\u4e00\u793e\uff09\u65e5\u672c\u30cf\u30a4\u30d1\u30fc\u30b5\u30fc\u30df\u30a2\u5b66\u4f1a\u30cb\u30e5\u30fc\u30b9No.110\u3010\u5b66\u8853\u5831\u544a45\u3011
\u30cf\u30a4\u30d1\u30fc\u30b5\u30fc\u30df\u30a2\u306b\u95a2\u3059\u308b\u6700\u8fd1\u306e\u8a71\u984c45<\/p>\n\n\n\n
\u9032\u884c\u6027\u30fb\u9ad8\u30ea\u30b9\u30af\u8edf\u90e8\u8089\u816b\u60a3\u8005\u306b\u5bfe\u3059\u308b\u9818\u57df\u52a0\u6e29\u4f75\u7528\u30b5\u30eb\u30d9\u30fc\u30b8\u7642\u6cd5\u306b\u3064\u3044\u3066<\/p>\n\n\n\n
\u91d1\u68ee\u660c\u5f66\u3001*\u8fd1\u85e4\u3000\u9686
\u5bcc\u5c71\u5927\u5b66\u5b66\u8853\u7814\u7a76\u90e8\u533b\u5b66\u7cfb\uff0c\u4eba\u9593\u79d1\u5b66\uff0c*\u653e\u5c04\u7dda\u8a3a\u65ad\u30fb\u6cbb\u7642\u5b66<\/p>\n\n\n\n
\u30a2\u30f3\u30c8\u30e9\u30b5\u30a4\u30af\u30ea\u30f3\u7cfb\u6297\u764c\u5264\u6cbb\u7642\u5f8c\u306b\u5897\u60aa\u3042\u308b\u3044\u306f\u518d\u767a\u3057\u305f\u8edf\u90e8\u8089\u816b(soft tissue
sarcoma\uff0c\u4ee5\u4e0bSTS)\u306e\u60a3\u8005\u306f\u4e88\u5f8c\u4e0d\u826f\u3068\u8003\u3048\u3089\u308c\u308b\uff0e\u305d\u306e\u305f\u3081\u624b\u8853\u53ef\u80fd\u306a\u72b6\u614b\u3078\u306e\u7e2e\u5c0f\u3092\u56f3\u308b\u304b\uff0c\u816b\u760d\u306e\u5897\u6b96\u5236\u5fa1\u3092\u76ee\u7684\u3068\u3057\u3066\uff0c\u30b5\u30eb\u30d9\u30fc\u30b8\u7642\u6cd5\u304c\u5b9f\u65bd\u3055\u308c\u308b\uff0e\u3053\u3053\u3067\u306f\u9818\u57df\u52a0\u6e29(regional hyperthermia\uff0c\u4ee5\u4e0bRHT)\u3092\u4f75\u7528\u3057\u305f
ICE \u7642\u6cd5(\u30a4\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9 6 g\/m2\uff0c\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3 400 mg\/m2\uff0c\u304a\u3088\u3073\u30a8\u30c8\u30dd\u30b7\u30c9
600 mg\/m2)\u3092\u8853\u524d\u5f8c\u306e\u5316\u5b66\u7642\u6cd5\u3068\u3057\u3066\u5b9f\u65bd\u3057\u305f\u6700\u65b0\u306e\u5831\u544a1) \u3092\u7d39\u4ecb\u3059\u308b\uff0e RHT\u306b\u306fBSD-2000
hyperthermia system (Pyrexar Medical Co., \u5468\u6ce2\u657075\uff5e140 MHz\uff0c8\u30a2\u30f3\u30c6\u30ca\u3092\u642d\u8f09\uff0c\u6700\u5927\u51fa\u529b1,300 W)\u3092\u4f7f\u7528\u3057\uff0c\u816b\u760d\u6e29\u5ea6\uff0c40-43\u00b0C\u306760\u5206\u9593\u3068\u3057\u305f\uff0e\u3053\u306e\u6cbb\u7642\u6cd5\u306b\u3064\u3044\u3066\uff0c\u5f8c
\u308d\u5411\u304d\u7814\u7a76\u3068\u3057\u3066\u6709\u52b9\u6027\u3068\u5b89\u5168\u6027\u3092\u8a55\u4fa1\u3057\u305f\uff0e\u5bfe\u8c61\u306f18\u6b73\u4ee5\u4e0a\u306e\u5c40\u6240\u9032\u884c\u6027\u9ad8\u30ea\u30b9\u30afSTS\u60a3\u8005\u3067\uff0c\u30d5\u30a1\u30fc\u30b9\u30c8\u30e9\u30a4\u30f3\u306e\u30a2\u30f3\u30c8\u30e9\u30b5\u30a4\u30af\u30ea\u30f3\u7cfb\u6297\u764c\u5264\u6cbb\u7642\u7121\u52b9\u4f8b\u306b\u5bfe\u3057\u3066\uff0cRHT\u4f75\u7528ICE\u7642\u6cd5\u3092\u53d7\u3051\u305f\u60a3\u8005\u3092\u8ee2\u79fb\u306e\u6709\u7121\u306b\u3088\u308a\u6bd4\u8f03\u3057\u305f\uff0e\u753b\u50cf\u8a55\u4fa1\uff0c\u6709\u5bb3\u4e8b\u8c61\uff0c\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593(progression free survival\uff0c\u4ee5\u4e0bPFS)\uff0c\u5168\u751f\u5b58\u671f\u9593(overall survival\uff0c\u4ee5\u4e0bOS)\u3092
\u8a55\u4fa1\u3057\u305f\uff0e \u30eb\u30fc\u30c8\u30f4\u30a3\u30d2\u30fb\u30de\u30af\u30b7\u30df\u30ea\u30a2\u30f3\u5927\u5b66\u30df\u30e5\u30f3\u30d8\u30f3(\u901a\u79f0\u30df\u30e5\u30f3\u30d8\u30f3\u5927\u5b66)\u9644\u5c5e\u75c5\u9662\u30671996\uff5e2018\u5e74\u306b213 \u540d\u306eSTS\u60a3\u8005\u304cICE\u6cbb\u7642\u3092\u53d7\u3051\u305f\u304c\uff0c\u3053\u306e\u3046\u3061\u9078\u629e\u57fa\u6e96\u306b\u5408\u81f4\u3059\u308b110\u540d\u304c\u5206
\u6790\u5bfe\u8c61\u3068\u306a\u3063\u305f\uff0e 54\u540d\u304c\u8ee2\u79fb\u306a\u3057\u306e\u5c40\u6240\u9032\u884c\u4f8b(LA-STS)\uff0c56\u540d\u304c\u8ee2\u79fb\u4f8b(M-STS)\u3067\u3042\u3063\u305f\uff0e\u75be\u60a3\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u304c\u3067\u304d\u305f\u306e\u306fLA-STS\u306759%\uff0cM-STS\u306747%\u3067\u3042\u3063\u305f\uff0eLA-STS\u3067\u306f21%\u3067\u753b\u50cf\u4e0a\u306e\u7e2e\u5c0f\u3092\u8a8d\u3081\uff0c7%(4\u540d)\u304c\u624b\u8853\u306b\u79fb\u884c\u3067\u304d\u305f\uff0e\u307e\u305fM-STS\u3067\u306f11%\u304c\u753b\u50cf\u4e0a\u7e2e\u5c0f\u3092\u793a\u3057\uff0c9%(5\u540d)\u304c\u624b\u8853\u53ef\u80fd\u3068\u306a\u3063\u305f\uff0ePFS\u306fLA-STS\u306710\u304b\u6708\u3068\u660e\u3089\u304b\u306bM-STS\u306e4\u304b\u6708\u3088\u308a\u9577\u304f(p<0.0001)\uff0cLA-STS\u306eOS\u306e\u4e2d\u592e\u5024\u306f26\u304b\u6708\uff0cM-STS\u3067\u306f12\u304b\u6708\u3067\u3042\u3063\u305f\uff0e\u591a\u5909\u91cf\u89e3\u6790\u306e\u7d50\u679c\uff0cOS\u306e\u6539\u5584\u306b\u304a\u3044\u3066\uff0c\u75be\u60a3\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3092\u3067\u304d\u305f\u3053\u3068\u304c\u552f\u4e00\u306e\u72ec\u7acb\u4e88\u5f8c\u6539\u5584\u56e0\u5b50\u3067\u3042\u3063\u305f\uff0e\u6709\u5bb3\u4e8b\u8c61\u3068\u3057\u3066\u597d\u4e2d\u7403\u6e1b\u5c11(\u75c7)\u6027\u767a\u71b1\u304c\u591a\u304f(25%)\uff0c\u6cbb\u7642\u95a2\u9023\u6b7b\u306f3\u4f8b\u3067\u3042\u3063\u305f\uff0e\u3059\u306a\u308f\u3061ICE\u4f75\u7528RHT\u7642\u6cd5\u306f\u9032\u884c\u6027\u30fb\u9ad8\u30ea\u30b9\u30afSTS\u306b\u5bfe\u3057\u3066\uff0c\u30a2\u30f3\u30c8\u30e9\u30b5\u30a4\u30af\u30ea\u30f3\u7cfb\u6297\u764c\u5264\u6cbb\u7642\u7121\u52b9\u7fa4\u3067\u3082\uff0c\u60a3\u8005\u306b\u3088\u3063\u3066\u306f\u52b9\u679c\u304c\u3042\u308a\uff0c\u624b\u8853\u3078\u306e\u79fb\u884c\u304c\u53ef\u80fd\u3067\u3042\u3063\u305f\uff0e\u4e00\u65b9\uff0c\u6709\u5bb3\u4e8b\u8c61\u4f8b\u3092\u8003\u616e\u3059\u308b\u3068\u7528\u91cf\u306f75%\u3078\u306e\u6e1b\u91cf\u304c\u63a8\u5968\u3055\u308c\u308b\u3082\u306e\u3068\u3057\u3066\u3044\u308b\uff0e
\u307e\u305f\uff0c\u540c\u3058\u304f\u9ad8\u30ea\u30b9\u30afSTS\u306b\u5bfe\u3059\u308bRHT\u4f75\u7528\u8853\u524d\u5316\u5b66\u7642\u6cd5\u306e\u52b9\u679c\u304cEORTC 62961-ESHO
95\u30e9\u30f3\u30c0\u30e0\u5316\u81e8\u5e8a\u8a66\u9a13\u6210\u7e3e\u3068\u3057\u3066\u5831\u544a\u3055\u308c\u3066\u3044\u308b2)\uff0e\u3053\u3053\u3067\u306f\uff0c\u5358\u72ec\u5316\u5b66\u7642\u6cd5\u7fa4(\u30a4\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9 6 g\/m2\uff0c\u30c9\u30ad\u30bd\u30eb\u30d3\u30b7\u30f350 mg\/m2\uff0c\u304a\u3088\u3073\u30a8\u30c8\u30dd\u30b7\u30c9 600 mg\/m2)\u3068RHT\u4f75
\u7528\u7fa4\u3068\u306e\u9593\u3067PFS\u304a\u3088\u3073OS\u304c\u8a55\u4fa1\u3055\u308c\u305f\uff0e\u5bfe\u8c61\u306f329\u4f8b(\u5e74\u9f62\u306e\u4e2d\u592e\u502451\u6b73\uff0c\u5973\u6027147\u540d\uff0c\u7537\u6027182 \u540d)\u3067\u3042\u308a\uff0c220 \u4f8b(67%)\u306b\u518d\u767a\u3092\u8a8d\u3081\uff0c188\u4f8b(57%)\u304c\u6b7b\u4ea1\u3057\u305f(\u8ffd\u8de1\u671f\u9593\u306e\u4e2d
\u592e\u5024\u306f11\uff0e3\u5e74)\uff0eRHT\u4f75\u7528\u306b\u3088\u308bPFS\u306e\u6539\u5584\u52b9\u679c\u306b\u95a2\u3059\u308b\u30cf\u30b6\u30fc\u30c9\u6bd4\u306f0.65\uff0c\u540c\u69d8\u306bOS\u306b\u95a2\u3059\u308b\u30cf\u30b6\u30fc\u30c9\u6bd4\u306f0.73\u3067\u3042\u3063\u305f\uff0e5\u5e74\u751f\u5b58\u7387\u306f\u5358\u72ec\u5316\u5b66\u7642\u6cd5\u7fa4\u304c51.3%\u3067\u3042\u308b\u306e\u306b\u5bfe\u3057\u3066\uff0cRHT\u4f75\u7528\u7fa4\u306762.7%\uff0c10\u5e74\u751f\u5b58\u7387\u306f\u5358\u72ec\u5316\u5b66\u7642\u6cd5\u7fa4\u306742.7%\uff0cRHT\u4f75\u7528\u7fa4\u306752.6%\u3067\u3042\u3063\u305f\uff0e\u3053\u306e\u3088\u3046\u306b\u9ad8\u30ea\u30b9\u30afSTS\u60a3\u8005\u306b\u304a\u3044\u3066\u5316\u5b66\u7642\u6cd5\u306bRHT\u3092\u4f75\u7528\u3059\u308b\u3053\u3068\u3067\uff0c\u4e88\u5f8c\u306e\u6539\u5584\u304c\u8a8d\u3081\u3089\u308c\u305f\uff0e
\u4e21\u8005\u306b\u5171\u901a\u3057\u3066\u7528\u3044\u3089\u308c\u3066\u3044\u308b\u85ac\u5264\u306f\u30a4\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\u3068\u30a8\u30c8\u30dd\u30b7\u30c9\u3067\u3042\u308b\u304c\uff0c\u30a2\u30f3\u30c8\u30e9\u30b5\u30a4\u30af\u30ea\u30f3\u7cfb\u6297\u764c\u5264\u306b\u52b9\u679c\u3092\u793a\u3055\u306a\u304b\u3063\u305f\u5834\u5408\u3067\u3082\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u306e\u4f7f\u7528\u304c\u6709\u52b9\u3067\u3042\u3063\u305f\u3053\u3068\u306b\u306f\u610f\u5473\u304c\u3042\u308b\u304b\u3082\u3057\u308c\u306a\u3044\uff0e\u3057\u304b\u3057\u306a\u304c\u3089\uff0c\u4ee5\u4e0a\u306e2\u3064\u306e\u8ad6\u6587\u306f\u9032\u884c\u6027\u30fb\u9ad8\u30ea\u30b9\u30afSTS\u60a3\u8005\u306b\u304a\u3044\u3066\uff0c\u85ac\u5264\u9078\u629e\u3060\u3051\u3092\u8003\u3048\u308b\u306e\u3067\u306f\u306a\u304f\uff0cRHT\u306e\u4f75\u7528\u304c\u4e88\u5f8c\u6539\u5584\u306b\u5411\u3051\u3066\u63a8\u5968\u3055\u308c\u308b\u3053\u3068\u3092\u793a\u3057\u3066\u304a\u308a\uff0c\u6cbb\u7642\u306b\u96e3\u6e0b\u3059\u308bSTS\u60a3\u8005\u306b\u6069\u6075\u3092\u3082\u305f\u3089\u3059\u3082\u306e\u3068\u3044\u3048\u308b\uff0e
\u53c2\u8003\u6587\u732e
1) B\u00fccklein V, et al. Ifosfamide, carboplatin, and etoposide (ICE) in
combination with regional hyperthermia as salvage therapy in patients with
locally advanced nonmetastatic and metastatic soft-tissue sarcoma. Sarcoma
27: 6901678, 2020.<\/p>\n\n\n\n
2) Issels RD, et al. Effect of neoadjuvant chemotherapy plus regional
hyperthermia on long-term outcomes among patients with localized high-risk
soft tissue sarcoma: The EORTC 62961-ESHO 95 randomized clinical trial. JAMA
Oncol 4: 483-492, 2018.
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