{"id":15,"date":"2007-06-15T15:32:10","date_gmt":"2007-06-15T06:32:10","guid":{"rendered":"http:\/\/aihara.la.coocan.jp\/blog\/?p=15"},"modified":"2014-04-16T15:36:25","modified_gmt":"2014-04-16T06:36:25","slug":"%e3%82%a2%e3%83%90%e3%82%b9%e3%83%81%e3%83%b3%e3%81%ae%e6%9c%89%e5%8a%b9%e6%80%a7","status":"publish","type":"post","link":"http:\/\/aihara.la.coocan.jp\/?p=15","title":{"rendered":"\u30a2\u30d0\u30b9\u30c1\u30f3\u306e\u6709\u52b9\u6027"},"content":{"rendered":"<div>\n<p>\u4e2d\u5916\u88fd\u85ac\u306e\u3001\u5927\u8178\u304c\u3093\u306e\u6297\u304c\u3093\u5264\u30d9\u30d0\u30b7\u30ba\u30de\u30d6\uff08\u30a2\u30d0\u30b9\u30c1\u30f3Avastin\uff09\u304c\u3001\u56fd\u5185\u3067\u5fc5\u8981\u306a\u81e8\u5e8a\u8a66\u9a13\u306e\u4e00\u90e8\uff08\u56fd\u5185\u7b2cII\u76f8\u81e8\u5e8a\u8a66\u9a13\uff09\u3092\u5b9f\u65bd\u305b\u305a\u306b\u7533\u8acb\u3057\u3001\uff08\u5f53\u521d\u4e88\u5b9a\u3088\u308a\u3082\u7d0418\u304b\u6708\u3082\u65e9\u304f\uff09\u8a31\u53ef\u3055\u308c\u307e\u3057\u305f\u3002\u30a2\u30d0\u30b9\u30c1\u30f3\u306f\u8840\u7ba1\u65b0\u751f\u3068\u3044\u3046\u3001\u304c\u3093\u7d44\u7e54\u306b\u6804\u990a\u3068\u9178\u7d20\u3092\u4f9b\u7d66\u3059\u308b\u8840\u7ba1\u7db2\u306e\u4f38\u5f35\u3092\u963b\u5bb3\u3059\u308b\u6cbb\u7642\u85ac\u3067\u3001\u672c\u5264\u306e\u4f75\u7528\u3067\u3001\u304c\u3093\u816b\u760d\u306e\u5897\u6b96\u3084\u5168\u8eab\u8ee2\u79fb\u304c\u9632\u304c\u308c\u3001\u3059\u3067\u306b\u30a2\u30e1\u30ea\u30ab\u3084\u30e8\u30fc\u30ed\u30c3\u30d1\u306a\u3069\u3067\u8ca9\u58f2\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<p><\/p>\n<p>\u4eca\u56de\u306e\u30a2\u30d0\u30b9\u30c1\u30f3\u306e\u85ac\u4fa1\u306f\u3001100mg\uff1d5\u4e07\u5186\u3001\u4f7f\u7528\u91cf\u304b\u3089\u3059\u308b\u3068\u300110mg\/kg\u3068\u3057\u3066\u3001\u7d04400mg\uff1d19\u4e07\u5186\u3067\u3059\u3002<br \/>\n\u3067\u306f\u3001\u3053\u306e\u85ac\u5264\u306e\u6709\u52b9\u6027\u306f\u3069\u306e\u7a0b\u5ea6\u306a\u306e\u3067\u3057\u3087\u3046\u304b\uff1f\u3000\u8ad6\u6587\u3092\u30c1\u30a7\u30c3\u30af\u3057\u3066\u307f\u307e\u3059\u3002<\/p>\n<p><\/p>\n<p><b>\u6587\u732e\uff1b<\/b><br \/>\n<u>Giantonio BJ, et al: J Clin Oncol. 2007 Apr 20;25(12):1539-44<br \/>\nBevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200.\u3000<\/u><\/p>\n<p><\/p>\n<p><b>\u7814\u7a76\u306e\u8981\u65e8\uff1a<\/b><br \/>\n\u25a0\u81e8\u5e8a\u7591\u554f:\u3000\u30aa\u30ad\u30b5\u30ea\u30d7\u30e9\u30c1\u30f3\u3092\u4e3b\u4f53\u3068\u3057\u305f\u5316\u5b66\u7642\u6cd5\u306e\u5b9f\u65bd\u304c\u3042\u308b\u8ee2\u79fb\u6027\u5927\u8178\u764c\u60a3\u8005\u3067\u3001Bevacizumab\uff08B\uff1a\u30d9\u30b6\u30b7\u30ba\u30de\u30d6)\u304c\u751f\u5b58\u671f\u9593\u306b\u304a\u3088\u307c\u3059\u52b9\u679c\u3092\u691c\u8a0e\u3059\u308b<br \/>\n\u25a0\u7814\u7a76\uff1a\u3000RCT(phase-III)\uff1a\u3000intention-to-treat\u89e3\u6790\u3002<br \/>\n\u25a0\u8a66\u9a13\u304c\u884c\u308f\u308c\u305f\u5834\u6240\uff08\u7c73\u56fd\u3001\u5357\u30a2\u30d5\u30ea\u30ab\u306e221\u65bd\u8a2d\uff09<br \/>\n\u25a0Efficacy\u7814\u7a76\u3001\u7814\u7a76\u671f\u9593\uff1a2001\uff5e2003\u5e74<br \/>\n\u25a0\u60a3\u8005\uff08P\uff09\uff1a\u3000\u8ee2\u79fb\u6027\u5927\u8178\u764c\u60a3\u8005\u3001\u5316\u5b66\u7642\u6cd5\u5b9f\u65bd\u4f8b\u3001800\u4eba<br \/>  \uff08\u5e74\u9f62\uff1d60\u6b73\uff1a\u3000\u7537\u602760%\u3001PS=0\uff5e1\u3001\u809d\u8ee2\u79fb70%\uff09\u3002<br \/>\n\u25a0\u4ecb\u5165\uff08I)\uff1a\u30003\u7fa4\u306b\u30e9\u30f3\u30c0\u30e0\u5272\u4ed8(1:1:1)\uff1a\u3000(1)FOLFOX4(+B)\u3001(2)FOLFOX4(-B), (3)Bevacizumab\u5358\u72ec\uff1a<br \/> 2\u9031\u9593\u306b\u4e00\u5ea6\u306e\u5316\u5b66\u7642\u6cd5\u30921\u30af\u30fc\u30eb\u3068\u3057\u3066\uff1b\u3000FOLFOX4(+B\uff09\u7fa410\u30b5\u30a4\u30af\u30eb\u3001FOLFOX (-B)\u7fa4\uff17\u30b5\u30a4\u30af\u30eb\u3001B\u5358\u72ec\u7fa4\uff14\u30b5\u30a4\u30af\u30eb\u3001<br \/>\n\u25a0\u30a2\u30a6\u30c8\u30ab\u30e0(O)\uff1a\u3000\u4e3b\u8981\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8\u306f &#8220;overall survival&#8221;<br \/>\n\u25a0\u89b3\u5bdf\u671f\u9593\uff08T)\uff1a\u3000median\u300028\u30f6\u6708<\/p>\n<p><\/p>\n<p><b>\u25cf\u7d50\u679c\uff1a<\/b><br \/>\n\u54043\u7fa4\u306e\u751f\u5b58\u671f\u9593\uff08median. \u6708\uff09\u306f\u3001\u5404\u3005\u300012.9, 10.8, 10.2\u3002\u524d2\u7fa4\u6bd4\u8f03\u3067\u306f\u3001Hazard \u6bd4= 0.75, p=0.0011<br \/>\n\u526f\u4f5c\u7528\u3068\u3057\u3066\u306f\u3001\u8840\u5727\u4e0a\u6607\u3001\u51fa\u8840\uff08\u7a7f\u5b54\u306a\u3069\uff09\u3001\u5614\u5410\u3001\u8840\u6813\u75c7\u3001\u6b7b\u4ea1\u306a\u3069\u304c\u3042\u3063\u305f\u3002<\/p>\n<p>xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx<\/p>\n<p><\/p>\n<p>[\u30b3\u30e1\u30f3\u30c8] GRADE system\u3092\u53c2\u8003\u306b\u3057\u3064\u3064\u3001\u3053\u306e\u85ac\u5264\u52b9\u679c\u3092\u30c1\u30a7\u30c3\u30af\u3059\u308b\u3068\u3001\u3069\u3046\u304b\uff1f<br \/>\n\u672c\u5831\u544a\u306f\u3001RCT\u3067\u3001\u6df1\u523b\u306alimitations\u306f\u306a\u3044\u304c\u3001\u6cbb\u7642\u53cd\u5fdc\u8a55\u4fa1\u306f\u72ec\u7acb\u3057\u305f\u30ec\u30d3\u30e5\u30fc\u3067\u306f\u306a\u3044\u3068\u8a18\u8f09\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<p><\/p>\n<p>\u307e\u305f\u4ed6\u306e\u985e\u4f3c\u3057\u305fRTC\u304c\u3042\u308b\u3082\u306e\u306e\uff08Tyagi, P 2006, Kabbinavar F 2005, Huuwitz H 2004, etc)\u3001\u4f75\u7528\u3059\u308b\u591a\u5264\u5316\u5b66\u7642\u6cd5\u306e\u76f8\u9055\u304c\u3042\u308a\u3001\u305d\u306e\u305f\u3081Bevacizumab\u4f75\u7528\u52b9\u679c\u306f\u7570\u306a\u3063\u3066\u3044\u307e\u3059\u3002\u540c\u3058FOLFOX4\u30ec\u30b8\u30e1\u30f3\u3067\u3082\u7d71\u8a08\u5b66\u7684\u306b\u6709\u610f\u5dee\u304c\u306a\u3044\u3068\u3059\u308b\u7d50\u679c\u3082\u3042\u308a\u307e\u3059\uff08Tyagi P: HR=0.89, p=0.1871)\u3002<\/p>\n<p><\/p>\n<p>\u5f93\u3063\u3066\u3001\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\u3068\u3057\u3066\u306f\u3001&#8221;High&#8221;\u3067\u3042\u308b\u304c\u3001grade-down\u9805\u76ee\u3068\u3057\u3066\u3001&#8221;inconsistency&#8221; (-1)\u3001\u304a\u3088\u3073 &#8220;imprecise\/sparse&#8221; (-1\uff09\u3001\u307e\u305f grade-up\u9805\u76ee\u3067\u7279\u306b\u30d7\u30e9\u30b9\u306e\u3082\u306e\u304c\u306a\u3044\u3053\u3068\u304b\u3089\u3001\u6700\u7d42\u7684\u306a\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u8cea\u3068\u3057\u3066\u306f\u3000&#8221;Low&#8221;\u3067\u3059\u3002<\/p>\n<p><\/p>\n<p>\u30cf\u30b6\u30fc\u30c9\u6bd4\uff08for death\uff09\u8868\u793a\u3067\u3001&#8221;\u6642\u9593\u56e0\u5b50&#8221;\u3001&#8221;\u6253\u3061\u5207\u308a&#8221;\u3000\u306e\u305f\u3081\u6b63\u78ba\u3067\u306f\u306a\u3044\u3082\u306e\u306e\u3001\u672c\u8ad6\u6587\u3067\u306eBevacizumab\u4f75\u7528\u306e\u76f8\u5bfe\u7684\u306a\u52b9\u679c\u3092\u6982\u7565\u3068\u3057\u30662&#215;2\u8868\u3067\u6bd4\u8f03\u3059\u308b\u3068\u3001<br \/>\n\u672c\u7814\u7a76\u306e\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\uff08\u6b7b\u4ea1\u5272\u5408\uff09\u306f\u3001B\u4f75\u7528\u7fa4 254\/286\u3001\u975eB\u4f75\u7528\u7fa4 264\/291\u3067\u3001 \u5358\u7d14\u306aRR\u3068\u3057\u3066\u306f\u30010.98, NNT=52(-33\uff5e15)\u3067\u30012\u30f6\u6708\u306e\u751f\u5b58\u671f\u9593\u306e\u76f8\u9055\u3060\u3051\u3067\u3059\u3002<\/p>\n<p><\/p>\n<p>FOLFOX4\u4f75\u7528\u306e\u526f\u4f5c\u7528\uff08\u795e\u7d4c\u75c7\u72b6\u306a\u3069\uff09\u306b\u3001\u3055\u3089\u306b\u672c\u5264\u306e\u526f\u4f5c\u7528\u304c\u52a0\u308f\u308f\u308a\u3001 \u672c\u5264\u306e\u533b\u7642\u30b3\u30b9\u30c8\u306f\u30012\u9031\u306b1\u5ea6\u306e\u4f7f\u7528\u300110\u30b5\u30a4\u30af\u30eb\u3067\u306f\u3001\u7d04200\u4e07\u5186\u3068\u306a\u308a\u307e\u3059\u3002<br \/>\n\u3057\u304b\u3082\u3001\u7d0450\u4eba\u3092\u6cbb\u7642\u3057\u30661\u4eba\u306e\u6069\u6075\u3068\u306a\u308b\u3068\u30fb\u30fb\u30fb1\u5104\u5186\u30fb\u30fb\u30fb\u3053\u308c\u304c\u3001\u65e9\u671f\u627f\u8a8d\u3068\u306a\u308b\u307b\u3069\u306e\u52b9\u679c\u306a\u306e\u3067\u3057\u3087\u3046\u304b\uff1f\u3057\u304b\u3082\u672c\u7814\u7a76\u306f\u53b3\u9078\u3055\u308c\u305f\u60a3\u8005\u3092\u5bfe\u8c61\u3068\u3057\u305f\u3082\u306e\u3067\u3042\u308a\u3001efficacy\u7814\u7a76\u3067\u3059\u3002<br \/>\n\u30b3\u30b9\u30c8\u3084Harm\u306a\u3069\u3092\u8003\u3048\u308b\u3068\u3001\u63a8\u5968\u306f\u201d\u5f31\u201d\u3067\u3057\u3087\u3046\u3002<\/p>\n<p><\/p>\n<p><a href=\"http:\/\/www.chugai-pharm.co.jp\/generalPortal\/pages\/detailTypeHeader.jsp?documentId=doc_9127&amp;lang=ja\" target=\"same\">\u56fd\u5185\u5168\u4f8b\u8abf\u67fb<\/a>\u3068\u3057\u30662,500\u4f8b\u3001\u8abf\u67fb\u671f\u959318\u30f6\u6708\u3067\u3001\u691c\u8a0e\u89e3\u6790\u4e2d\u306e\u3088\u3046\u3067\u3059\u3002<br \/>\n\u8fd1\u5e74\u306f\u7d50\u8178\uff65\u76f4\u8178\u304c\u3093\u306f\u3001\u6700\u3082\u60a3\u8005\u6570\u306e\u591a\u3044\u304c\u3093\u306e\u4e00\u3064\u3067\u3001\u65e5\u672c\u3067\u306f\u30012005\u5e74\u306e\u5e74\u9593\u65b0\u898f\u7d50\u8178\uff65\u76f4\u8178\u304c\u3093\u7f79\u60a3\u60a3\u8005\u6570\u3068\u3057\u3066115,000\u4eba\u304c\u63a8\u8a08\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u4e2d\u5916\u88fd\u85ac\u306e\u767a\u58f2\u521d\u5e74\u5ea6\u306e\u58f2\u4e0a\u9ad8\u306f70\u5104\u5186\u306e\u898b\u901a\u3057\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u4e2d\u5916\u88fd\u85ac\u306e\u3001\u5927\u8178\u304c\u3093\u306e\u6297\u304c\u3093\u5264\u30d9\u30d0\u30b7\u30ba\u30de\u30d6\uff08\u30a2\u30d0\u30b9\u30c1\u30f3Avastin\uff09\u304c\u3001\u56fd\u5185\u3067\u5fc5\u8981\u306a\u81e8\u5e8a\u8a66\u9a13\u306e\u4e00\u90e8\uff08\u56fd\u5185\u7b2cII\u76f8\u81e8\u5e8a\u8a66\u9a13\uff09\u3092\u5b9f\u65bd\u305b\u305a\u306b\u7533\u8acb\u3057\u3001\uff08\u5f53\u521d\u4e88\u5b9a\u3088\u308a\u3082\u7d0418\u304b\u6708\u3082\u65e9\u304f\uff09\u8a31\u53ef\u3055\u308c\u307e\u3057\u305f\u3002\u30a2\u30d0\u30b9\u30c1\u30f3\u306f\u8840\u7ba1\u65b0\u751f\u3068\u3044\u3046 [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[18],"tags":[19,20],"_links":{"self":[{"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/15"}],"collection":[{"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=15"}],"version-history":[{"count":1,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/15\/revisions"}],"predecessor-version":[{"id":667,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/15\/revisions\/667"}],"wp:attachment":[{"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=15"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=15"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=15"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}