放射線治療が著効した放射線誘発Glioblastomaの1例

A Case Showing Effective Radiotherapy for a Radiation-induced Glioblastoma

I．はじめに

　放射線誘発脳腫瘍は同じ組織型の自然発生腫瘍に比べ，悪性度が高く予後が悪いと言われている^6,7,9）．また，安全な放射線照射線量が少なくなることが予想されるため，十分な線量を照射しにくいことが治療上問題となってくる^9）．今回，われわれは予後不良と予測された放射線誘発神経膠芽腫に対し放射線療法が著効した例を経験したので報告する．

Radiation-induced glioblastoma is usually resistant to all treatments. We report a case with radiation-in-duced glioblastoma, in which radiotherapy was remarkably effective. A14-year-old female with a history ofacute lymphoblastic leukemia, at the age of 7, underwent 15 Gy of radiotherapy to the whole brain, Shewas admitted to our department due to the development of headache and nausea. Magnetic resonance im-aging showed an irregularly enhanced mass in the left frontal lobe. Partial removal of the mass was per-formed and histological examination showed it to be glioblastoma with a high MIB-1 index. The patientunderwent 40 Gy of local radiotherapy and chemotherapy with ACNU and Interferon-β for 2 years. Theresidual tumor disappeared after the radiotherapy, and her status is still “complete remission”, 29 monthsafter the onset.