m2\u3068\u3057\u3066\u8a08\u7b97\u3057\u3066\u304f\u3060\u3055\u3044\u3002\u307e\u305f\uff0c\uff12\u6b73\u672a\u6e80\uff08\uff10\u6b73\u3068\uff11\u6b73\u5150\uff09\u306e\u4f8b\u3067\u306f\u814e\u6a5f\u80fd\u3078\u306e\u8ca0\u62c5\u8efd\u6e1b\u3092\u76ee\u7684\u306b\uff0cCDDP\u309224\u6642\u9593\u6301\u7d9a\u70b9\u6ef4\u6295\u4e0e\u3068\u3057\u307e\u3059\u3002<\/span><\/p>\n

    \u3000\uff10\u6b73\u5150CDDP\u6295\u4e0e\u91cf = 20mg\/30kgx\u4f53\u91cd(kg)<\/span><\/p>\n

    \u00a0ICE\u5316\u5b66\u7642\u6cd5\u3067\u306fCDDP\u3084IFOS\u3092\u7528\u3044\u308b\u305f\u3081\uff0c\u901a\u5e38\u306e\u8f38\u6db2\u91cf\u306b\u6bd4\u3079\u5927\u91cf\u306e\u8f38\u6db2\u3092\u5fc5\u8981\u3068\u3057\u307e\u3059\u3002\u5f97\u306b\uff0cCDDP\u306e\u814e\u81d3\u304b\u3089\u306e\u6392\u51fa\u3092\u4fc3\u3059\u305f\u3081\u3067\u3059\u3002\u540c\u52b9\u306e\u85ac\u5264\u3067\u3082\uff0c\u88fd\u85ac\u4f1a\u793e\u306b\u3088\u3063\u3066\u540d\u79f0\u304c\u5909\u308f\u308a\u307e\u3059\u306e\u3067\u6ce8\u610f\u3057\u3066\u4e0b\u3055\u3044\u3002\u7528\u91cf\u306f\uff0c\u4f7f\u7528\u3055\u308c\u308b\u85ac\u5264\u306e\u7528\u6cd5\u306b\u5f93\u3063\u3066\u4e0b\u3055\u3044\u3002\u524d\u6295\u4e0e\u3068\u3057\u3066\u306e\u88dc\u6db2\u306b\u306fCl\uff08\u30af\u30ed\u30fc\u30eb\uff09\u6fc3\u5ea6\u306e\u9ad8\u3044\u7d30\u80de\u5916\u6db2\u306b\u8fd1\u3044\u3082\u306e\u3092\u7528\u3044\u3066\u307e\u3059\u3057\uff0c\u5316\u5b66\u7642\u6cd5\u4e2d\u306b\u98df\u4e8b\u6442\u53d6\u304c\u4e0d\u826f\u3068\u306a\u308b\u3053\u3068\u304c\u591a\u3044\u306e\u3067\u3067\u304d\u308c\u3070\u7cd6\u8cea\uff08\u30ab\u30ed\u30ea\u30fc\uff09\u306e\u88dc\u5145\u3067\u304d\u308b\u3082\u306e\u3092\u9078\u629e\u3057\u307e\u3059\u3002<\/span><\/p>\n

    \u00a0\u88dc\u6db2\u5185\u5bb9\u3092\u542b\u3081\u305f\uff11\u6b73\u5150\u4f8b\u306b\u5bfe\u3059\u308bICE\u5316\u5b66\u7642\u6cd5\u306e\uff11\u4f8b\u3092\u4f8b\u793a\u3057\u307e\u3059\u3002<\/span><\/h4>\n

    CDDP\u306f\uff12\u6b73\u4ee5\u4e0a\u3068\u7570\u306a\u308a5\u65e5\u9593\u6301\u7d9a\u6295\u4e0e\u3067\u3059\u306e\u3067\u6ce8\u610f\u3057\u3066\u4e0b\u3055\u3044\u3002\u30bd\u30eb\u30e1\u30c9\u30ed\u30fc\u30eb\u306f\u4fdd\u967a\u8a3a\u7642\u3067\u8a8d\u3081\u3089\u308c\u3066\u3044\u307e\u305b\u3093\u3002\u5614\u5410\u306e\u5f37\u3044\u53ef\u80fd\u6027\u306e\u3042\u308b\u60a3\u8005\u3055\u3093\u306b\u4f7f\u3063\u3066\u4e0b\u3055\u3044\u3002\u30ea\u30f3\u30c7\u30ed\u30f3\u306a\u3069\u306e\u30b9\u30c6\u30ed\u30a4\u30c9\u3067\u4ee3\u7528\u3059\u308b\u3053\u3068\u3082\u826f\u3044\u3067\u3057\u3087\u3046\u3002\u3053\u306e\u4f8b\u3067\u306e\u88dc\u6db2\u7dcf\u91cf\u306f1,150ml\/day\u306b\u306a\u308a\u307e\u3059\u304c\u4f53\u91cd\u306b\u5fdc\u3058\u3066\u9069\u5b9c\u5909\u66f4\u3057\u3066\u4e0b\u3055\u3044\u3002\u98df\u4e8b\u6442\u53d6\u304c\u60aa\u3044\u3068\u304d\u306b\u306f\u88dc\u6db2\u3092\u5897\u91cf\u3057\u3066\u3082\u3088\u3044\u3067\u3059\u3002\u6295\u4e0e\u91cf\u306e\u8a08\u7b97\u306f\uff0c\uff11\u6b73\u672a\u6e80\uff080\u6b73\u5150\uff09\u306f30kg\/m2\u3068\u4eee\u5b9a\u3057\u3066\u4f53\u91cd\u3042\u305f\u308a\u306b\u3066\u6295\u4e0e\u91cf\u6c7a\u5b9a\u3057\u307e\u3059\u3002<\/span><\/p>\n

    \u4f8b\uff1bCDDP 20 mg \/ 30 kg x body weight (kg)<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
    \n

    09:00-10:00<\/span><\/p>\n<\/td>\n

    		\n

    \u30bd\u30ea\u30bfT1 100 ml + 5-HT3\u53d7\u5bb9\u4f53\u62ee\u6297\u5264
    \n<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    10:00-\u7fcc\u671d10:00 <\/span><\/p>\n

    (24\u6642\u9593\u6301\u7d9a\u6295\u4e0e)<\/span><\/p>\n<\/td>\n

    		\n

    CDDP \u00a020mg\/m2 +\u751f\u98df 250ml<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    11:30-12:00<\/span><\/p>\n<\/td>\n

    		\n

    5-HT3\u53d7\u5bb9\u4f53\u62ee\u6297\u5264 + \u30bd\u30eb\u30e1\u30c9\u30ed\u30fc\u30eb50mg\/m2 + \u751f\u98df 50 ml
    \n<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    12:00-14:00<\/span><\/p>\n<\/td>\n

    		\n

    VP-16 \u00a060mg\/m2 +\u751f\u98df50ml
    \n<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    14:00-14:30<\/span><\/p>\n<\/td>\n

    		\n

    MESNA \u00a0270mg\/m2 +\u751f\u98df50ml<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    14:30-16:30<\/span><\/p>\n<\/td>\n

    		\n

    IFOS \u00a0900mg\/m2 +\u751f\u98df50ml<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    16:30-17:00<\/span><\/p>\n<\/td>\n

    		\n

    MESNA \u00a0270mg\/m2 +\u751f\u98df50ml<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    17:00-\u7fcc\u671d 9:00<\/span><\/p>\n<\/td>\n

    		\n

    \u30bd\u30ea\u30bfT3G 500ml<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    19:00-19:30<\/span><\/p>\n<\/td>\n

    		\n

    MESNA \u00a0270mg\/m2 +\u751f\u98df50ml<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    ICE regimen\u306e\u6cbb\u7642\u6bd2\u6027\u306e\u5224\u5b9a\u3068\u5bfe\u7b56<\/span><\/h3>\n

    \u904e\u53bb\u306e\u7d4c\u9a13\u304b\u3089ICE\u7642\u6cd5\u3067\u306f\uff0c\u9aa8\u9ac4\u6291\u5236\u3092\u4e3b\u3068\u3057\u305f\u526f\u4f5c\u7528\u306b\u3088\u308afull dose\uff08\u898f\u5b9a\u91cf\uff09\u3092\uff14\u9031\u9593\u6bce\u306b\u6295\u4e0e\u3059\u308b\u3053\u3068\u306f\u56f0\u96e3\u306a\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002\u5f93\u3063\u3066\uff0c\u6cbb\u7642\u671f\u9593\u3092\u5ef6\u9577\u305b\u305a\u306b\u7d99\u7d9a\u3059\u308b\u305f\u3081\u306b\uff0c\u5404\u7a2e\u85ac\u5264\u306b\u3088\u308b\u6cbb\u7642\u6bd2\u6027\uff08\u6709\u5bb3\u4e8b\u8c61\u8a55\u4fa1\uff09\u306e\u5224\u5b9a\u306b\u57fa\u3065\u3044\u305f\uff0c\u6295\u4e0e\u91cf\u306e\u5909\u66f4\u304c\u91cd\u8981\u306a\u56e0\u5b50\u3068\u306a\u308a\u307e\u3059\u3002<\/span><\/p>\n

    \u00a0\u814e\u6a5f\u80fd<\/span><\/h4>\n

    \u691c\u67fb\uff1b\u3000\u5404\u30b3\u30fc\u30b9\u6cbb\u7642\u76f4\u524d\u3068\u6cbb\u7642\u5f8c\uff11\u9031\u9593\u4ee5\u5185\u3067CCr\u3092\u6e2c\u5b9a\u3059\u308b\u3002<\/span><\/p>\n

    \u5bfe\u7b56\uff1b\u3000hydration\u3084mannitol\u3092\u4f7f\u7528\u3057\u3066\u5c3f\u91cf\u3092\u78ba\u4fdd\u3059\u308b\u3002\u901a\u5e38\uff12\u6b73\u4ee5\u4e0a\u3067\u306f1,500ml\u4ee5\u4e0a\uff0c\uff16\u6b73\u4ee5\u4e0a\u30672,000ml\u4ee5\u4e0a\uff0c\u6210\u4eba\u3067\u306f3,000ml\u4ee5\u4e0a\u306e\u8f38\u6db2\u3092\u884c\u3046\u3002\uff12\u6b73\u672a\u6e80\u306e\u75c7\u4f8b\u3067\u306f\uff0cCDDP\u306f24\u6642\u9593\u6301\u7d9a\u6295\u4e0e\u3068\u3057\u3066\u30de\u30f3\u30cb\u30c8\u30fc\u30eb\u3092\u4f7f\u7528\u3057\u306a\u3044\u3002\u6cbb\u7642\u524d\u306eCCr\u5024\u306b\u3088\u308a\u4e0b\u8a18\u306e\u5982\u304fCDDP\u6295\u4e0e\u91cf\u3092\u5909\u66f4\u3059\u308b\u3002<\/span><\/p>\n

    \u3000\u3000\u3000CCr<\/span>\u2265<\/span>70ml\/min\u306e\u5834\u5408\uff0cCDDP100%\u91cf\u6295\u4e0e\u3002<\/span><\/p>\n

    \u3000\u3000\u3000CCr<70ml\/min\u306e\u5834\u5408\uff0cCDDP\u306e\u307f\u6295\u4e0e\u4e2d\u6b62\u3002<\/span><\/p>\n

    \u7279\u306b\u6ce8\u610f\u3057\u3066\u307b\u3057\u3044\u306e\u306f\uff0c\u5c3f\u5d29\u75c7(DI)\u306e\u3042\u308b\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\u5c3f\u6bd4\u91cd\u304c\u4f4e\u4e0b\u3057\u3066\u5c3f\u91cf\u304c\u591a\u304f\u306a\u308a\u904e\u304e\u306a\u3044\u3088\u3046\u306b\uff0cDDAVP\u30c7\u30b9\u30e2\u30d7\u30ec\u30c3\u30b7\u30f3\uff08\u3042\u308b\u3044\u306f\u6c34\u6eb6\u6027\u30d4\u30c8\u30ec\u30c3\u30b7\u30f3\uff09\u3092\u4f7f\u7528\u3057\u3064\u3064ICE\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3046\u3053\u3068\u3067\u3059\u3002DI\u3092\u653e\u7f6e\u3057\u305f\u307e\u307eICE\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3048\u3070\uff0c\u4f4e\u30ca\u30c8\u30ea\u30a6\u30e0\u8840\u75c7\u306a\u3069\u3092\u62db\u304d\uff0c\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u304c\u56f0\u96e3\u3068\u306a\u308a\u307e\u3059\u3002\u904e\u5ea6\u306e\u4f4e\u6bd4\u91cd\u5c3f\u304c\u591a\u91cf\u306b\u306a\u3089\u306a\u3044\u3088\u3046\u306b\u3057\u3066\u4e0b\u3055\u3044\u3002<\/span><\/p>\n

    \u00a0\u8074\u529b<\/span><\/h4>\n

    \u691c\u67fb\uff1bCDDP\u306f\u5f37\u3044\u8074\u6bd2\u6027\u3092\u3082\u3063\u3066\u3044\u308b\u306e\u3067\uff0cpure-tone audiometry(PTA)\u306b\u3088\u308b\u8074\u529b\u8a55\u4fa1\u3092\u884c\u3044\u307e\u3059\u3002\u305f\u3060\u3057\uff0c\u901a\u5e38\uff14\u6b73\u4ee5\u4e0b\u3067\u306f\uff0caudiometry\u306b\u3088\u308b\u8a55\u4fa1\u306f\u56f0\u96e3\u3067\u3059\u306e\u3067\uff0c<\/span>\u8033\u97f3\u97ff\u53cd\u5c04\u691c\u67fb distortion product otoacoustic emission (DPOAE)\u3067\u8a55\u4fa1\u3057\u307e\u3059\u3002\u5404\u30b3\u30fc\u30b9\u306e\u6295\u4e0e\u7d42\u4e8610\uff5e14\u65e5\u306e\u9593\u306b\u8a55\u4fa1\u3059\u308b\u306e\u304c\u826f\u3044\u3067\u3057\u3087\u3046\u3002\u3061\u306a\u307f\u306b\uff0cCBDCA\uff08\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\uff09\u3082\u8074\u6bd2\u6027\u306f\u3042\u308b\u306e\u3067\u304a\u5fd8\u308c\u306a\u304f\u3002<\/span><\/p>\n

    \u5bfe\u7b56\uff1b4,000-8,000Hz\u306740dB\u672a\u6e80\u306e\u8efd\u5ea6\u8074\u529b\u4f4e\u4e0b\u6642\u306b\u306f\uff0c\u30b9\u30c6\u30ed\u30a4\u30c9\u5264\u3084ATP\u88fd\u5264\u3092\u6295\u4e0e\u3057\u3066CDDP\u306e\u6e1b\u91cf\u3092\u3057\u307e\u305b\u3093\u30024,000-8,000Hz\u306740dB\u4ee5\u4e0a\u306e\u4f4e\u4e0b\u3092\u307f\u3066\u3082\u4f1a\u8a71\u57df50-2,000Hz\u3067\u7570\u5e38\u3092\u8a8d\u3081\u306a\u3044\u5834\u5408\u306f\uff0cCDDP\u306e\u6b21\u56de\u6295\u4e0e\u91cf\u309215mg\/m2\u306b25%\u6e1b\u91cf\u3057\u307e\u3059\u3002\u4f1a\u8a71\u57df\u306720dB\u672a\u6e80\u306e\u4f4e\u4e0b\u304c\u307f\u3089\u308c\u305f\u5834\u5408\uff0cCDDP\u306e\u6295\u4e0e\u91cf\u309210mg\/m2\u3078\u306850%\u6e1b\u91cf\u3057\u307e\u3059\u3002\u4f1a\u8a71\u57df\u3067\u5316\u5b66\u7642\u6cd5\u524d\u3088\u308a\u66f4\u306b20dB\u4ee5\u4e0a\u306e\u4f4e\u4e0b\u304c\u307f\u3089\u308c\u305f\u5834\u5408\u306f\uff0cCDDP\u6295\u4e0e\u3092\u4e2d\u6b62\u3057\u307e\u3059\u3002<\/span><\/p>\n

    \u9aa8\u9ac4\u6a5f\u80fd\u306e\u6291\u5236<\/span><\/h4>\n

    \u691c\u67fb\uff1bHb\u5024\u30fb\u767d\u8840\u7403\u6570(total WBC)\u30fb\u597d\u4e2d\u7403\u6570 (ANC, absolute neutrophil count)\u30fb\u8840\u5c0f\u677f\u6570\u3092\u6e2c\u5b9a\u3057\u307e\u3059\u3002\u3053\u308c\u304cICE\u5316\u5b66\u7642\u6cd5\u3067\u6700\u3082\u91cd\u8981\u306a\u30e2\u30cb\u30bf\u30fc\u3067\u3059\u3002\u6cbb\u7642\u524d\u306a\u3089\u3073\u306b\u6cbb\u7642\u5f8c\u306f\uff13\uff5e7\u65e5\u306b\u4e00\u5ea6\u306e\u5272\u5408\u3067\u63a1\u8840\u3092\u884c\u3044\u307e\u3059\u304c\uff0c\u5c0f\u5150\u3067\u306f\u63a1\u8840\u91cf\u304c\u5c11\u306a\u304f\u306a\u308b\u3088\u3046\u306b\u5de5\u592b\u3057\u3066\u4e0b\u3055\u3044\u3002\u305f\u3060\u3057\uff0c\u767d\u8840\u7403\u6570\u304c2,000\/\u03bcL\u672a\u6e80\u3082\u3057\u304f\u306f\u597d\u4e2d\u7403\u65701,000\/\u03bcL\u672a\u6e80\u306b\u306a\u3063\u305f\u5834\u5408\u306f\u9694\u65e5\u3067\u63a1\u8840\u3092\u884c\u3044\u307e\u3059\u3002\u9ad8\u5ea6\u306anadir\uff08\u9aa8\u9ac4\u6291\u5236\u304c\u6700\u3082\u5f37\u3044\u6642\u671f\uff09\u306e\u6642\u306f\u9023\u65e5\u306e\u63a1\u6c7a\u3092\u3059\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3057\uff0c\u56de\u5fa9\u5f8c\u306f5\uff5e7\u65e5\u306b\u4e00\u5ea6\u306e\u5272\u5408\u3068\u3057\u307e\u3059\u3002\u305f\u3060\u3057\uff0cG-CSF\uff08\u9846\u7c92\u7403\u30b3\u30ed\u30cb\u30fc\u523a\u6fc0\u56e0\u5b50\uff09\u6295\u4e0e\u4e2d\u6b62\u5f8c\u306f\u518d\u3073\u6025\u901f\u306b\u518d\u4f4e\u4e0b\u3092\u3059\u308b\u3053\u3068\u3082\u3042\u308b\u306e\u3067\u6ce8\u610f\u3057\u307e\u3059\u3002<\/span><\/p>\n

    \u5bfe\u7b56\uff1b\u85ac\u5264\u306e\u6295\u4e0e\u91cf\u3092\u9069\u5207\u306b\u6e1b\u91cf\u3059\u308b\u3053\u3068\u3067\uff0c\u6cbb\u7642\u9593\u9694\u3092\u9075\u5b88\u3059\u308b\u3053\u3068\u304c\u53ef\u80fd\u3067\u3059\u304b\u3089\uff0c\u6b21\u56de\u6cbb\u7642\u306e\u5ef6\u671f\u306f\u53ef\u80fd\u306a\u9650\u308a\u907f\u3051\u308b\u3079\u304d\u3067\u3059\u3002<\/p>\n

    \uff11)\u767d\u8840\u7403\u30fb\u9846\u7c92\u7403\u7cfb<\/span><\/p>\n

    \u767d\u8840\u7403\u6570\u304c1,000\/\u03bcL\u672a\u6e80(grade 4)\u3082\u3057\u304f\u306f\u597d\u4e2d\u7403\u6570500\/\u03bcL\u672a\u6e80(grade 4)\u3067G-CSF\u306e\u6295\u4e0e\u3092\u958b\u59cb\u3057\u307e\u3059\u3002\u30a8\u30f3\u30d3\u30e9\u30b1\u30a2\u306a\u3069\u306e\u7a7a\u6c17\u6e05\u6d44\u5668\u3092\u30d9\u30c3\u30c9\u30b5\u30a4\u30c9\u306b\u304a\u3044\u3066\uff0c\u3067\u304d\u308c\u3070\u500b\u5ba4\u7ba1\u7406\u3068\u3057\u3066\uff0c\u60a3\u8005\u3055\u3093\u306e\u884c\u52d5\u5236\u9650\u3082\u3057\u307e\u3059\u3002\u7121\u83cc\u5ba4\u306b\u5165\u5ba4\u3055\u305b\u308b\u5fc5\u8981\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u9762\u4f1a\u306e\u3042\u308b\u7a0b\u5ea6\u306e\u5236\u9650\u3082\u3057\u305f\u65b9\u304c\u826f\u3044\u3067\u3057\u3087\u3046\u3002<\/span><\/p>\n

    \uff12)\u8840\u5c0f\u677f\u7cfb<\/span><\/p>\n

    \u8840\u5c0f\u677f\u6570\u304c25,000\/\u03bcL\u672a\u6e80(grade 4)\u3082\u3057\u304f\u306f30,000\/\u03bcL\u672a\u6e80\u3067\u9f3b\u51fa\u8840\u7b49\u306e\u51fa\u8840\u75c7\u72b6\u304c\u51fa\u73fe\u3057\u305f\u5834\u5408\u306b\u8840\u5c0f\u677f\u8f38\u8840\u3092\u884c\u3044\u307e\u3059\u3002<\/span><\/p>\n

    \uff13)\u8d64\u8840\u7403\u7cfb<\/span><\/p>\n

    \u6b21\u306e\u5316\u5b66\u7642\u6cd5\u524d\u306bHb\u5024\u304c8g\/dl(grade 3-4)\u672a\u6e80\u3067\u3042\u308c\u3070\uff0c\u7167\u5c04\u3057\u305f\u8d64\u8840\u7403\u6db2\u8f38\u8840\u3092\u884c\u3044\u307e\u3059\u3002<\/span><\/p>\n

    \u00a0\u9aa8\u9ac4\u6291\u5236\u306b\u5bfe\u3059\u308bIFOS\/VP-16 dose reduction criteria<\/span><\/p>\n

    \u9aa8\u9ac4\u6291\u5236\u51fa\u73fe\u6642\u306f\u4ee5\u4e0b\u306b\u8a18\u8f09\u3059\u308b\u5404\u6761\u4ef6\u8a2d\u5b9a\u306b\u57fa\u3065\u304d\uff0cVP-16\u3068IFOS\u306e\u6b21\u56de\u6295\u4e0e\u91cf\u3092\u6c7a\u5b9a\u3057\u307e\u3059\u3002\u4e0b\u8a181)\uff5e4)\u306e\u6e1b\u70b9\u6761\u4ef6\u3092\u6e80\u305f\u3057\u305f\u5834\u5408\uff0c\u5404\u3005\u306b\u3064\u304d\uff11\u30dd\u30a4\u30f3\u30c8\u6e1b\u70b9\u3068\u3057\uff0c\u305d\u306e\u5408\u8a08\u70b9\u3092\u524d\u56de\u307e\u3067\u306e\u6e1b\u70b9\u5206\u306b\u7d2f\u7a4d\u3057\u3066\u6295\u4e0e\u91cf\u3092\u6c7a\u5b9a\u3057\u307e\u3059\u3002\uff12\u30b3\u30fc\u30b9\u7d9a\u3051\u3066\u6e1b\u70b9\u306e\u7121\u3044\u5834\u5408\u306f\uff0c\u9006\u306b\uff11\u70b9\u3092\u52a0\u70b9\u3057\u5897\u91cf\u3057\u307e\u3059\u3002\u305f\u3060\u3057\uff0c\u6b21\u56de\u6cbb\u7642\u76f4\u524d\u5024\uff08G-CSF\u4f7f\u7528\u6642\u306b\u306f\u6295\u4e0e\u7d42\u4e86\uff13\u65e5\u5f8c\u306e\u5024\uff09\u306b\u3066\u767d\u8840\u7403\u6570\uff0c\u9846\u7c92\u7403\u6570\u3082\u3057\u304f\u306f\u8840\u5c0f\u677f\u6570\u304c\uff0cCTC grade 3\u3082\u3057\u304f\u306fgrade 4\u306b\u6b62\u307e\u308b\u6642\u306b\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u306e\u6642\u671f\u3092\u4e00\u9031\u9593\u9045\u5ef6\u3057\u307e\u3059\u3002\u30dd\u30a4\u30f3\u30c8\u6bce\u306e\u6295\u4e0e\u91cf\u3092\u4e0b\u8868\u306b\u793a\u3057\u307e\u3059\u306e\u3067\u53c2\u8003\u306b\u3057\u3066\u4e0b\u3055\u3044\u3002\u305d\u308c\u305e\u308c\u306e\u85ac\u5264\u306e\u521d\u56de\u6295\u4e0e\u8a2d\u5b9a\u91cf\u306b\u5bfe\u3059\u308b%\u3067\u8868\u793a\u3057\u3066\u3042\u308a\u307e\u3059\u3002<\/span><\/p>\n

    \u6e1b\u70b9\u6761\u4ef6<\/p>\n

    \uff11) \u767d\u8840\u7403\u6570\u3082\u3057\u304f\u306f\u597d\u4e2d\u7403\u6570\u306enadir\u304cCTC grade 4\u306e\u5834\u5408\u30de\u30a4\u30ca\u30b9\uff11\u30dd\u30a4\u30f3\u30c8\u3068\u3059\u308b\u3002<\/span><\/p>\n

    \uff12) \u8840\u5c0f\u677f\u6570\u306enadir\u304cCTC grade 4\u306e\u5834\u5408\u30de\u30a4\u30ca\u30b9\uff11\u30dd\u30a4\u30f3\u30c8\u3068\u3059\u308b\u3002<\/span><\/p>\n

    \uff13) 38.0\u2103\u4ee5\u4e0a\u306e\u767a\u71b1\u3092\u793a\u3059granulocytopenic fever\u3084\uff0c\u30d8\u30eb\u30da\u30b9\u611f\u67d3\u75c7\u3084\u4ed6\u306e\u611f\u67d3\u75c7\uff0c\u9f3b\u51fa\u8840\u7b49\u306e\u51fa\u8840\u75c7\u72b6\u304c\u751f\u3058\u305f\u5834\u5408\u30de\u30a4\u30ca\u30b9\uff11\u30dd\u30a4\u30f3\u30c8\u3068\u3059\u308b\u3002<\/span><\/p>\n

    \uff14) \u6b21\u56de\u6cbb\u7642\u76f4\u524d\u5024\uff08G-CSF\u4f7f\u7528\u6642\u306b\u306f\u6295\u4e0e\u7d42\u4e86\uff13\u65e5\u5f8c\u306e\u5024\uff09\u306b\u3066\u767d\u8840\u7403\u6570\uff0c\u597d\u4e2d\u7403\u6570\u3082\u3057\u304f\u306f\u8840\u5c0f\u677f\u6570\u304c\uff0cCTC\u00a0grade 1\u306e\u5834\u5408\u30de\u30a4\u30ca\u30b9\uff11\u30dd\u30a4\u30f3\u30c8\u3068\u3059\u308b\u3002CTC grade 2\u306e\u5834\u5408\u30de\u30a4\u30ca\u30b9\uff12\u30dd\u30a4\u30f3\u30c8\u3068\u3059\u308b\u3002<\/span>
    \n<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
    \n

    Points<\/span><\/p>\n<\/td>\n

    		\n

    VP-16\u6295\u4e0e\u91cf<\/span><\/p>\n<\/td>\n

    		\n

    IFOS \u6295\u4e0e\u91cf<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    0<\/span><\/p>\n<\/td>\n

    		\n

    100 %<\/span><\/p>\n<\/td>\n

    		\n

    100%<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    -1<\/span><\/p>\n<\/td>\n

    		\n

    100 %<\/span><\/p>\n<\/td>\n

    		\n

    75%<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    -2<\/span><\/p>\n<\/td>\n

    		\n

    75%<\/span><\/p>\n<\/td>\n

    		\n

    75%<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    -3<\/span><\/p>\n<\/td>\n

    		\n

    75%<\/span><\/p>\n<\/td>\n

    		\n

    60%<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    -4<\/span><\/p>\n<\/td>\n

    		\n

    60%<\/span><\/p>\n<\/td>\n

    		\n

    60%<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    -5<\/span><\/p>\n<\/td>\n

    		\n

    100 %<\/span><\/p>\n<\/td>\n

    		\n

    0%<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    -6<\/span><\/p>\n<\/td>\n

    		\n

    75%<\/span><\/p>\n<\/td>\n

    		\n

    0%<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    -7<\/span><\/p>\n<\/td>\n

    		\n

    60%<\/span><\/p>\n<\/td>\n

    		\n

    0%<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    \u4f8b\uff1b\u524d\u56de\u6cbb\u7642\u306b\u3088\u308a\u6e1b\u70b9\uff12\u3068\u306a\u308a\uff0c\u4eca\u56de\u306e\u6295\u4e0e\u91cf\u304cVP-16\uff0cIFOS\u3068\u3082\u306b\u521d\u56de\u91cf\u306e75%\u91cf\u3068\u3055\u308c\u305f\u5834\u5408\uff0c\u4eca\u56de\u306e\u6cbb\u7642\u3067\u3055\u3089\u306b\uff13\u30dd\u30a4\u30f3\u30c8\u304c\u6e1b\u70b9\u3055\u308c\u308b\u3068\uff0c\u8a08\uff15\u30dd\u30a4\u30f3\u30c8\u306e\u6e1b\u70b9\u3068\u306a\u308a\uff0c\u6b21\u56de\u306e\u6295\u4e0e\u91cf\u306f\u521d\u56de\u91cf\u306eVP-16\u304c100%\u3067\uff0cIFOS\u306f\uff10%\u3067\u6295\u4e0e\u4e2d\u6b62\u3068\u306a\u308b\u3002<\/span><\/p>\n

    \u30aa\u30ea\u30b8\u30ca\u30eb\u3067\u306fCTC (common terminology criteria for\u00a0adverse events, 2004)\u3092\u7528\u3044\u307e\u3057\u305f\u3002\u65b0\u3057\u3044\u30af\u30e9\u30a4\u30c6\u30ea\u30a2\u3067\u3082\u540c\u69d8\u306b\u5fdc\u7528\u3067\u304d\u307e\u3059\u3002<\/span><\/p>\n\n\n\n\n\n\n\n
    \n

    Grade<\/span><\/p>\n<\/td>\n

    		\n

    1<\/span><\/p>\n<\/td>\n

    		\n

    2<\/span><\/p>\n<\/td>\n

    		\n

    3<\/span><\/p>\n<\/td>\n

    		\n

    4<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    Hb (g\/dl)<\/span><\/p>\n<\/td>\n

    		\n

    <LLN-10.0<\/span><\/p>\n<\/td>\n

    		\n

    <10.0-8.0<\/span><\/p>\n<\/td>\n

    		\n

    <8.0-6.5<\/span><\/p>\n<\/td>\n

    		\n

    <6.5<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    total WBC \/mm2<\/span><\/p>\n<\/td>\n

    		\n

    <LLN-3000<\/span><\/p>\n<\/td>\n

    		\n

    <3000-2000<\/span><\/p>\n<\/td>\n

    		\n

    <2000-1000<\/span><\/p>\n<\/td>\n

    		\n

    <1000<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    neutrophils \/mm2<\/span><\/p>\n<\/td>\n

    		\n

    <LLN-1500<\/span><\/p>\n<\/td>\n

    		\n

    <1500-1000<\/span><\/p>\n<\/td>\n

    		\n

    <1000-500<\/span><\/p>\n<\/td>\n

    		\n

    <500<\/span><\/p>\n<\/td>\n<\/tr>\n

    \n

    platelets \/mm2<\/span><\/p>\n<\/td>\n

    		\n

    <LLN-75000<\/span><\/p>\n<\/td>\n

    		\n

    <75000-50000<\/span><\/p>\n<\/td>\n

    		\n

    <50000-25000<\/span><\/p>\n<\/td>\n

    		\n

    <25000<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    \u00a0<\/span>\u51fa\u8840\u6027\u8180\u80f1\u708e<\/h4>\n

    \u691c\u67fb\uff1bIFOS\u306e\u526f\u4f5c\u7528\u3068\u3057\u3066\u51fa\u8840\u6027\u8180\u80f1\u708e\u304c\u3042\u308a\u307e\u3059\uff0c\u305d\u308c\u3092\u7279\u7570\u7684\u306b\u4e88\u9632\u3059\u308b\u306e\u304cMESNA\u3067\u3059\u3002\u6295\u4e0e\u671f\u9593\u4e2d\u306f\u5c3f\u6f5c\u8840\u3092\u6bce\u65e5\u89b3\u5bdf\u3059\u308b\u304b\uff0c\u5b9a\u671f\u7684\u306b\u691c\u67fb\u3057\u307e\u3059\u3002<\/span><\/p>\n

    \u5bfe\u7b56\uff1bMESNA\u3068IFOS\u306e\u4f75\u7528\u6295\u4e0e\u3092\u5fc5\u305a\u884c\u3044\u307e\u3059\u3002\u9855\u5fae\u93e1\u7684\u8840\u5c3f\u304c\u51fa\u73fe\u3057\u305f\u5834\u5408\uff0c\u8089\u773c\u7684\u8840\u5c3f\u306e\u51fa\u73fe\u306e\u6709\u7121\u306b\u3064\u3044\u3066\u5341\u5206\u6ce8\u610f\u3057\u307e\u3059\u3002\u8089\u773c\u7684\u8840\u5c3f\u51fa\u73fe\u306e\u969b\u306b\u306fIFOS\u6295\u4e0e\u3092\u4e2d\u65ad\u3057\u3066\u30a2\u30eb\u30d6\u30df\u30f3\u3084\u30b9\u30c6\u30ed\u30a4\u30c9\u5264\u306e\u6295\u4e0e\u3092\u884c\u3044\uff0c\u3053\u308c\u306f\u9855\u5fae\u93e1\u7684\u306b\u3082\u8840\u5c3f\u304c\u6d88\u3048\u308b\u307e\u3067\u7d99\u7d9a\u3057\u307e\u3059\u3002\u3055\u3089\u306b\u6b21\u306e\u6cbb\u7642\u6642\u306b\u306fIFOS\u3092\u6e1b\u91cf\u3057\u3066\uff0c\u521d\u56de\u6295\u4e0e\u91cf\u306e75\uff05\u91cf\u306e\u6295\u4e0e\u3068\u3057\u307e\u3059\u3002\u8840\u5c3f\u304c\u6539\u5584\u3059\u308c\u3070\u5143\u306b\u623b\u3057\u3066\u3088\u3044\u304c\uff0c\u9006\u306b\u8089\u773c\u7684\u8840\u5c3f\u304c\u518d\u767a\u3057\u305f\u5834\u5408\u306fIFOS\u306e\u6295\u4e0e\u3092\u4e2d\u6b62\u3057\u307e\u3059\u3002<\/span><\/p>\n

    \u6587\u732e<\/h4>\n

    1) Aoyama H, Sawamura Y et al. : Induction chemotherapy followed by low-dose involved-field radiotherapy for intracranial germ cell tumors. J Clin Oncol 20: 857-865 2002<\/span><\/p>\n

    2) Roberts RO, et al. : Medulloblastoma: a population-based study of 532 cases. \u00a0J Neuropathol Exp Neurol 50: 134-144, 1991<\/span><\/p>\n

    3) Evans AE, et al. : The treatment of medulloblastoma\u3002 Results of a prospective randomized trial of radiation therapy with and without CCNU, vincristine, and prednisone. \u00a0J Neurosurg 72: 572-582, 1990<\/span><\/p>\n

    4) Johnson DL, et al.: Quality of long-term survival in young children with medulloblastoma. J Neurosurg 80: 1004-1010, 1994<\/span><\/p>\n

    5) Sawamura Y, et al.: Induction Chemotherapy followed by reduced-volume radiation therapy for newly diagnosed central nervous system germinoma. J Neurosurg 88: 66-72, 1998<\/span><\/p>\n

    6) Sawamura Y, et al.: Combined irradiation and chemotherapy using ifosfamide, cisplatin, and etoposide for children with medulloblastoma\/posterior fossa primitive neuroectodermal tumor. \u00a0Neurol Med Chirur (Tokyo) 36: 632-638, 1996<\/span><\/p>\n

    \u00a0<\/span><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

    ICE chemotherapy ifosfamide, cisplatin, etoposide \u3053\u306e\u6cbb\u7642\u306e\u6700\u521d\u306e\u539f\u8457\u306f\uff0cSawamura Y, et al.: Combined irradiation and che […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-189","post","type-post","status-publish","format-standard","hentry","category-pediattumor"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/189","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=189"}],"version-history":[{"count":21,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/189\/revisions"}],"predecessor-version":[{"id":16572,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/189\/revisions\/16572"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/media?parent=189"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/categories?post=189"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/tags?post=189"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}