悪性神経膠腫のACNU，増感剤併用照射療法の試み

A TRIAL OF ACNU AND RADIATION THERAPY WITH SENSITIZING AGENTS FOR MALIGNANT GLIOMAS

　抄録　悪性神経膠腫12例（anaplastic astrocytoma 4例，glioblastoma 8例），（再発3例，初発9例）に手術後，ACNUと放射線増感剤を用いた380 rad，週2回照射療法を行なった。放射線増感剤としてbromo-uracil deoxyriboside （BUdR），Vidarabine （Ara-A），Aciclovir （ACV）を用いた。BUdRは照射前夜に患側頸動脈内投与を行ない，Ara-A,ACVは照射中，後に静脈内に投与した。照射は計50-60Greyを行なった。再発例は全例，初発例は8例が経過中死亡した。再発例の平均生存期間は17.7か月で，死亡した初発例の平均生存期間は13.4か月であった。生存している例はglioblastomaの例で24か月を経ている。初発例のCTスキャン上での著効（complete response；CR）は5／9で，その率が高いことより悪性神経膠腫に対する治療として本療法は有効であると考える。

Twelve cases of malignant gliomas (anaplastic astrocytoma 4, glioblastoma 8, recurrent 3, primary 9) were treated with ACNU and radiation with sensitizing agents after the surgical removal of the tumor. BUdR, Vidarabine (Ara-A), Aciclovir (ACV) were applied for sensitizing agents. BUdR was administrated intraarterially prior to radiation (380 rad, two times a week), and Ara-A and ACV intravenously during and after the radiation. Total dosage of the radiation was 50-60 Grey for each case.

All recurrent and eight primary patients died. The mean survival time of the recurrent patients was 17.7 months, while that of the primary pa-tients was 13.4 months. One of the primary pa-tient was glioblastoma and is still surviving more than 24 months by now. The complete response (CR) rate of the primary tumor patients observed by computerized tomography (CT) scan was 5/9. We can expect the availability of this trial for malignant gliomas because of high CR rate in pri-mary tumor cases.