{"id":1563,"date":"2013-01-06T09:46:49","date_gmt":"2013-01-06T00:46:49","guid":{"rendered":"\/sawamura\/blog\/?p=1563"},"modified":"2025-04-11T16:23:05","modified_gmt":"2025-04-11T07:23:05","slug":"glioblastom","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/glioma\/glioblastom\/","title":{"rendered":"\u81a0\u82bd\u816b\uff08\u3053\u3046\u304c\u3057\u3085\uff09IDH\u91ce\u751f\u578b"},"content":{"rendered":"<h5>WHO <span style=\"color: #ff0000;\">\u30b0\u30ec\u30fc\u30c9\uff14<\/span>\u306e\u60aa\u6027\u816b\u760d<\/h5>\n<ul>\n<li>\u30b0\u30ea\u30aa\u30d6\u30e9\u30b9\u30c8\u30fc\u30de\uff0c\u696d\u754c\u7528\u8a9e\u3067<span style=\"color: #000080;\"><strong>\u30b0\u30ea\u30d6\u30e9<\/strong><\/span>\u3068\u3044\u3044\u307e\u3059<\/li>\n<li>\u82f1\u8a9e\u3067\u306f<span style=\"color: #000080;\"> <strong>GBM (glioblastoma multiforme)\u00a0\u30b8\u30fc\u30d3\u30fc\u30a8\u30e0<\/strong><\/span>\u3068\u3044\u3044\u307e\u3059<\/li>\n<li>\u8133\u306e\u795e\u7d4c\u7d30\u80de\u3092\u652f\u3048\u308b\u795e\u7d4c\u81a0\u7d30\u80de\uff08\u661f\u7d30\u80de\uff0c\u672a\u5206\u5316\u30b0\u30ea\u30a2\uff09\u304c\u816b\u760d\u5316\u3057\u305f\u3082\u306e\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>IDH\u3068\u3044\u3046\u907a\u4f1d\u5b50\u306b\u306f\u5909\u7570\u304c\u306a\u3044\u91ce\u751f\u578b wild type \u3067\u3059<\/strong><\/span><\/li>\n<li>\u5927\u8133\u306b\u767a\u751f\u3057\u3066\u3001<span style=\"color: #ff0000;\"><strong>\u5468\u56f2\u306e\u8133\u306b\u6ef2\u307f\u8fbc\u3080\u3088\u3046\u306b\u5e83\u304c\u308a\u307e\u3059<\/strong><\/span>\uff08\u6d78\u6f64\uff09<\/li>\n<li><span style=\"color: #000080;\"><strong>\u6210\u4eba<a style=\"color: #000080;\" title=\"\u30b0\u30ea\u30aa\u30fc\u30de glioma \u795e\u7d4c\u81a0\u816b\" href=\"\/sawamura\/blog\/braintumors\/glioma\/sum\/\">\u30b0\u30ea\u30aa\u30fc\u30de<\/a><\/strong><\/span> \u306e40%\u304f\u3089\u3044\u3068\u983b\u5ea6\u304c\u9ad8\u304f\uff0c<strong><span style=\"color: #ff0000;\">\u6700\u3082\u60aa\u6027\u306e\u816b\u760d\u3067\u3059<\/span><\/strong><\/li>\n<li>\u60aa\u6027\u8133\u816b\u760d\u306e\u4e2d\u3067\u6700\u3082\u983b\u5ea6\u306e\u9ad8\u3044\u816b\u760d\u3067\u3059\uff08\u982d\u84cb\u5185\u816b\u760d\u306e10\uff05\u5f31\uff09<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u4e16\u754c\u4e2d\u3067\u6ce8\u76ee\u3092\u3042\u3073\u3066\u7814\u7a76\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u5c0f\u5150\u3067\u306f\u3068\u3066\u3082\u307e\u308c\u3067\uff0c<strong><span style=\"color: #ff0000;\">\u9ad8\u9f62\u8005\u306b\u306a\u308b\u307b\u3069\u983b\u5ea6\u304c\u9ad8\u3044<\/span><\/strong>\u3067\u3059<\/li>\n<li>\u591a\u304f\u306e\u60a3\u8005\u3055\u3093\u306f60\u6b73\u4ee5\u4e0a\u3067\u3059<\/li>\n<li>2021\u5e74\u73fe\u5728\u3067\u3082\uff0c<strong><span style=\"color: #ff0000;\">5\u5e74\u751f\u5b58\u5272\u5408\u306f10\uff05<\/span><\/strong>\u307b\u3069\u3067\u3059<\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u5e73\u5747\u4f59\u547d\u306f2\u5e74\u304f\u3089\u3044<\/strong><\/span>\u3060\u3068\u8003\u3048\u3066\u304f\u3060\u3055\u3044<\/li>\n<li>\u9032\u884c\u304c\u65e9\u3044\u306e\u3067MRI\u3067\u898b\u3064\u304b\u3063\u3066\u304b\u30892\u9031\u9593\u304f\u3089\u3044\u3067\u500d\u304f\u3089\u3044\u306e\u5927\u304d\u3055\u306b\u306a\u3063\u3066\u3057\u307e\u3046\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<h5>\u307e\u305aMRI\u3067\u8a3a\u65ad\u3067\u3059<\/h5>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-21992\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk1-300x293.jpg\" alt=\"\" width=\"300\" height=\"293\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk1-300x293.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk1-550x538.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk1.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-21993\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk2-300x284.jpg\" alt=\"\" width=\"300\" height=\"284\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk2-300x284.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk2-550x521.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk2-768x727.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk2-1536x1455.jpg 1536w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk2.jpg 1892w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u53f3\u5074\u982d\u8449\u5cf6\u306e\u75c5\u5909\u3067\u3059\u30021\u5e74\u9593\u306e\u7d4c\u904e\u3067\u306f\u3063\u304d\u308a\u5897\u5927\u3057\u305f\u306e\u3067\uff0c\u7121\u75c7\u72b6\u3067\u3057\u305f\u304c\u751f\u691c\u8853\u3092\u884c\u3044\u307e\u3057\u305f\u3002\u75c5\u7406\u7d44\u7e54\u3067\u306f\uff0c\u7570\u578b\u30b0\u30ea\u30a2\u306e\u5897\u6b96\u306f\u3042\u308a\u307e\u3057\u305f\u304c\uff0c\u6838\u5206\u88c2\u8535\uff0c\u8840\u7ba1\u5185\u76ae\u306e\u5897\u751f\u3084\u58ca\u6b7b\u306f\u660e\u3089\u304b\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u3057\u304b\u3057\uff0c\u907a\u4f1d\u5b50\u8a3a\u65ad\u3067\u306f<strong><span style=\"color: #000080;\">IDH1\/2 \u91ce\u751f\u578b<\/span><\/strong>\uff0cATRX retained\uff0cTERT promotor\u91ce\u751f\u578b\uff0c1p\/19q\u5171\u6b20\u5931\u306a\u3057\u3067\u3057\u305f\u3002<span style=\"color: #000080;\"><strong>\u81a0\u82bd\u816b\u3068\u3044\u3046\u78ba\u5b9a\u75c5\u7406\u8a3a\u65ad<\/strong><\/span>\u3067\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk3-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-21995\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk3-1-300x281.jpg\" alt=\"\" width=\"300\" height=\"281\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk3-1-300x281.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk3-1-550x515.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk3-1.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk4-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-21997\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk4-1-300x276.jpg\" alt=\"\" width=\"300\" height=\"276\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk4-1-300x276.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk4-1-550x505.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbmtk4-1.jpg 692w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u6a19\u6e96\u6cbb\u7642\u3092\u52a0\u3048\u307e\u3057\u305f\u304c\uff0c\u6570\u30f6\u6708\u5f8c\u306b\u6025\u6fc0\u306a\u5897\u5927\u3092\u5448\u3057\u307e\u3057\u305f\u3002\u30b0\u30ec\u30fc\u30c94\u306e\u81e8\u5e8a\u50cf\u3067\u3059\u3002MRI\u753b\u50cf\u3088\u308a\u3082\u75c5\u7406\u7d44\u7e54\u50cf\u3088\u308a\u3082\uff0c\u907a\u4f1d\u5b50\u8a3a\u65ad\u306e\u65b9\u304c\u3088\u308a\u6027\u683c\u306b\u4e88\u5f8c\u3092\u793a\u3059\u4f8b\u3067\u3059\u3002<\/p>\n<h5>\u75c5\u7406\u7d44\u7e54\u50cf\u3092\u898b\u305f\u3089\u6b21\u306b\u907a\u4f1d\u5b50\u8a3a\u65ad\u3092\u3057\u3066\u78ba\u5b9a\u75c5\u7406\u8a3a\u65ad\u3068\u3057\u307e\u3059<br \/>\n<a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/pathocase\/glioblastoma\/\">\u5225\u30da\u30fc\u30b8\u306b\u8a73\u3057\u304f\u66f8\u3044\u3066\u3044\u307e\u3059\u304b\u3089\uff0c\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af<\/a><\/h5>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-9274 size-large\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomahe2-550x419.jpg\" alt=\"glioblastomahe2\" width=\"550\" height=\"419\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomahe2-550x419.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomahe2-300x229.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomahe2-768x585.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomahe2.jpg 798w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/p>\n<p>\u3053\u308c\u306f\u666e\u901a\u306e\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u3067\u3059\u3002\u3053\u308c\u3060\u3051\u3067\u81a0\u82bd\u816b\u3068\u3044\u3046\u8a3a\u65ad\u306f\u3064\u304d\u307e\u3059\uff0c<\/p>\n<h5>2022\u5e74\u6642\u70b9\u3067\u306e\u75c5\u7406\u5b66\u3067\u306e\u5b9a\u7fa9\u3068\u81e8\u5e8a<\/h5>\n<ul>\n<li>\u7d44\u7e54\u5b66\u7684\u306b\u306f\uff0c\u3073\u307e\u3093\u6027\u306e\u661f\u7d30\u80de\u7cfb\u30b0\u30ea\u30aa\u30fc\u30de\u3067\u3042\u308a\uff0c<strong>\u8840\u7ba1\u5185\u76ae\u5897\u751f\u3068\u58ca\u6b7b\u304c\u7279\u5fb4<\/strong>\u3067\u3059<\/li>\n<li>IDH\u3068H3\u907a\u4f1d\u5b50\u306b\u306f\u5909\u7570\u304c\u3042\u308a\u307e\u305b\u3093 \u91ce\u751f\u578b wild type\u3068\u3044\u3044\u307e\u3059<\/li>\n<li>\u7279\u7570\u7684\u306a\u907a\u4f1d\u5b50\u7570\u5e38\u3068\u3057\u3066\uff0c<i>TERT<\/i> promoter mutation, <i>EGFR<\/i> gene amplification and\/or a +7\/\u201310 cytogenetic signature\u304c\u307f\u3089\u308c\u307e\u3059<\/li>\n<li>\u7d44\u7e54\u8a3a\u65ad\u3067\u4f4e\u60aa\u6027\u5ea6\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3067\u3082\uff0cIDH wild type\u3067\u304b\u3064\uff0c<strong><i>TERT<\/i> promoter mutation<\/strong>, <i>EGFR<\/i> gene amplification, +7\/\u201310 copy number changes \u306e\u3069\u308c\u304b\u4e00\u3064\u304c\u3042\u308c\u3070\uff0c\u81a0\u82bd\u816b\u30b0\u30ec\u30fc\u30c94\u3068\u8a3a\u65ad\u3057\u307e\u3059<\/li>\n<li>\u7d44\u7e54\u8a3a\u65ad\u304c\u81a0\u82bd\u816b\u3067\u3042\u3063\u3066\u3082IDH\u306b\u5909\u7570\u304c\u3042\u308c\u3070\uff0c\u661f\u7d30\u80de\u7cfb\u816b\u760d\u30b0\u30ec\u30fc\u30c9\uff14\u306b\u5206\u985e\u3055\u308c\uff0c\u75c5\u7406\u8a3a\u65ad\u306f\u81a0\u82bd\u816b\u3068\u3057\u307e\u305b\u3093\u00a0(<span style=\"color: #000080;\"><strong>IDH-mutant astrocytoma, WHO grade 4, Homozygous deletion of <i>CDKN2A\/B<\/i> locus<\/strong><\/span>)\u304c\uff0c\u6cbb\u7642\u65b9\u6cd5\u306f\u81a0\u82bd\u816b\u3068\u540c\u3058\u306a\u306e\u3067\u81e8\u5e8a\u533b\u306b\u3068\u3063\u3066\u306f\u540c\u3058\u3053\u3068\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u81e8\u5e8a\u7684\u306b\u306f\uff0c\u3068\u306b\u304b\u304f\u5f93\u6765\u306e\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u3067\u81a0\u82bd\u816b\u3067\u3042\u308c\u3070\u81a0\u82bd\u816b\u3067\u3059<\/li>\n<\/ul>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomaseqquence.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-large wp-image-23339\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomaseqquence-550x291.jpg\" alt=\"\" width=\"550\" height=\"291\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomaseqquence-550x291.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomaseqquence-300x159.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomaseqquence-768x407.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomaseqquence-1536x814.jpg 1536w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastomaseqquence-2048x1085.jpg 2048w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/>s\u3044<\/a><\/p>\n<p>\u30b7\u30fc\u30b1\u30f3\u30b9\u691c\u67fb\u306e\u7d50\u679c\u3067\u3059\uff0cIDH\u907a\u4f1d\u5b50\u3068IDH2\u907a\u4f1d\u5b50\u306b\u5909\u7570 mutation\u306f\u306a\u3044\u306e\u3067\uff0c\u91ce\u751f\u578b\u3068wild typoe \u3044\u3044\u307e\u3059\u3002\u3053\u308c\u3067\u661f\u7d30\u80de\u816b\u3068\u306e\u9451\u5225\u304c\u78ba\u5b9f\u3068\u306a\u308a\u307e\u3059\u3002\u901a\u5e38\u306e\u75c5\u9662\u3067\u306f\uff0c\u514d\u75ab\u7d44\u7e54\u67d3\u8272\u3068\u3044\u3046\u624b\u6bb5\u3067\u91ce\u751f\u578b\u304b\u3069\u3046\u304b\u3092\u307f\u308b\u306e\u3067\u3059\u304c\u8aa4\u8a3a\u306e\u78ba\u7387\u304c\u4f4e\u304f\u306f\u306a\u3044\u306e\u3067\uff0c\u30b7\u30fc\u30b1\u30f3\u30b9\u691c\u67fb\u304c\u5fc5\u8981\u3067\u3059\u3002\u3061\u306a\u307f\u306b\u3053\u306e\u4f8b\u3067\u306f\u3055\u3089\u306b\u4f3c\u305f\u3088\u3046\u306aMRI\u3068\u75c5\u7406\u6240\u898b\u3092\u793a\u3059\u9ad8\u60aa\u6027\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de\u3092\u9451\u5225\u3059\u308b\u305f\u3081\u306b\u8abf\u3079\u305f\u3068\u3053\u308d\uff0cBRAF v600 wild type, H3F 3A K27 wild type, HIST H3B K27 wild type, MGMT score 0\u3067\u3057\u305f\u3002<\/p>\n<h5>\u4e16\u754c\u6a19\u6e96\u6cbb\u7642\u306f\uff0c<\/h5>\n<p><strong><span style=\"color: #ff0000;\">\u958b\u982d\u624b\u8853<\/span><\/strong>\u3067\u53ef\u80fd\u306a\u9650\u308a\u6458\u51fa\u3057\u3066\uff0c\u75c5\u7406\u8a3a\u65ad\u304c\u78ba\u5b9a\u3057\u305f\u3089\uff0c<strong><span style=\"color: #ff0000;\">\u653e\u5c04\u7dda\u6cbb\u7642<\/span><\/strong>\uff0830\u56de\u5206\u5272\u306760\u30b0\u30ec\u30a4\u306e\u5c40\u6240\u7167\u5c04\uff09\u3068\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\uff08<a href=\"\/sawamura\/blog\/glioma\/temozolo\/\"><strong><span style=\"color: #ff0000;\">\u30c6\u30e2\u30be\u30ed\u30df\u30c9<\/span><\/strong><span style=\"color: #ff0000;\"><b>\uff0c\u30c6\u30e2\u30c0\u30fc\u30eb<\/b><\/span><\/a>\uff09\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3063\u3066\uff0c\u9000\u9662\u5f8c\u306b\u5916\u6765\u3067\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\uff08\u6708\u306b5\u65e5\u9593\uff09\u3092\u7dad\u6301\u7642\u6cd5\u3068\u3057\u3066\u8ffd\u52a0\u3059\u308b\u3053\u3068\u3067\u3059<\/p>\n<hr \/>\n<ul>\n<li>\u624b\u8853\u3067\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u90e8\u5206\u304c95%\u4ee5\u4e0a (70%\u4ee5\u4e0a\u3068\u3044\u3046\u610f\u898b\u3082\u3042\u308b) \u5207\u9664\u3067\u304d\u308b\u3068\u751f\u5b58\u671f\u9593\u304c\u306e\u3073\u308b\u3068\u3044\u3046\u306e\u304c\u5b9a\u8aac\u3067\u3059<\/li>\n<li>\u305d\u308c\u4ee5\u4e0b\u3060\u3068\uff0c\u6458\u51fa\u5ea6\u3068\u751f\u547d\u4e88\u5f8c\u306e\u95a2\u4fc2\u306f\u306f\u3063\u304d\u308a\u3057\u306a\u3044\u8003\u3048\u3089\u308c\u307e\u3059<\/li>\n<li>\u53f3\u306e\u5074\u982d\u8449\u306b\u3067\u304d\u305f\u81a0\u82bd\u816b\u306f\u624b\u8853\u6458\u51fa\u5ea6\u304c\u3042\u304c\u308a\u307e\u3059\u304b\u3089\uff0c\u8996\u5e8a\u306b\u3067\u304d\u305f\u81a0\u82bd\u816b\u3088\u308a\u3082\u751f\u5b58\u671f\u9593\u304c\u9577\u3044\u3067\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c<strong><span style=\"color: #000080;\">\u81a0\u82bd\u816b\u304c\u767a\u751f\u3057\u305f\u5834\u6240\u3067\uff0c\u751f\u547d\u4e88\u5f8c\u304c\u5927\u304d\u304f\u5909\u308f\u308a\u307e\u3059<\/span><\/strong><\/li>\n<li>\u60a3\u8005\u3055\u3093\u306e\u5e74\u9f62\u304c\u9ad8\u3044<span style=\"color: #ff0000;\"><strong>\uff08\u9ad8\u9f62\u8005\uff09\u307b\u3069\u60aa\u6027\u306e\u7d4c\u904e<\/strong><\/span>\u3092\u3060\u3069\u308a\u307e\u3059\uff08\u4e88\u5f8c\u304c\u60aa\u3044\u3068\u8a00\u3044\u307e\u3059\uff09<\/li>\n<li>\u518d\u767a\u3057\u305f\u3068\u304d\u306b\u306f\u69d8\u3005\u306a\u6cbb\u7642\u6cd5\u304c\u63d0\u6848\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u3053\u308c\u304c\u826f\u3044\u3068\u6a19\u6e96\u5316\u3055\u308c\u305f\u6cbb\u7642\u65b9\u6cd5\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u518d\u767a\uff08\u6b63\u78ba\u306b\u306f\u518d\u71c3 relapse \u3068\u3044\u3044\u307e\u3059\uff09\u3059\u308b\u3068\u4f59\u547d\u306f\uff11\u5e74\u4ee5\u5185\u304f\u3089\u3044\u3067\u3059<\/li>\n<li>\u4f59\u547d\u306b\u95a2\u4fc2\u3059\u308b\u907a\u4f1d\u5b50\u306f\uff0cMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u3068IDH\u5909\u7570\u306a\u306e\u3067\u3059\u304c\uff0c\u305d\u308c\u304c\u89e3\u3063\u3066\u3082\u6cbb\u7642\u6cd5\u304c\u5909\u308f\u308b\u3068\u3044\u3046\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u3082\u3046\u4e00\u3064\uff0c\u75c7\u4f8b\u304c\u591a\u3044\u75c5\u9662 \uff08high-volume hospital \u5e74\u959323\u4f8b\u4ee5\u4e0a\u306e\u81a0\u82bd\u816b\uff09\u3067\u6cbb\u7642\u3059\u308b\u3068\u4e88\u5f8c\u304c\u826f\u3044\u3053\u3068\u304c\u77e5\u3089\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u65e5\u672c\u306b\u306f\u305d\u3046\u3044\u3046\u65bd\u8a2d\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u521d\u767a\u306e\u60a3\u8005\u3055\u3093\u306f<span style=\"color: #000080;\"><strong><span style=\"color: #000080;\"><a href=\"\/sawamura\/blog\/glioma\/novottf\/\">\u30aa\u30d7\u30c1\u30e5\u30fc\u30f3<\/a><\/span>\u3068\u3044\u3046\u88c5\u7f6e<\/strong><\/span>\u3092\u4f7f\u3046\u3053\u3068\u304c\u3067\u304d\u307e\u3059<\/li>\n<li>\u9ad8\u9f62\u8005\u3084<span style=\"color: #000080;\"><strong>\u72b6\u614b\u306e\u60aa\u3044\u60a3\u8005\u3055\u3093\u3067\u306f\u624b\u8853\u3082\u4f55\u3082\u3057\u306a\u3044\u3067\u7de9\u548c\u30b1\u30a2\u3092\u9078\u3076<\/strong><\/span>\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<hr \/>\n<h4>\u8a3a\u65ad\uff1aMRI\u3067\u306e\u7279\u5fb4<\/h4>\n<div>\n<ul>\n<li><span style=\"color: #000080;\"><strong>\u8a3a\u65ad\u306fMRI\u691c\u67fb<\/strong><\/span>\u3092\u3057\u307e\u3059\uff0c\u305d\u308c\u3060\u3051\u3067\u5341\u5206\u3067\u3059<\/li>\n<li>\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u9020\u5f71\u5264\u3067\u816b\u760d\u306e\u5468\u8fba\u304c\u767d\u304f\u9020\u5f71\u3055\u308c\u307e\u3059<\/li>\n<li>\u3044\u3073\u3064\u306a\u5f62\u306b\u306a\u308b\u306e\u304c\u7279\u5fb4\u3067\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u307b\u3093\u3068\u3046\u306e\u816b\u760d\u306e\u5e83\u304c\u308a\u306f\uff0c<span style=\"color: #000080;\"><strong>T2\u5f37\u8abf\u3042\u308b\u3044\u306fFLAIR\uff08\u30d5\u30ec\u30a2\uff09\u3068\u3044\u3046\u753b\u50cf\u3067\uff0c\u767d\u304f\u6ef2\u3080\u3088\u3046\u306b\u5199\u308b\u90e8\u5206<\/strong><\/span>\u3059\u3079\u3066\u3067\u3059<\/li>\n<li>\u624b\u8853\u3067\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u90e8\u5206\u304c\u5168\u90e8\u53d6\u308c\u308b\u3068\uff0c\u304a\u533b\u8005\u3055\u3093\u306f\u5168\u6458\u51fa\u3067\u304d\u305f\u3068\u3044\u3044\u307e\u3059\u304c\uff0c\u305d\u308c\u306f\u9593\u9055\u3044\u3067\u3059<\/li>\n<li>FLAIR\u753b\u50cf\u3067\u767d\u304f\u898b\u3048\u308b\u90e8\u5206\u304c\u5168\u3066\u53d6\u308c\u3066\u306f\u3058\u3081\u3066\uff0c\u753b\u50cf\u4e0a\u3067\u306e\u5168\u6458\u51fa\u3068\u8a00\u3048\u307e\u3059<\/li>\n<li>\u305d\u308c\u3067\u3082\u306a\u304a\uff0c\u96a0\u308c\u305f\u816b\u760d\u7d30\u80de\u306f\u5468\u56f2\u306b\u6ef2\u307f\u8fbc\u3093\u3067\u6b8b\u3063\u3066\u3044\u307e\u3059<\/li>\n<li><strong><span style=\"color: #000080;\">\u30ab\u30c6\u30fc\u30c6\u30eb\u3092\u7528\u3044\u308b\u8133\u8840\u7ba1\u64ae\u5f71\u306f\u3042\u307e\u308a\u5f79\u306b\u7acb\u3061\u307e\u305b\u3093\uff0c\u304a\u91d1\u3082\u304b\u304b\u308a\u307e\u3059\u3057\u8133\u6897\u585e\u306a\u3069\u306e\u5408\u4f75\u75c7\u3082\u3042\u308b\u4fb5\u8972\u7684\u306a\u691c\u67fb\u3067\u3059<\/span><\/strong><\/li>\n<li>\u5165\u9662\u691c\u67fb\u306e\u4e88\u5b9a\u3092\u7acb\u3066\u3066\u3044\u308b\u3046\u3061\u306b\u5897\u5927\u3057\u3066\u3057\u307e\u3063\u3066\uff0c\u624b\u304c\u3064\u3051\u3089\u308c\u306a\u304f\u306a\u308b\u3088\u3046\u306a\u9032\u884c\u306e\u65e9\u3044\u816b\u760d\u3067\u3059<\/li>\n<\/ul>\n<div><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm05s1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-4139\" title=\"gbm05s1\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm05s1-197x200.jpg\" alt=\"\" width=\"197\" height=\"200\" \/><\/a><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm05s2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-4140\" title=\"gbm05s2\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm05s2-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm05s3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-4141\" title=\"gbm05s3\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm05s3-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><\/div>\n<\/div>\n<p>\u5178\u578b\u7684\u306a\u81a0\u82bd\u816b\u306e<span style=\"color: #000080;\"><strong>\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u753b\u50cf<\/strong><\/span>\u3067\u3059\u3002\u53f3\u306e\u5074\u982d\u8449\u304b\u3089\u767a\u751f\u3057\u305f\u305f\u3081\u306b\u76ee\u7acb\u3063\u305f\u75c7\u72b6\u304c\u7121\u304f\uff0c\u3053\u306e\u5927\u304d\u3055\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u4f55\u3068\u306a\u304f\u30dc\u30c3\u3068\u3057\u3066\u3044\u308b\u3068\u8a00\u3046\u306e\u304c\u8a34\u3048\u3067\u3057\u305f\u3002\u816b\u760d\u306e\u5468\u56f2\u304c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u3067\u767d\u304f\u5897\u5f37\u3055\u308c\u3066\uff0c\u5185\u90e8\u306f\u58ca\u6b7b\u3067\u4f4e\u4fe1\u53f7\uff08\u9ed2\u3063\u307d\u3044\uff09\u306b\u306a\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n<p><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/b8112a31b0cb97e3ed256c2c040429f61.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-5836\" title=\"glioblastomano1\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/b8112a31b0cb97e3ed256c2c040429f61-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/59a9978e7f78b882f8e26832326c3cbe1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-5837\" title=\"glioblastomano2\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/59a9978e7f78b882f8e26832326c3cbe1-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><br \/>\n<span style=\"color: #333333;\">\u5de6\u304c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u50cf\u3067\uff0c\u624b\u8853\u3067\u306f\u3053\u306e\u90e8\u5206\u304c\u53d6\u308c\u308c\u3070\u5168\u6458\u51fa\u3068\u3044\u308f\u308c\u308b\u306e\u3067\u3059\u304c\uff0c\u5b9f\u969b\u306f\u53f3\u5074\u306e\u30d5\u30ec\u30a2\u753b\u50cf\u3067\u767d\u3063\u307d\u304f\u898b\u3048\u308b\u6240\u306b\u306f\u816b\u760d\u304c\u6ef2\u307f\u8fbc\u3093\u3067\u3044\u307e\u3059\u3002\u3053\u306e\u90e8\u5206\u3092\u5168\u3066\u6458\u51fa\u3057\u3066\u306f\u3058\u3081\u3066\uff0c\u753b\u50cf\u4e0a\u306e\u5168\u6458\u51fa\u3068\u3044\u3044\u307e\u3059\u3002\u5168\u6458\u51fa\u306f\u7121\u7406\u3067\u3057\u3087\u3046<\/span>\u3002<\/p>\n<h3><span style=\"color: #ff0000;\"><span style=\"color: #000080;\">2021\u5e74\u6642\u70b9\u3067\u79d1\u5b66\u7684\u306b\u63a8\u5968\u5ea6\u306e\u9ad8\u3044\u6cbb\u7642\u65b9\u91dd\uff1a\u6a19\u6e96\u6cbb\u7642<\/span>\u3000Stupp\u30ec\u30b8\u30e1\u30f3<\/span><\/h3>\n<ol>\n<li>\u521d\u767a\u81a0\u82bd\u816b\u3067\u306f\u958b\u982d\u624b\u8853\u3067\u75c7\u72b6\u3092\u60aa\u5316\u3055\u305b\u306a\u3044\u3088\u3046\u306b\u53ef\u80fd\u306a\u9650\u308a\u6458\u51fa\u3059\u308b<\/li>\n<li>\u624b\u8853\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642 (60\u30b0\u30ec\u30a4\uff0f30-33\u5206\u5272\uff0f6\u9031\u9593)\u3092\u3059\u308b<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u958b\u59cb\u3068\u540c\u6642\u306b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9 (75mg\/m2)\u306e\u6295\u4e0e\u3092\u958b\u59cb\u3059\u308b<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u7d42\u4e86\u5f8c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9 (100-200mg\/m2)\u306e\u6295\u4e0e\u30926\u30b3\u30fc\u30b9\u884c\u3046<\/li>\n<\/ol>\n<p>\u6cbb\u7642\u306b\u5bfe\u3059\u308b\u6709\u52b9\u6027\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30eb\u306e\u9ad8\u3044\u3082\u306e\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\uff0c\u624b\u8853\u6458\u51fa\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5316\u5b66\u7642\u6cd5\u306e\u9806\u3067\u3059\u3002\u3053\u308c\u306f2005\u5e74\u304b\u3089\u306f<span style=\"color: #000080;\"><strong>\u4e16\u754c\u6a19\u6e96\u6cbb\u7642<\/strong><\/span>\u3068\u306a\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4><span style=\"color: #000080;\">\u304a\u305d\u3089\u304f\u65e5\u672c\u3067\u5e83\u304f\u884c\u308f\u308c\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u6cbb\u7642\u6cd5\uff08\u521d\u56de\u6cbb\u7642\u306e\u307f\uff09<\/span><\/h4>\n<h5>\u9ad8\u5ea6\u306e\u60aa\u6027\u5ea6\u3092\u6709\u3059\u308b\u816b\u760d\u3067\u3042\u308a\uff0c\u6700\u5927\u9650\u306e\u62b5\u6297\u3092\u3059\u308b\u305f\u3081\u306b\uff0c\u6b21\u306e\u3088\u3046\u306a\u6cbb\u7642\u6cd5\u304c\u5c0e\u5165\u3055\u308c\u3066\u3044\u307e\u3059<\/h5>\n<div>\n<ul>\n<li>\u81a0\u82bd\u816b\u3068\u753b\u50cf\u8a3a\u65ad\u3055\u308c\u305f\u3089\uff0c\u3067\u304d\u308b\u9650\u308a\u65e9\u304f\u958b\u982d\u624b\u8853\u3067\u53ef\u80fd\u306a\u9650\u308a\u6458\u51fa\u3057\u307e\u3059\u3002\u9032\u884c\u304c\u65e9\u3044\u75c5\u6c17\u306a\u306e\u3067\u3053\u3053\u3092\u6025\u304c\u306a\u3044\u3068\u610f\u5473\u304c\u3042\u308a\u307e\u305b\u3093\u3002<\/li>\n<li>\u624b\u8853\u4e2d\u306b\u8fc5\u901f\u75c5\u7406\u8a3a\u65ad\u3092\u3057\u3066\uff0c\u60aa\u6027\u795e\u7d4c\u81a0\u816b\u306e\u8a3a\u65ad\u304c\u5f97\u3089\u308c\u308c\u3070\uff0c\u816b\u760d\u3092\u6458\u51fa\u3057\u3066\u3057\u3063\u304b\u308a\u6b62\u8840\u3057\u305f\u5f8c\u306b\uff0c\u30ae\u30ea\u30a2\u30c7\u30eb\u3092\u816b\u760d\u6458\u51fa\u8154\u306b\u8cbc\u308a\u3064\u3051\u307e\u3059\u3002\u6700\u5927\uff18\u679a\uff08\uff11\u679a\u3042\u305f\u308aBCNU 7.7mg\u542b\u6709\uff09\u3067\u3059\u3002<\/li>\n<li>\u75c5\u7406\u78ba\u5b9a\u8a3a\u65ad\u3092\u6025\u304e\u307e\u3059\u3002\u540c\u6642\u306b\u60a3\u8005\u3055\u3093\u306e\u624b\u8853\u304b\u3089\u306e\u56de\u5fa9\u3092\u6025\u304e\u307e\u3059\u3002\u307e\u305f\u540c\u6642\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u8a08\u753b\u3092\u884c\u3044\u307e\u3059\u3002\u3053\u308c\u306f3\u9031\u9593\u4ee5\u5185\u306b\u7d42\u3048\u307e\u3059\u3002<\/li>\n<li><span style=\"color: #000080;\"><strong>IDH\u907a\u4f1d\u5b50\u5909\u7570\u304c\u3042\u3063\u3066\u3082\u306a\u304f\u3066\u3082\u540c\u3058\u6cbb\u7642<\/strong><\/span>\u306b\u306a\u308b\u306e\u3067\u5206\u5b50\u8a3a\u65ad\u306f\u5f85\u3061\u307e\u305b\u3093\u3002<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642 (60Gy, 1.8-2Gy\/day, 10Gy\/week, generous local field)\u306e\u958b\u59cb\u3068\u540c\u6642\u306b\uff0c\u30c6\u30e2\u30c0\u30fc\u30eb (75mg\/m2\/everyday\uff0c\u7d4c\u53e3)\u3092\u6295\u4e0e\u3057\u307e\u3059\u3002<\/li>\n<li>\u305d\u306e\u5f8c\u306b\uff0c\u30c6\u30e2\u30be\u30ed\u30df\u30c9 (100-200mg\/m2\/every 4 weeks)\uff0c\u7d4c\u53e3\u6295\u4e0e)\u30926\u30b3\u30fc\u30b9\u3042\u308b\u3044\u306f\u3055\u3089\u306b\u9577\u671f\u306b\u6295\u4e0e\u3057\u307e\u3059\u3002<\/li>\n<li>\u3053\u308c\u3089\u3092\u7d42\u3048\u3066\u306a\u304a\u72b6\u614b\u306e\u826f\u3044\u60a3\u8005\u3055\u3093\u3067\u306f\u30aa\u30d7\u30c1\u30e5\u30fc\u30f3\u3092\u88c5\u7740\u3059\u308b\u304b\u3069\u3046\u304b?\u3092\u8003\u3048\u307e\u3059<\/li>\n<\/ul>\n<h5>\u3053\u3053\u3067\u5927\u5207\u306a\u3053\u3068<\/h5>\n<ul>\n<li><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u30ae\u30ea\u30a2\u30c7\u30eb\" href=\"\/sawamura\/blog\/braintumors\/glioma\/gliadel\/\">\u30ae\u30ea\u30a2\u30c7\u30eb\u306e\u52b9\u679c\u306e\u81e8\u5e8a\u8a66\u9a13\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30eb\u306f\u304b\u306a\u308a\u4f4e\u3044<\/a><\/strong><\/span>\u3067\u3059<\/li>\n<li>2014\u5e74\u306b<span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u30a2\u30d0\u30b9\u30c1\u30f3\" href=\"\/sawamura\/blog\/braintumors\/glioma\/avastine\/\">\u30a2\u30d0\u30b9\u30c1\u30f3\u306f\u81a0\u82bd\u816b\u306e\u751f\u5b58\u671f\u9593\u3092\u5ef6\u9577\u3057\u306a\u3044<\/a><\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u304c\u9006\u306b\u8a3c\u660e\u3055\u308c\u307e\u3057\u305f\u30022019\u5e74\u6642\u70b9\u3067\u306f\uff0c\u81a0\u82bd\u816b\u306e\u521d\u671f\u6cbb\u7642\u306b\u30a2\u30d0\u30b9\u30c1\u30f3\u3092\u4f7f\u7528\u3057\u306a\u3044\u65b9\u304c\u3088\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/li>\n<li><a href=\"\/sawamura\/blog\/glioma\/novottf\/\"><strong><span style=\"color: #000080;\">\u30aa\u30d7\u30c1\u30e5\u30fc\u30f3\u3092\u88c5\u7740<\/span><\/strong><\/a>\u3059\u308b\u3053\u3068\u306b\u5229\u70b9\u304c\u3042\u308b\u3068\u63a8\u6e2c\u3055\u308c\u308b\u306e\u306f\uff0c<span style=\"color: #000080;\"><strong>\u8a3a\u65ad\u5f8c4\u30f6\u6708\u307b\u3069\u304c\u904e\u304e\u3066\u3042\u308b\u7a0b\u5ea6\u72b6\u614b\u306e\u826f\u3044\u60a3\u8005\u3055\u3093<\/strong><\/span>\u306e\u307f\u3067\uff0c\u7528\u3044\u308b\u3053\u3068\u304c\u6a19\u6e96\u6cbb\u7642\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u30022017\u5e74 \u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306f\u63a8\u5968\u3057\u307e\u305b\u3093\u304c\uff0c2017\u5e74 \u7c73\u56fd\u306eNCCN\u306f\u30aa\u30d7\u30c1\u30e5\u30fc\u30f3\u3092\u52a0\u3048\u308b\u3053\u3068\u3092\u30ab\u30c6\u30b4\u30ea\u30fc\uff11\u306e\u6cbb\u7642\u6cd5\u3068\u3057\u3066\u63a8\u5968\u3057\u3066\u3044\u307e\u3059\u3002\u65e5\u672c\u8133\u816b\u760d\u5b66\u4f1a\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\uff0c\u63a8\u5968\u30b0\u30ec\u30fc\u30c9B\uff08\u4f7f\u7528\u3067\u304d\u308b\u306a\u3089\u884c\u3046\u3088\u3046\u52e7\u3081\u3089\u308c\u308b\uff09\u3068\u3057\u3066\u3044\u307e\u3059\u3002<\/li>\n<\/ul>\n<\/div>\n<h5>\u3053\u308c\u304c\u65e5\u672c\u3067\u3067\u304d\u308b\u9650\u754c\u306e\u6cbb\u7642\u624b\u6bb5\u3067\u3057\u3087\u3046\u3002<\/h5>\n<div>\n<h4><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\" href=\"\/sawamura\/blog\/braintumors\/glioma\/temozolo\/\">\u30c6\u30e2\u30be\u30ed\u30df\u30c9\u306b\u3064\u3044\u3066\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/strong><\/span><\/h4>\n<h4><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u30a2\u30d0\u30b9\u30c1\u30f3\" href=\"\/sawamura\/blog\/braintumors\/glioma\/avastine\/\">\u30a2\u30d0\u30b9\u30c1\u30f3\u306b\u3064\u3044\u3066\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/strong><\/span><\/h4>\n<h4><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u30ae\u30ea\u30a2\u30c7\u30eb\" href=\"\/sawamura\/blog\/braintumors\/glioma\/gliadel\/\">\u30ae\u30ea\u30a2\u30c7\u30eb\u306b\u3064\u3044\u3066\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/strong><\/span><\/h4>\n<h4><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u30b0\u30ea\u30aa\u30fc\u30de glioma \u795e\u7d4c\u81a0\u816b\" href=\"\/sawamura\/blog\/braintumors\/glioma\/sum\/\">\u30b0\u30ea\u30aa\u30fc\u30de\u306b\u3064\u3044\u3066\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/strong><\/span><\/h4>\n<\/div>\n<h4><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"NovoTTF tumor treatment field\" href=\"\/sawamura\/blog\/braintumors\/glioma\/novottf\/\">\u30aa\u30d7\u30c1\u30e5\u30fc\u30f3\u306b\u3064\u3044\u3066\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/strong><\/span><\/h4>\n<h1>\u4e16\u754c\u4e2d\u3067\uff0c\u3059\u3054\u304f\u305f\u304f\u3055\u3093\u306e\u65b0\u3057\u3044\u6cbb\u7642\u85ac\u304c\u958b\u767a\u4e2d\u3067\u3059\u304b\u3089\uff0c\u81a0\u82bd\u816b\u3092\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3067\u304d\u308b\u85ac\u304c\u51fa\u73fe\u3059\u308b\u53ef\u80fd\u6027\u306f\u9ad8\u3044\u3067\u3059<\/h1>\n<hr \/>\n<h5>\u91cd\u8981\u60c5\u5831<\/h5>\n<h4>\u00a0\u30a2\u30d0\u30b9\u30c1\u30f3\u306f\u81a0\u82bd\u816b\u306e\u751f\u5b58\u671f\u9593\u3092\u5ef6\u9577\u3057\u306a\u3044\uff08\u81e8\u5e8a\u7b2c3\u76f8\u8a66\u9a13\uff09<\/h4>\n<p>Gilbert MR, et al.: A randomized trial of bevacizmab for newly diagnosed glioblastoma.\u00a0 N Engl J Med 370: 699-708, 2014<br \/>\n<span style=\"color: #000080;\"><span style=\"color: #ff0000;\"><strong>AVAglio \u30a2\u30d0\u30b0\u30ea\u30aa\u00a0<\/strong><\/span><span style=\"color: #000000;\">\u3068\u3044\u3046\u56fd\u969b\u5171\u540c\u7814\u7a76<\/span><\/span>\u3067\u3059\u3002Stupp\u30ec\u30b8\u30e1\u30f3\u306b\u30a2\u30d0\u30b9\u30c1\u30f3\uff08\u30d9\u30d0\u30b7\u30ba\u30de\u30d6\uff09\u3092\u4e0a\u4e57\u305b\u3059\u308b\u4f75\u7528\u6cbb\u7642\u3067\u3059\u300260\u30b0\u30ec\u30a4\uff081\u65e5\u3042\u305f\u308a2Gy\u7167\u5c04\u30926\u9031\u9593\uff09\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u4e2d\u306b\u3001\u30c6\u30e2\u30c0\u30fc\u30eb\uff081\u65e5\u3042\u305f\u308a75mg\/m2\uff09\u9023\u65e5\u6295\u4e0e\u3001<span style=\"color: #000080;\"><strong>\u30a2\u30d0\u30b9\u30c1\u30f3\u30922\u9031\u9593\u9593\u9694\u306710 mg\/kg\u6295\u4e0e\u3057\u307e\u3057\u305f\u3002\u305d\u306e\u5f8c\u306f\uff0c\uff13\u9031\u9593\u9694\u3067\u30a2\u30d0\u30b9\u30c1\u30f3\u306e\u6295\u4e0e\u309212\u30b5\u30a4\u30af\u30eb\u7d99\u7d9a\u3057\u307e\u3057\u305f\u3002<\/strong><\/span>637\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u6cbb\u7642\u3055\u308c\uff0c\u30a2\u30d0\u30b9\u30c1\u30f3\u4f7f\u7528\u7fa4\u306e\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593 PFS\u306f10.7\u30f6\u6708\uff0c\u4f7f\u7528\u3057\u306a\u3044\u5834\u5408\u306f7.3\u30f6\u6708\u3067\u6709\u610f\u5dee\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u5168\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024 OS\u306f\uff0c\u30a2\u30d0\u30b9\u30c1\u30f3\u4f7f\u7528\u7fa4\u306715.7\u30f6\u6708\uff0c\u4f7f\u7528\u3057\u306a\u3044\u5834\u5408\u306f16.1\u30f6\u6708\u3067\u3042\u308a\uff0c\u3053\u308c\u306b\u306f\u6709\u610f\u306a\u5dee\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u3053\u3053\u3067\u3082<span style=\"color: #ff0000;\"><strong>\u75c5\u52e2\u306e\u9032\u884c\u306f\u3042\u308b\u7a0b\u5ea6\u6291\u3048\u3089\u308c\u308b\u3051\u308c\u3069\u3082\uff0c\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u306f\u5f97\u3089\u308c\u306a\u3044<\/strong><\/span>\u3068\u3044\u3046\u6700\u7d42\u6210\u7e3e\u3067\u3059\u3002\u3055\u3089\u306b\u30a2\u30d0\u30b9\u30c1\u30f3\u3092\u4f7f\u7528\u3057\u305f\u7fa4\u3067\uff0c\u8a08\u753b\u6642\u306b\u671f\u5f85\u3057\u305f\u52b9\u679c\u306f\u5f97\u3089\u308c\u306a\u304b\u3063\u305f\uff0c\u89b3\u5bdf\u671f\u9593\u306e\u5ef6\u9577\u3068\u3068\u3082\u306b\u75c7\u72b6\u306e\u60aa\u5316\u30fb\u751f\u5b58\u306e\u8cea QOL \u306e\u60aa\u5316\u30fb\u8a8d\u77e5\u6a5f\u80fd\u306e\u60aa\u5316\u304c\u3042\u3063\u305f\u3068\u306e\u8ffd\u8a18\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u306f\uff0c\u30a2\u30d0\u30b9\u30c1\u30f3\u306b\u30b9\u30fc\u30c9\u30d7\u30ed\u30b0\u30ec\u30c3\u30b7\u30e7\u30f3\u3092\u6291\u5236\u3059\u308b\u898b\u304b\u3051\u306e\u52b9\u679c\u304c\u3042\u308b\u305f\u3081\u3067\u3042\u3063\u3066\uff0c\u771f\u306e\u6297\u816b\u760d\u52b9\u679c true effect \u3067\u306f\u306a\u3044\u3068\u3044\u3046\u8ad6\u8a55\u3082\u3042\u308a\u307e\u3059\u3002<br \/>\nChinot OL, et al.: Bebacizmab plus radiotherapy-temozolomide for newly diagnosed gliomblastoma. N Engl J Med 370: 709-722, 2014<br \/>\n\u30e8\u30fc\u30ed\u30c3\u30d1\u304b\u3089\u306e\u3082\u306e(RTOG 0825)\u3067\uff0c921\u4eba\u306e\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093\u3092\u5bfe\u8c61\u3068\u3057\u3066\u30a2\u30d0\u30b0\u30ea\u30aa\u3068\u540c\u69d8\u306e\u8a66\u9a13\u304c\u3055\u308c\u307e\u3057\u305f\u3002\u30a2\u30d0\u30b9\u30c1\u30f3\u4f7f\u7528\u7fa4\u306e\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593 PFS\u306f10.6\u30f6\u6708\uff0c\u4f7f\u7528\u3057\u306a\u3044\u5834\u5408\u306f6.2\u30f6\u6708\u3067\u6709\u610f\u5dee\u304c\u3042\u308a\u307e\u3057\u305f\u30022\u5e74\u751f\u5b58\u5272\u5408 2-year OS\u306f\uff0c\u30a2\u30d0\u30b9\u30c1\u30f3\u4f7f\u7528\u7fa4\u306733.9%\uff0c\u4f7f\u7528\u3057\u306a\u3044\u5834\u5408\u306f30.1%\u3067\u3042\u308a\uff0c\u3053\u308c\u306b\u306f\u6709\u610f\u306a\u5dee\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u30a2\u30d0\u30b9\u30c1\u30f3\u3092\u4f7f\u7528\u3057\u305f\u307b\u3046\u304c\uff0c\u306eQOL\u3068PS\u306e\u7dad\u6301\u304c\u3067\u304d\u305f\u3051\u308c\u3069\u3082\uff0c\u526f\u4f5c\u7528\uff08\u6709\u5bb3\u4e8b\u8c61\uff09\u304c\u591a\u304b\u3063\u305f\u3068\u3044\u3046\u7d50\u679c\u3067\u3059\u3002<strong><span style=\"color: #ff0000;\">\u30a2\u30d0\u30b9\u30c1\u30f3\u3092\u4f7f\u7528\u3057\u3066\u3082\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u304c\u306a\u3044<\/span><\/strong>\u3068\u3044\u3046\u7d50\u8ad6\u3067\u3057\u305f\u3002<\/p>\n<h5 class=\"style2\">ACNU\u3068\u30a4\u30f3\u30bf\u30fc\u30d5\u30a7\u30ed\u30f3-\u03b2<\/h5>\n<p>\u30cb\u30c9\u30e9\u30f3(ACNU)\u306f1970\u5e74\u4ee3\u304b\u3089\uff0c\u30a4\u30f3\u30bf\u30fc\u30d5\u30a7\u30ed\u30f3-\u03b2\u306f1980\u5e74\u4ee3\u304b\u3089\u65e5\u672c\u56fd\u306b\u8a8d\u53ef\u3055\u308c\u3066\u6570\u5341\u5e74\u306b\u4e98\u3063\u3066\u4f7f\u7528\u3055\u308c\u3066\u304d\u307e\u3057\u305f\u3002\u3067\u3082<strong><span style=\"color: #ff0000;\">\u3053\u308c\u3089\u306e\u85ac\u5264\u304c\u81a0\u82bd\u816b\u306b\u6709\u52b9\u3067\u3042\u308b\u3068\u3044\u3046\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30eb\u306e\u9ad8\u3044\u79d1\u5b66\u7684\u6839\u62e0\u304c\u3042\u308a\u307e\u305b\u3093<\/span><\/strong>\u3002\u3067\u3059\u304b\u3089\uff0c\u4e16\u754c\u3067\u306f\u65e5\u672c\u3060\u3051\u3067\u81a0\u82bd\u816b\u306b\u5bfe\u3057\u3066 &#8220;\u6709\u52b9\u3067\u3042\u308b\u3068\u4fe1\u3058\u3089\u308c\u3066\u3044\u308b&#8221; \u6cbb\u7642\u85ac\u3068\u8a00\u3063\u3066\u3044\u3044\u3067\u3057\u3087\u3046\u3002\u3053\u3093\u306a\u3068\u3053\u308d\u3067\u3082\u30ac\u30e9\u30d1\u30b4\u30b9\u5316\u3057\u3066\u3044\u308b\u65e5\u672c\u3068\u8a00\u3048\u307e\u3059\u3002\u6709\u52b9\u304b\u3069\u3046\u304b\u6539\u3081\u3066\u5b9f\u8a3c\u3059\u308b\u304b\uff0c\u305d\u308c\u3068\u3082\u3053\u308c\u3089\u306e\u85ac\u5264\u3092\u4fdd\u967a\u8a3a\u7642\u304b\u3089\u5916\u3059\u304b\u3057\u306a\u3044\u3068\uff0c\u65e5\u672c\u306e\u8133\u816b\u760d\u5b66\u306f\u4e16\u754c\u306b\u4fe1\u7528\u3055\u308c\u306a\u304f\u306a\u308a\u307e\u3059\u3002<\/p>\n<h5>\u30aa\u30d7\u30c1\u30e5\u30fc\u30f3\u306e\u8a55\u4fa1<\/h5>\n<p>\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3067\u521d\u767a\u81a0\u82bd\u816b\u306e\u751f\u5b58\u671f\u9593 OS\u304c15\u30f6\u6708\u3068\u306a\u3063\u305f\u3068\u3044\u3046\u9a5a\u304d\u306f\uff0c2005\u5e74\u306e\u3082\u306e\u3067\u3057\u305f\u30022015\u5e74\u300c\u30aa\u30d7\u30c1\u30e5\u30fc\u30f3\u3092\u4f7f\u7528\u3059\u308b\u3068OS\u304c20\u30f6\u6708\u306b\u3082\u4f38\u3073\u308b\uff01\u300d\uff0c\u3059\u3054\u304f\u9a5a\u304d\u307e\u305b\u3093\u304b\uff1f<br \/>\n\u30aa\u30d7\u30c1\u30e5\u30fc\u30f3\u306e\u81e8\u5e8a\u7814\u7a76\u306b\u767b\u9332\u3055\u308c\u305f\u60a3\u8005\u3055\u3093\u306f\uff0c\u8a3a\u65ad\u304b\u3089\u30e9\u30f3\u30c0\u30e0\u5316\u307e\u30673.8\u30f6\u6708\u304b\u304b\u3063\u3066\u3044\u307e\u3059\u3002\u624b\u8853\uff0c\u75c5\u7406\uff0c\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u306b\u6642\u9593\u304c\u8cbb\u3084\u3055\u308c\u3044\u3066\u3044\u308b\u304b\u3089\u3067\u3059\u3002\u3053\u306e\u671f\u9593\u306b\u3059\u3067\u306b30%\u306e\u60a3\u8005\u3055\u3093\u3067\u60aa\u5316 progression\u304c\u3042\u308a\uff0c\u3053\u308c\u3089<strong><span style=\"color: #000080;\">\u4e88\u5f8c\u306e\u7279\u306b\u60aa\u3044\u65e9\u671f\u5897\u60aa early progression\u3092\u5448\u3059\u308b\u81a0\u82bd\u816b\u60a3\u8005\u3055\u3093\u304c\uff0c\u767b\u9332\u6642\u70b9\u3067\u7701\u304b\u308c\u3066\u3044\u308b<\/span><\/strong>\u304b\u3089\u3067\u3059\u3002<\/p>\n<h5><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"\/sawamura\/blog\/contact-natsume\/\">\u590f\u76ee\u6566\u81f3\u304c\u76f8\u8ac7\u306b\u306e\u308a\u307e\u3059\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/span><\/h5>\n<p>\u81a0\u82bd\u816b\u306b\u3064\u3044\u3066\u30e1\u30fc\u30eb\u3067\u76f8\u8ac7\u3067\u304d\u307e\u3059\u3002<strong><a style=\"color: #000080;\" href=\"\/sawamura\/blog\/contact-natsume\/\">\u76f8\u8ac7\u30d5\u30a9\u30fc\u30e0\u3092\u30af\u30ea\u30c3\u30af\u3057\u3066\u958b\u3044\u3066\u304f\u3060\u3055\u3044\u3002<\/a><\/strong><\/p>\n<h3><strong><span style=\"color: #333333;\">\u81a0\u82bd\u816b\u306e\u624b\u8853<\/span><\/strong><\/h3>\n<h5>\u81a0\u82bd\u816b\u306f\u624b\u8853\u3060\u3051\u3067\u6cbb\u3059\u3053\u3068\u304c\u3067\u304d\u306a\u3044\u816b\u760d\u3067\u3059\uff0c\u624b\u8853\u306e\u5f79\u5272\u306f\uff0c\u5ef6\u547d\u304c\u6570\u9031\u9593\u3042\u308b\u3044\u306f\u6570\u30f6\u6708\u3067\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u306b\u6ce8\u610f\u3057\u3066\u8aad\u3093\u3067\u304f\u3060\u3055\u3044\uff0c\u91cd\u3044\u75c7\u72b6\u3092\u51fa\u3059\u3088\u3046\u306a\u624b\u8853\u306f\u907f\u3051\u307e\u3059<\/h5>\n<h4>\u624b\u8853\u306e\u57fa\u672c\u7684\u8003\u3048\u65b9<\/h4>\n<p><span style=\"color: #000080;\"><strong>\u6e1b\u8377\u624b\u8853 cytoreduction surgery, bulk-reduction surgery<\/strong><\/span>\u3068\u8a00\u3044\u307e\u3059\u3002\u75c5\u7406\u8a3a\u65ad\u3068\u6642\u3092\u7a3c\u3050\u305f\u3081\u306e\u624b\u8853\u3067\u3059\u3002\u81a0\u82bd\u816b\u3092\u624b\u8853\u3067\u6cbb\u3059\u3068\u3044\u3046\u8003\u3048\u306f\u3057\u307e\u305b\u3093\u3002<\/p>\n<h4><span style=\"color: #000080;\"><strong>\u958b\u982d\u624b\u8853\u3092\u53d7\u3051\u305f\u307b\u3046\u304c\u3044\u3044\u60a3\u8005\u3055\u3093\u306e\u57fa\u6e96\uff08\u30a8\u30d3\u30c7\u30f3\u30b9\u30af\u30e9\u30b9 I\uff0c\u63a8\u5968\u5ea6 A\uff09<\/strong><\/span><\/h4>\n<p><span style=\"color: #000080;\"><strong>70\u6b73\u672a\u6e80\u306e\u60a3\u8005\u3055\u3093<\/strong><\/span>\u3067\u3042\u308a\uff0c\u304b\u3064<span style=\"color: #000080;\"><strong>KPS 70\u4ee5\u4e0a<\/strong><\/span>\uff08\u4ecb\u52a9\u3092\u53d7\u3051\u306a\u3044\u3067\u81ea\u5206\u306e\u8eab\u306e\u56de\u308a\u3053\u3068\u304c\u3067\u304d\u308b\uff09\u3068\u3044\u3046\u6761\u4ef6\u304c\u3042\u308c\u3070\uff0c\u958b\u982d\u624b\u8853\u304c\u53ef\u80fd\u3067\u3042\u3063\u3066<span style=\"color: #000080;\"><strong>\u5927\u304d\u306a\u969c\u5bb3\u3092\u51fa\u3055\u306a\u3044\u3068\u3044\u3046\u6761\u4ef6\u4e0b<\/strong><\/span>\u3067\uff0c\u958b\u982d\u624b\u8853\u306b\u3088\u308b\u816b\u760d\u6458\u51fa\u3092\u53d7\u3051\u305f\u65b9\u304c\u3044\u3044\u3068\u3055\u308c\u307e\u3059\u3002<\/p>\n<h4>\u6458\u51fa\u5272\u5408 EOR extent of resection<\/h4>\n<p>\u4f55%\u6458\u51fa\u3067\u304d\u305f\u304b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u304b\u3064\u3066\u306f\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u9020\u5f71\u5264\u3067\u767d\u304f\u306a\u308b\uff08\u5897\u5f37\u3055\u308c\u308b\uff09\u3068\u3053\u308d\u3092\u8a55\u4fa1\u3057\u3066\u3044\u307e\u3057\u305f\u304c\uff0c2020\u5e74\u6642\u70b9\u3067\u306fMRI\u306eT2\/\u30d5\u30ec\u30a2\u5f37\u8abf\u753b\u50cf\u3068\u3044\u3046\u306e\u3092\u307f\u3066\uff0c\u4f53\u7a4d\u8a08\u7b97\u3057\u307e\u3059\u300250%\u3068\u304b95%\u3068\u304b\u8868\u73fe\u3057\u307e\u3059\u3002100%\u306f\u3042\u308a\u5f97\u306a\u3044\u306e\u3067\uff0c\u304a\u533b\u8005\u3055\u3093\u304b\u3089\u5168\u90e8\u53d6\u308c\u305f\u3068\u3044\u308f\u308c\u305f\u3068\u304d\u306b\u306f\uff0c\u4fe1\u3058\u307e\u305b\u3093\u3002<\/p>\n<h4>\u304a\u3088\u305d\u5168\u3066\u306e\u816b\u760d\u304c\u6458\u51fa\u3067\u304d\u305f\u6642\u306b\u306e\u307f\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u304c\u5f97\u3089\u308c\u308b<\/h4>\n<p>\u5927\u898f\u6a21\u306a\u81e8\u5e8a\u7814\u7a76\u306e\u7d50\u679c\uff0c\u81a0\u82bd\u816b\u306f\u624b\u8853\u306770-98%\u304f\u3089\u3044\u6458\u51fa\u3067\u304d\u308b\u3068\u751f\u547d\u4e88\u5f8c\u304c\u4f38\u3073\u308b\u3068\u3055\u308c\u3066\u304d\u307e\u3057\u305f\u3002\u5225\u306a\u8a00\u3044\u65b9\u3092\u3059\u308c\u3070\uff0c<span style=\"color: #000080;\"><strong>\u816b\u760d\u306e\u304b\u306a\u308a\u306e\u90e8\u5206\u304c\u6458\u51fa\u3067\u304d\u306a\u3044\u3068\u624b\u8853\u306e\u610f\u7fa9\u306f\u7121\u3044<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u3067\u3082\u3042\u308a\u307e\u3059\u30022017\u5e74\uff0c\u30e8\u30fc\u30ed\u30c3\u30d1\u306eEANO\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\uff0cAlthough some studies reported gradual improvement in outcome with increasing extent of resection, only gross total resection might be associated with improved outcome.\u3068\u66f8\u304b\u308c\u3066\u3042\u308a\u307e\u3059\u3002\u305f\u304f\u3055\u3093\u53d6\u308c\u305f\u65b9\u304c\u3044\u3044\u3068\u3044\u3046\u5831\u544a\u3082\u3042\u308b\u3051\u308c\u3069\uff0c<span style=\"color: #ff0000;\"><strong>\u7d50\u679c\u7684\u306b\u4e88\u5f8c\u3092\u826f\u304f\u3067\u304d\u308b\u306e\u306f\u5927\u65b9\u5168\u90e8\u306e\u816b\u760d\u304c\u3068\u308c\u305f\u6642\u3060\u3051\u3067\u3042\u308d\u3046<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u53e4\u304f\u304b\u3089\u306e\u3086\u308b\u304e\u306a\u3044\u30b3\u30f3\u30bb\u30f3\u30b5\u30b9\u306e\u3042\u308b\u3068\u3053\u308d\u3067\u306f\uff0c95%\u4ee5\u4e0a\u306e\u6458\u51fa\u3067\u4e88\u5f8c\u304c\u6539\u5584\u3059\u308b\u3068\u306e\u8003\u3048\u65b9\u304c\u6a19\u6e96\u7684\u3067\u3059\u3002<\/p>\n<h4>\u81a0\u82bd\u816b\u306f\u53ef\u80fd\u306a\u9650\u308a\u591a\u304f\u306e\u91cf\u3092\u6458\u51fa\u3059\u308b\u3068\u3044\u3046\u65b9\u91dd\u3067\u826f\u3044\u306e\u304b\uff1f<br \/>\n\u624b\u8853\u3067\u305f\u304f\u3055\u3093\u53d6\u308c\u305f\u65b9\u304c\u751f\u5b58\u671f\u9593\u304c\u5ef6\u3073\u308b\u304b\uff1f<\/h4>\n<p>\u3055\u307e\u3056\u307e\u306a\u5927\u5b66\u3067\uff0cMRI\u753b\u50cf\u306e\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\uff08\u767d\u304f\u5199\u308b\uff09\u90e8\u5206\u3092\uff0c\u3069\u306e\u7a0b\u5ea6\u6458\u51fa\u3067\u304d\u3066\u3044\u308b\u3068\u751f\u5b58\u671f\u9593\u304c\u5ef6\u3073\u308b\u304b\u304c\u8abf\u67fb\u3055\u308c\u307e\u3057\u305f\u30022019\u5e74\u3067\u306f\uff0c<span style=\"color: #000080;\"><strong>T2\/FLAIR\u3067\u9ad8\u4fe1\u53f7\uff08\u767d\u304f\u6620\u308b\uff09\u306e\u90e8\u5206\u3092\u3069\u306e\u7a0b\u5ea6\u6458\u51fa\u3067\u304d\u308b\u304b<\/strong><\/span>\u3068\u306e\u8a55\u4fa1\u306b\u5909\u308f\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n<ul>\n<li><span class=\"highlight\">Molinaro AM: Association<\/span> of <span class=\"highlight\">Maximal<\/span> <span class=\"highlight\">Extent<\/span> of <span class=\"highlight\">Resection<\/span> of <span class=\"highlight\">Contrast-Enhanced<\/span> and <span class=\"highlight\">Non-Contrast-Enhanced<\/span><span class=\"highlight\">Tumor<\/span> With <span class=\"highlight\">Survival<\/span> Within <span class=\"highlight\">Molecular<\/span> <span class=\"highlight\">Subgroups<\/span> of <span class=\"highlight\">Patients<\/span> With <span class=\"highlight\">Newly<\/span> <span class=\"highlight\">Diagnosed<\/span> <span class=\"highlight\">Glioblastoma<\/span>. <span role=\"menubar\">JAMA Oncol.<\/span> 2020<br \/>\n<span style=\"color: #000080;\"><strong>\u82e5\u3044\u5e74\u9f62\u5c64\u3067\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u90e8\u5206 CE\u3068\u9020\u5f71\u3055\u308c\u306a\u3044\u9ad8\u4fe1\u53f7\u90e8\u5206 NCE\u3092\u304b\u306a\u308a\u7a4d\u6975\u7684\u306b\u6458\u51fa\u3057\u305f\u5834\u5408\uff0cIDH\u304cwild type\u3067\u3082\u5168\u751f\u5b58\u671f\u9593 OS\u306f37\u30f6\u6708<\/strong><\/span>\u306b\u9054\u3057\u307e\u3057\u305f\u3002\u4e00\u65b9\uff0cNSE\u3092\u6b8b\u305b\u307016.5\u30f6\u6708\u3067\u3057\u305f\u300237\u30f6\u6708\u3068\u3044\u3046\u306e\u306f mutant type\u306e\u751f\u5b58\u671f\u9593\u306b\u5339\u6575\u3057\u307e\u3059\u3002\u307e\u305fMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306e\u6709\u7121\u3067\u3053\u306e\u751f\u5b58\u671f\u9593\u306b\u5909\u308f\u308a\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u3057\u304b\u3057\uff0c\u9ad8\u9f62\u8005\u3067\u306f\u3053\u306e\u5dee\u306f\u306a\u304f\uff0c\u9006\u306bCE\u90e8\u5206\u306e\u7a4d\u6975\u7684\u6458\u51fa\u306e\u307f\u3067\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u304c\u3042\u308a\u307e\u3059\uff0c\u3057\u304b\u3057\u4e2d\u592e\u5024\u306f12\u30f6\u6708\u306b\u3059\u304e\u307e\u305b\u3093\u3002<\/li>\n<li><span class=\"highlight\">Ellingson BM, et al.:\u00a0<\/span>Validation of post-operative residual contrast enhancing tumor volume as an independent prognostic factor for overall survival in newly diagnosed glioblastoma.\u00a0<span role=\"menubar\">Neuro Oncol.<\/span> 2018<br \/>\nUCLA\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u624b\u8853\u6458\u51fa\u5ea6 EOR \u304c\u4e88\u5f8c\u306b\u5927\u304d\u306a\u95a2\u308f\u308a\u3092\u6301\u3064\u3053\u3068\u3092\u5f37\u8abf\u3057\u3066\u3044\u307e\u3059\u3002\u3057\u304b\u3057\u4e00\u65b9\u3067\uff0c<span style=\"color: #000080;\"><strong>12cc\u4ee5\u4e0a\u306e\u816b\u760d\u4f53\u7a4d\u3092\u6b8b\u3059\u3088\u3046\u3060\u3068\u624b\u8853\u3059\u308b\u5229\u70b9\u304c\u306a\u3044<\/strong><\/span>\u3002\u3064\u307e\u308a\u76f4\u5f842.5cm\u307b\u3069\u306e\u816b\u760d\u304c\u6b8b\u308b\u306a\u3089\u305d\u308c\u4ee5\u4e0a\u306e\u30ea\u30b9\u30af\u3092\u72af\u3059\u624b\u8853\u3059\u308b\u5fc5\u8981\u306f\u306a\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/li>\n<li>Brown TJ, et al. Association of the extent of resection with survival in glioblastoma: a systematic review and meta-analysis. JAMA Oncol. 2016<br \/>\nSTR\u3088\u308aGTR\u306e\u65b9\u304c\u6709\u610f\u306bOS, PFS\u3092\u5ef6\u9577\u3059\u308b\u305d\u3046\u3067\u3059\u3002meta-analysis\u306a\u306e\u3067FLAIR\u753b\u50cf\u306e\u75c5\u5909\u5207\u9664\u7387\u3092\u53cd\u6620\u3057\u3066\u3044\u308b\u3068\u306f\u601d\u3048\u307e\u305b\u3093\u3002<\/li>\n<li>Kotrotsou A, et al. Multi-center study finds postoperative residual non-enhancing compo-nent of glioblastoma as a new determinant of patient outcome. J Neurooncol. 2018<br \/>\n\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u306a\u3044\u75c5\u5909\u304c\uff0c\u624b\u8853\u5f8c\u306b\u3069\u306e\u7a0b\u5ea6\u6b8b\u5b58\u3057\u3066\u3044\u308b\u304b\u3067\u751f\u5b58\u5272\u5408\u304c\u5909\u308f\u308b\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u5225\u306a\u8a00\u8449\u3067\u8a00\u3048\u3070\uff0cFLAIR\u9ad8\u4fe1\u53f7\u9818\u57df\u306e\u5e83\u3044\u5927\u304d\u306aGBM\u306f\u751f\u547d\u4e88\u5f8c\u304c\u4e0d\u826f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/li>\n<li>Marko NF, et al.: Extent of resection of glioblastoma revisited: personalized survival modeling facilitates more accurate survival prediction and supports a maximum-safe-resection approach to surgery. J Clin Oncol, 2014<br \/>\nMD\u30a2\u30f3\u30c0\u30fc\u30bd\u30f3\u764c\u30bb\u30f3\u30bf\u30fc\u306e\u5831\u544a\u3067\u3059\u3002accelerated failure time (AFT) modeling\u3068\u3044\u3046\u4e88\u5f8c\u89e3\u6790\u65b9\u6cd5\u304c\u7528\u3044\u3089\u308c\u307e\u3057\u305f\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0c80%\u3060\u306e95%\u3060\u306e\u3068\u3044\u3046\u5024 threshhold \u3092\u6301\u3063\u3066\u624b\u8853\u304c\u6709\u7528\u304b\u3069\u3046\u304b\u306e\u8b70\u8ad6\u3067\u306f\u306a\u304f\uff0c<span style=\"color: #000080;\"><strong>a maximum safe resection? \uff08\u5b89\u5168\u306b\u6458\u51fa\u3067\u304d\u308b\u3060\u3051\u3068\u308b\uff09\u3068\u3044\u3046\u624b\u8853\u6226\u7565\u306b\u610f\u7fa9\u304c\u3042\u308b<\/strong><\/span>\u3068\u3057\u307e\u3057\u305f\u3002\u624b\u8853\u306e\u524d\u306b\uff0c\u500b\u3005\u306e\u60a3\u8005\u3055\u3093\u306e\u4f59\u547d\u3092\u4e88\u6e2c\u3059\u308b\u76ee\u7684\u3067\uff0c\u3053\u306e\u30e2\u30c7\u30eb\u3092\u4f7f\u3046\u305f\u3081\u306b\u306f\u60a3\u8005\u3055\u3093\u304c<span style=\"color: #000080;\"><strong>\u8853\u5f8c\u306e\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3092\u671b\u3080<\/strong><\/span>\u304b\u3069\u3046\u304b\u306e\u60c5\u5831\u304c\u5fc5\u8981\u3067\u3059\u3002\u8981\u3059\u308b\u306b\u300c\u3067\u304d\u308b\u3060\u3051\u3068\u308b\u300d\u3068\u3044\u3046\u30aa\u30fc\u30bd\u30c9\u30c3\u30af\u30b9\u306a\u8003\u3048\u65b9\u306b\u6a29\u5a01\u3092\u4e0e\u3048\u305f\u3068\u3082\u3044\u3048\u308b\u3067\u3057\u3087\u3046\u3002\u4e00\u65b9\u3067\uff0c\u3053\u306e\u8ad6\u6587\u306e\u7d50\u8ad6\u304c\u624b\u8853\u306e\u597d\u304d\u306a\u8133\u5916\u79d1\u533b\u306e\u9593\u3067\u5e83\u307e\u308b\u3068\uff0c\u5371\u967a\u306a\u611f\u3058\u304c\u3057\u307e\u3059\u304c\u3002<\/li>\n<li>Grabowski MM, et al.: Residual tumor volume versus extent of resection: predictors of survival after surgery for glioblastoma. J Neurosurg, 2014<br \/>\n\u30af\u30ea\u30fc\u30d6\u30e9\u30f3\u30c9\u5927\u5b66\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u624b\u8853\u5f8c\u306e\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b<span style=\"color: #000080;\"><strong>\u816b\u760d\u306e\u91cf\u304c2cc\u4ee5\u4e0b<\/strong><\/span>\u3067\u3042\u308c\u3070\u4f59\u547d\u304c\u9577\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u65e7\u6765\u306e\u6458\u51fa\u7387\u3067\u8a00\u3048\u3070<span style=\"color: #000080;\"><strong>98%\u6458\u51fa\u3067\u304d\u305f\u6642<\/strong><\/span>\u3067\u3059\u3002<\/li>\n<li><span class=\"highlight\">Chaichana KL et al.:\u00a0<\/span>Establishing percent resection and residual volume thresholds affecting survival and recurrence for patients with newly diagnosed intracranial <span class=\"highlight\">glioblastoma<\/span>.\u00a0<span role=\"menubar\">Neuro Oncol.<\/span> 2014<br \/>\n\u30b8\u30e7\u30f3\u30ba\u30db\u30d7\u30ad\u30f3\u30ba\u5927\u5b66\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>70%\u6458\u51fa<\/strong><\/span>\u3042\u308b\u3044\u306f<strong><span style=\"color: #000080;\">5cc\u4ee5\u4e0b<\/span><\/strong>\u306e\u6b8b\u5b58\u816b\u760d\u3067\u3042\u3063\u305f\u6642\uff0c\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u304c\u3042\u308b\u3068\u3057\u307e\u3057\u305f\u3002<\/li>\n<li>Beiko J: IDH1 mutant malignant astrocytomas are more amenable to surgical resection and have a survival benefit associated with maximal surgical resection. Neuro Oncol 2014<br \/>\n\u30b0\u30ec\u30fc\u30c93\u4ee5\u4e0a\u306e\u661f\u7d30\u80de\u7cfb\u816b\u760d335\u4f8b\u3067\uff0cIDH\u5909\u7570\u306e\u3042\u308b\u4f8b\u3067\u306f93%\u3067\u5168\u6458\u51fa\uff08\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u90e8\u5206\uff09\u304c\u3067\u304d\u307e\u3057\u305f\u304c\uff0cIDH\u5909\u7570\u306e\u306a\u3044\u4f8b\u3067\u306f67%\u3057\u304b\u3067\u304d\u306a\u304b\u3063\u305f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002IDH\u5909\u7570\u306e\u306a\u3044\u4f8b\u3067\u306f<span style=\"color: #000080;\"><strong>\u5897\u5f37\u3055\u308c\u306a\u3044\u75c5\u5909\u3092\u8ffd\u52a0\u5207\u9664\u3057\u3066\u3082\u4e88\u5f8c\u306e\u6709\u610f\u306a\u6539\u5584\u306f\u3042\u308a\u307e\u305b\u3093<\/strong><\/span>\u3067\u3057\u305f\u3002<\/li>\n<\/ul>\n<ul>\n<li>Kreth FW, et al. Gross total but not incomplete resection of glioblastoma prolongs survival in the era of radiochemotherapy. Ann Oncol 2013<br \/>\n<span style=\"color: #333333;\">\u30df\u30e5\u30f3\u30d8\u30f3\u5927\u5b66\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002<\/span><strong><span style=\"color: #000080;\">\u307b\u307c\u5168\u6458 GTR\u3092\u53d7\u3051\u305f\u60a3\u8005\u3055\u3093\u3067\u306e\u307f\u4e88\u5f8c\u304c\u6539\u5584<\/span><\/strong>\u3055\u308c\uff0c\u958b\u982d\u90e8\u5206\u6458\u51fa incomplete resection \u306e\u4fa1\u5024\u306b\u306f\u7591\u554f\u304c\u6b8b\u308b\u3068\u3057\u3066\u3044\u307e\u3059\u3002<\/li>\n<li>Sanai N, et al.: An extent of resection threshold for newly diagnosed glioblastomas. J Neurosurg, 2011<br \/>\n\u30b5\u30f3\u30d5\u30e9\u30f3\u30b7\u30b9\u30b3\u5927\u5b66\u304b\u3089\u306e\u8ad6\u6587\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>8\u5272\u7a0b\u5ea6 (78%) \u4ee5\u4e0a<\/strong><\/span>\u304c\u6458\u51fa\u3067\u304d\u308b\u3068\u751f\u5b58\u671f\u9593\u304c\u5ef6\u3073\u308b\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/li>\n<\/ul>\n<h5 align=\"left\"><span style=\"color: #000080;\"><strong>40\uff05\u6458\u51fa\u3057\u3066\u308270%\u6458\u51fa\u3057\u3066\u3082\uff0c\u81a0\u82bd\u816b\u306e\u4e88\u5f8c\u306f\u307b\u3068\u3093\u3069\u5909\u308f\u3089\u306a\u3044<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u306f\u771f\u5b9f\u3067\u3059\u3002\u3060\u304b\u3089\uff0c\u624b\u8853\u306f\u7121\u7406\u3092\u3057\u306a\u3044\u3002\u3082\u3046\u4e00\u70b9\uff0c\u305d\u3082\u305d\u3082\u624b\u8853\u3067\u6458\u51fa\u3057\u3084\u3059\u3044\u5834\u6240\u306e\u81a0\u82bd\u816b\u306f\u6d45\u304f\u8868\u9762\u3067\uff0c\u624b\u8853\u3067\u304d\u306a\u3044\u81a0\u82bd\u816b\u306f\u8133\u306e\u6df1\u90e8\u306b\u3042\u308b\u306e\u3067\uff0c<span style=\"color: #000080;\"><strong>\u624b\u8853\u6458\u51fa\u3067\u304d\u308b\u304b\u3069\u3046\u304b\u306f\uff0c\u624b\u8853\u306e\u88c5\u7f6e\u3084\u6280\u8853\u3067\u5927\u5dee\u306f\u306a\u304f\uff0c\u816b\u760d\u306e\u767a\u751f\u90e8\u4f4d\u3067\u3059\u3067\u306b\u6c7a\u307e\u3063\u3066<\/strong><strong>\u3044\u308b<\/strong><\/span>\u306e\u3067\u3059\u3002<\/h5>\n<h3 align=\"left\"><span style=\"color: #000080;\">\u81a0\u82bd\u816b\u306e\u653e\u5c04\u7dda\u6cbb\u7642<\/span><\/h3>\n<ul>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u3053\u3068\u306b\u3088\u3063\u3066\uff0c\u751f\u547d\u4e88\u5f8c\u304c\u304a\u3088\u305d\uff12\u500d\u306b\u4f38\u3073\u307e\u3059<\/li>\n<li>\u304b\u3064\u3066\u306f\u8853\u5f8c3\u9031\u4ee5\u5185\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u958b\u59cb\u3057\u305f\u65b9\u304c\u3044\u3044\u3068\u8003\u3048\u3089\u308c\u307e\u3057\u305f\u304c\uff0c\u907a\u4f1d\u5b50\u8a3a\u65ad\u306a\u3069\u306b\u6642\u9593\u3092\u8cbb\u3084\u3057\u3066\uff0c\u8853\u5f8c5\u9031\u76ee\u304f\u3089\u3044\u3067\u958b\u59cb\u3057\u3066\u3082\u4e88\u5f8c\u306b\u5909\u308f\u308a\u306f\u306a\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u3067\u3082\uff0c\u8853\u524d\u306b\u6025\u901f\u306a\u5897\u5927\u50be\u5411\u3092\u793a\u3057\u305f\u81a0\u82bd\u816b\u306b\uff0c\u8853\u5f8c\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u9045\u308c\u308b\u3068\u75c7\u72b6\u304c\u4e00\u6c17\u306b\u5897\u60aa\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>60\u30b0\u30ec\u30a4\u30921\u65e5\u3042\u305f\u308a1\u00b78\u20132\u00b70\u30b0\u30ec\u30a4\u3067\u7167\u5c04\u3057\u307e\u3059<\/li>\n<li>1\u9031\u9593\u306b5\u56de\u3067\u3059\u304b\u3089\uff0c1\u65e5\uff12\u30b0\u30ec\u30a4\u3067\u6cbb\u7642\u306b\u306f6\u9031\u9593\u304f\u3089\u3044\u304b\u304b\u308a\u307e\u3059<\/li>\n<li>1\u65e51.8\u30b0\u30ec\u30a4\u306f\u3055\u3089\u306b\u6cbb\u7642\u671f\u9593\u304c\u5ef6\u3073\u308b\u306e\u3067\u3042\u307e\u308a\u4f7f\u7528\u3055\u308c\u307e\u305b\u3093<\/li>\n<li>70\u6b73\u4ee5\u4e0a\u306e\u72b6\u614b\u306e\u826f\u3044\u60a3\u8005\u3055\u3093\u3067\u7dda\u91cf\u3092\u7d5e\u308a\u305f\u3044\u6642\u306b\u306f\uff0c50\u30b0\u30ec\u30a4\uff081\u00b78\u30b0\u30ec\u30a4\/\u65e5\uff09\u3067\u3082\u52b9\u679c\u306f\u3042\u308a\u307e\u3059<\/li>\n<li>MRI\u3067\u816b\u760d\u304c\u3042\u308b\u3068\u5224\u65ad\u3055\u308c\u308b\u90e8\u5206\u3088\u308a\uff0c\u5168\u5468 2cm\u304f\u3089\u3044\u5e45\u5e83\u304f\u653e\u5c04\u7dda\u3092\u5f53\u3066\u307e\u3059\uff08generous local field)<\/li>\n<li>IMRT \u5f37\u5ea6\u5909\u8abf\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u3044\u3046\u65b9\u6cd5\u3067\uff0c\u6b63\u5e38\u8133\u306e\u88ab\u66dd\u3092\u907f\u3051\u308b\u305f\u3081\u306e\u8907\u96d1\u306a\u7167\u5c04\u8a08\u753b\u304c\u3055\u308c\u308b\u50be\u5411\u306b\u3042\u308a\u307e\u3059<\/li>\n<li>\u521d\u671f\u6cbb\u7642\u306b\u304a\u3044\u3066\u306e\uff0c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\uff08\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642\uff09\u3084\u30b5\u30a4\u30d0\u30fc\u30ca\u30a4\u30d5\uff08\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\uff09\u306f\u6709\u52b9\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<\/ul>\n<h3><span style=\"color: #000080;\">\u9ad8\u9f62\u8005\u306e\u81a0\u82bd\u816b<\/span><\/h3>\n<ul>\n<li>\u3082\u3068\u3082\u3068\u81a0\u82bd\u816b\u306f\u9ad8\u9f62\u8005\u306b\u591a\u3044\u60aa\u6027\u816b\u760d\u3067\u3059\uff0c\u534a\u6570\u304f\u3089\u3044\u304c65\u6b73\u4ee5\u4e0a\u306b\u767a\u751f\u3057\u307e\u3059<\/li>\n<li>\u9ad8\u9f62\u8005\u81a0\u82bd\u816b\u306e\u4f59\u547d\u306f\u82e5\u3044\u60a3\u8005\u3055\u3093\u3088\u308a\u3055\u3089\u306b\u77ed\u304f\u306a\u308a\u307e\u3059<\/li>\n<li>2012\u5e74Lancet Oncology\u306e\u5831\u544a\u3067\u624b\u8853\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3082<span style=\"color: #000080;\"><strong>\u5e73\u5747\u4f59\u547d\u306f8\u30f6\u6708\u304b\u308910\u30f6\u6708<\/strong><\/span>\u7a0b\u5ea6\u3067\u3059\uff0c2017\u5e74\u306eNew Eng Med\u306e\u5831\u544a\u30677\u30f6\u6708\u304b\u30899\u30f6\u6708\u3067\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c<span style=\"color: #000080;\"><strong>\u9ad8\u9f62\u8005\u306b\u306f\u7121\u7406\u306a\u6cbb\u7642\u3092\u3057\u306a\u3044<\/strong><\/span>\u3068\u3044\u3046\u8003\u3048\u65b9\u3082\u5e83\u304c\u3063\u3066\u3044\u307e\u3059<\/li>\n<li>\u4f8b\u3048\u3070\uff0c<span style=\"color: #000080;\"><strong>75\u6b73\u4ee5\u4e0a\u306e\u81a0\u82bd\u816b\u60a3\u8005\u3055\u3093\u306b\u306f\u958b\u982d\u624b\u8853\u3092\u3057\u306a\u3044<\/strong><\/span>\u3068\u3044\u3046\u9078\u629e\u80a2\u306a\u3069\u3067\u3059<\/li>\n<li>KPS\u304c60\uff05\u4ee5\u4e0b\u306e\u72b6\u614b\u306e\u60aa\u3044\u60a3\u8005\u3055\u3093\u306f\uff0c\u4e88\u5f8c\u304c\u3068\u3066\u3082\u77ed\u3044\u306e\u3067\u624b\u8853\u3092\u542b\u3081\u305f\u7a4d\u6975\u7684\u306a\u6cbb\u7642\u3092\u63a7\u3048\u308b\u306e\u3082\u9078\u629e\u80a2\u3067\u3059<\/li>\n<li>\u305d\u306e\u5834\u5408\u306b\u306f\uff0c<strong><span style=\"color: #000080;\">\u7de9\u548c\u30b1\u30a2<\/span><\/strong>\u3092\u9078\u3093\u3067\u306a\u308b\u3079\u304f\u3064\u3089\u3044\u601d\u3044\u3092\u3057\u306a\u3044\u3088\u3046\u306b\u4ecb\u8b77\u3057\u307e\u3057\u3087\u3046<\/li>\n<li>\u9ad8\u9f62\u8005\u306b\u306f\uff0c<span style=\"color: #000080;\"><strong>25\u30b0\u30ec\u30a4\u3092\uff15\u5206\u5272\u3057\u30661\u9031\u9593<\/strong><\/span>\uff0840\u30b0\u30ec\u30a4\u309215\u5206\u5272\u3057\u3066\uff13\u9031\u9593\uff0c\u3042\u308b\u3044\u306f34\u30b0\u30ec\u30a4\u309210\u5206\u5272\uff12\u9031\u9593\uff09\u3067\u7d42\u3048\u308b\u3068\u3044\u3046<span style=\"color: #ff0000;\"><strong>\u77ed\u671f\u9593\u653e\u5c04\u7dda\u6cbb\u7642<\/strong><\/span> <span style=\"color: #000080;\"><strong>short course radiation therapy<\/strong><\/span> \u304c\u52e7\u3081\u3089\u308c\u307e\u3059<\/li>\n<li>\u3053\u306e\u5834\u5408\u306f\uff0c\u526f\u4f5c\u7528\u3092\u8003\u3048\u3066\u30c6\u30e2\u30c0\u30fc\u30eb\u3082\u7a4d\u6975\u7684\u306b\u306f\u4f7f\u7528\u3057\u307e\u305b\u3093<\/li>\n<li>\u3068\u304f\u306bMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306e\u306a\u3044\u9ad8\u9f62\u8005\u306e\u60a3\u8005\u3055\u3093\u306b\u306f\u30c6\u30e2\u30c0\u30fc\u30eb\u3092\u4f7f\u7528\u3057\u307e\u305b\u3093<\/li>\n<li>\u3067\u3082\u9006\u306b\uff0c\u75c5\u7406\u8a3a\u65ad\u3067<strong><span style=\"color: #000080;\">MGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u304c\u3042\u308b\u60a3\u8005\u3055\u3093\u3067\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3067\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9(\uff15\u65e5\u9593\u6295\u4e0e\uff09\u309212\u30f6\u6708\u6295\u4e0e\u3057\u307e\u3059<\/span><\/strong>\u304c\uff0c\u305d\u308c\u3068\u653e\u5c04\u7dda\u5358\u72ec\u6cbb\u7642\u306e\u6210\u7e3e\u306f\u5909\u308f\u3089\u306a\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u9006\u306e\u3053\u3068\u3082\u8a00\u3048\u307e\u3059\uff0c\u9ad8\u9f62\u8005\u3067\u3082\u5168\u8eab\u72b6\u614b\u304c\u975e\u5e38\u306b\u826f\u304f\u3066\uff0c\u75c7\u72b6\u304c\u3068\u3066\u3082\u8efd\u304f\u3066\uff0c\u816b\u760d\u304c\u6458\u51fa\u3057\u3084\u3059\u3044\u90e8\u4f4d\u306b\u3042\u308a\uff0cMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u304c\u3042\u308b\u3068\u304d\u306b\u306f\uff0c\u82e5\u5e74\u6210\u4eba\u3068\u540c\u69d8\u306b\uff0c\u901a\u5e38\u306e60\u30b0\u30ec\u30a4\u7167\u5c04\u3068\u30c6\u30e2\u30c0\u30fc\u30eb\u6cbb\u7642\u3092\u3057\u305f\u65b9\u304c\u3088\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093\uff08\u304b\u306a\u308a\u9650\u3089\u308c\u305f\u4f8b\u3067\u3059\uff09<\/li>\n<li>\u72b6\u614b\u306e\u3068\u3066\u3082\u826f\u3044\u65b9\u3067\uff0c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u90e8\u5206\u3092\u307b\u307c\u624b\u8853\u6458\u51fa\u3067\u304d\u3066\uff0c\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u304c\u3067\u304d\u3066\u306e\u751f\u5b58\u671f\u9593\u306f\uff0c12\u30f6\u6708\u307b\u3069\u3067\u3059 (JAMA Oncol 2020)\uff0c\u304b\u306a\u308a\u9811\u5f35\u308c\u308b\u9ad8\u9f62\u8005\u30671\u5e74\u306e\u4f59\u547d\u3068\u3044\u3046\u3053\u3068\u3067\u3057\u3087\u3046<\/li>\n<\/ul>\n<h4>\u4e88\u5f8c<\/h4>\n<ul>\n<li>2020\u5e74\u6642\u70b9\u306e\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f\uff0c<span style=\"color: #000080;\"><strong>IDH\u91ce\u751f\u578b\u306e\u666e\u901a\u306e\u81a0\u82bd\u816b\u30671.2\u5e74<\/strong><\/span>\uff0c\u5c11\u6570\u306eIDH\u5909\u7570\u578b\u3067\u306f3.6\u5e74\u304f\u3089\u3044\u3067\u3059\u3002<\/li>\n<li>\u5168\u90e8\u306e\u81a0\u82bd\u816b\u3092\u5408\u308f\u305b\u308b\u3068\u3082\u3063\u3068\u751f\u5b58\u671f\u9593\u306f\u77ed\u3044\u3067\u3059\uff0c\u306a\u305c\u306a\u3089\u8ad6\u6587\u3067\u5831\u544a\u3055\u308c\u308b\u306e\u306f\u81e8\u5e8a\u8a66\u9a13\u306e\u7d50\u679c\u3060\u304b\u3089\u3067\u3059<\/li>\n<li>\u7b2c\uff13\u76f8\u81e8\u5e8a\u8a66\u9a13\u306b\u3055\u3048\u5165\u308c\u306a\u3044\u72b6\u614b\u306e\u60aa\u3044\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093\u306f5\u5272\u304f\u3089\u3044\u3044\u307e\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u8a3a\u65ad\u6642\u306b\u7de9\u548c\u30b1\u30a2\u3092\u9078\u3076\u3079\u304d\u60a3\u8005\u3055\u3093\u306f\u3068\u3066\u3082\u591a\u3044\u3067\u3059<\/li>\n<\/ul>\n<h3><span style=\"color: #000080;\">\u5c0f\u3055\u306a\u7591\u554f\u3044\u308d\u3044\u308d<\/span><\/h3>\n<h4><span style=\"color: #000080;\">\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306f\u3044\u3064\u307e\u3067\u7d9a\u3051\u308b\u306e\u304b<\/span><\/h4>\n<ul>\n<li><span style=\"color: #000080;\"><strong>\u7d50\u8ad6\u306f\uff0c2021\u5e74\u6642\u70b9\u3067\u4e0d\u660e\u3067\u3059<\/strong><\/span><\/li>\n<li>\u4e16\u754c\u6a19\u6e96\u6cbb\u7642\u3067\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306b6\u30b3\u30fc\u30b9\uff08\u7d046\u30f6\u6708\uff09\u3068\u306a\u3063\u3066\u3044\u307e\u3059<\/li>\n<li>7\u30b3\u30fc\u30b9\u4ee5\u4e0a\u7d99\u7d9a\u3067\u304d\u3066\u3082\u751f\u547d\u4e88\u5f8c\u306f\u6539\u5584\u3057\u306a\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0cMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306e\u3042\u308b\u81a0\u82bd\u816b\u3067\u306f\uff0c12\u30b3\u30fc\u30b9\u307e\u3067\u7d9a\u3051\u308b\u3079\u304d\u3060\u3068\u306e\u610f\u898b\u306f\u5f37\u3044\u3067\u3059<\/li>\n<li>\u3067\u3082\uff0c\u65e5\u672c\u3067\u306f\u73fe\u5b9f\u7684\u306b\uff0c\u53ef\u80fd\u3067\u3042\u308c\u307024\u30b3\u30fc\u30b9\u307e\u3067\u7d99\u7d9a\u3055\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3057\u3087\u3046<\/li>\n<li>\u306a\u305c\u306a\u3089\uff0c\u4fdd\u967a\u8a3a\u7642\u3067\u3082\u5236\u9650\u3055\u308c\u3066\u3044\u307e\u305b\u3093\u3057\uff0c\u6b62\u3081\u308b\u3068\u6025\u306a\u816b\u760d\u518d\u71c3\u304c\u751f\u3058\u308b\u3053\u3068\u304c\u307e\u307e\u3042\u308b\u304b\u3089\u3067\u3059<\/li>\n<\/ul>\n<h4><span style=\"color: #000080;\">\u307e\u308c\u306aIDH\u5909\u7570\u306e\u3042\u308b\u81a0\u82bd\u816b\u306e\u6cbb\u7642\u306f\u3069\u3046\u3059\u308b<\/span><\/h4>\n<ul>\n<li>\u307b\u3068\u3093\u3069\u306e\u81a0\u82bd\u816b\u306f\u91ce\u751f\u578b\u3067\uff0cIDH1\u3068IDH2\u907a\u4f1d\u5b50\u306b\u5909\u7570\u304c\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u3057\u304b\u3057\u7d44\u7e54\u50cf\u3067\u81a0\u82bd\u816b\u306b\u898b\u3048\u3066\u3082\uff0c10%\u5f31\u306b\u5909\u7570 mutation \u304c\u3042\u308b\u3068\u3055\u308c\u307e\u3059<\/li>\n<li>\u5909\u7570\u578b\u306f\u30b0\u30ec\u30fc\u30c92\u3042\u308b\u3044\u306f\u30b0\u30ec\u30fc\u30c93\u306eastrocytic tumor\u304b\u3089\u60aa\u6027\u5ea6\u304c\u5897\u3059\u3053\u3068\u304c\u591a\u3044\u306e\u3067\uff0csecondary glioblastoma\u3068\u3082\u3044\u308f\u308c\u307e\u3059\u304c\uff0castrocytoma WHO grade 4\u3068\u3044\u3046\u306e\u304c\u6b63\u78ba\u3067\u3059<\/li>\n<li>\u91ce\u751f\u578b\u3088\u308a\u306f\u3084\u3084\u9577\u3044\u81e8\u5e8a\u7d4c\u904e\u3092\u305f\u3069\u308a\uff0c\u9577\u671f\u751f\u5b58\u3067\u304d\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>IDH\u5909\u7570\u578b\u306f\uff0cIDH-mutant\u306eastrocytoma grade 3 \u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c9\uff13\u3068\u540c\u3058\u65b9\u91dd\u3067\u6cbb\u7642\u3055\u308c\u308b\u3088\u3046\u306b\u306a\u3063\u3066\u304d\u3066\u3044\u307e\u3059<\/li>\n<li>2021\u5e74\u306e\u6642\u70b9\u3067\uff0cIDH-mutant glioblastoma\u306f\uff0cIDH-mutant astrocytoma grade 4\u3068\u547c\u79f0\u3055\u308c\u307e\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0cIDH\u306e\u907a\u4f1d\u5b50\u691c\u67fb\u7d50\u679c\u304c100%\u6b63\u3057\u3044\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u304b\u3064\u3066IDH-mutant \u81a0\u82bd\u816b\u306f\uff0c\u5358\u306b\u81a0\u82bd\u816b\u3068\u3057\u3066\u6cbb\u7642\u3055\u308c\u3066\u304d\u307e\u3057\u305f\u304c\uff0c10\u5e74\u751f\u5b58\u304c\u307b\u307c0%\u3067\u3042\u3063\u305f\u3053\u3068\u3092\u8003\u3048\u308c\u3070\uff0c\u4eca\u307e\u3067\u3069\u304a\u308a\u81a0\u82bd\u816b\u3068\u3057\u3066\u6cbb\u7642\u3092\u7d9a\u3051\u308b\u3079\u304d\u3067\u3042\u308b\u3068\u3044\u3046\u610f\u898b\u3082\u5f37\u3044\u3067\u3059<\/li>\n<\/ul>\n<h4>\u751f\u5b58\u671f\u9593\u304c\u9577\u3044\u81a0\u82bd\u816b\u60a3\u8005\u3055\u3093\u306e\u6761\u4ef6<\/h4>\n<p><span style=\"color: #ff0000;\"><strong>\u4e88\u5f8c\u56e0\u5b50<\/strong><\/span>\u3068\u8a00\u3044\u307e\u3059\u3002 2011\u5e74\u306eInt J Radiat Oncol Biol Phys\u8ad6\u6587\u3067\u306f\uff0c\u5e74\u9f62\uff0c\u8853\u524d\u306e\u5168\u8eab\u72b6\u614b PS\uff0c\u624b\u8853\u6458\u51fa\u5ea6\uff0c\u795e\u7d4c\u75c7\u72b6\uff08\u6a5f\u80fd\uff09\u306e\uff14\u3064\u3067\u3059\u3002\u8981\u3059\u308b\u306b\uff0c\u82e5\u304f\u3066\u5143\u6c17\u3067\uff0c\u75c7\u72b6\u3082\u8efd\u304f\u3066\u816b\u760d\u304c\u767a\u898b\u3055\u308c\u3066\uff0c\u624b\u8853\u3067\u304b\u306a\u308a\u306e\u816b\u760d\u304c\u6458\u51fa\u3067\u304d\u308c\u3070\u4e88\u5f8c\u304c\u826f\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u9006\u306b\uff0c\u9ad8\u9f62\u3067\u5168\u8eab\u72b6\u614b\u304c\u60aa\u304f\u3066\u75c7\u72b6\u3082\u91cd\u304f\u3066\uff0c\u624b\u8853\u3067\u307b\u3068\u3093\u3069\u6458\u51fa\u3067\u304d\u306a\u3044\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093\u306e\u4f59\u547d\u306f\u304b\u306a\u308a\u77ed\u3044\uff08RPA class V\u3067\uff17\u30f6\u6708\uff09\u3068\u8a00\u3048\u307e\u3059\u3002\u5f53\u305f\u308a\u524d\u3068\u8a00\u3048\u3070\u5f53\u305f\u308a\u524d\u306e\u3088\u3046\u306a^-^;\u3000\u4e0b\u306e\u307b\u3046\u306b\u66f8\u3044\u3066\u3042\u308b\uff0c\u816b\u760d\u306eIDH\u3068MDMT\u907a\u4f1d\u5b50\u306b\u3088\u3063\u3066\u3082\u751f\u547d\u4e88\u5f8c\u304c\u5909\u308f\u308a\u307e\u3059\u3002<\/p>\n<h4>10\u5e74\u4ee5\u4e0a\u751f\u5b58\u3059\u308b\u60a3\u8005\u3055\u3093\u306f\u3044\u306a\u3044\u306e\u304b\uff1f<\/h4>\n<p><strong><span style=\"color: #000080;\">\u7b54\u3048\u306f\uff0c\u300c\u3044\u307e\u3059\u300d<\/span><\/strong>\u3002\u8d85\u9577\u671f\u751f\u5b58\u5831\u544a\u306e\u6761\u4ef6\u3067\u3082\u3063\u3068\u3082\u91cd\u8981\u306a\u306e\u306f\u816b\u760d\u306e\u90e8\u4f4d\u3067\uff0c\u53f3\u524d\u982d\u8449\u3084\u5074\u982d\u8449\u306e\u5148\u7aef\u90e8\u3068\u304b\uff0c\u816b\u760d\u3092\u5468\u308a\u306e\u6b63\u5e38\u8133\u3092\u542b\u3081\u3066\u304b\u306a\u308a\u5e83\u7bc4\u56f2\u306b\u624b\u8853\u6458\u51fa\u3067\u304d\u308b\u3082\u306e\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u30022013\u5e74\u306b\u6771\u4eac\u306e\u56fd\u7acb\u304c\u3093\u30bb\u30f3\u30bf\u30fc\u75c5\u9662\u304b\u3089\uff0c24\u6b73\u3067\u767a\u75c7\u3057\u306621\u5e74\u9593\u751f\u5b58\u3057\u3066\u3044\u308b\u81a0\u82bd\u816b\u60a3\u8005\u3055\u3093\u306e\u5831\u544a\u304c\u3042\u308a\uff0c\u6700\u9577\u751f\u5b58\u4f8b\u306e\u4e00\u4eba\u3068\u306e\u3053\u3068\u3067\u3059\u3002Fukushima S, et al.: A case of more than 20 years survival with glioblastoma&#8212;-. Neuropathology 2013<\/p>\n<h3><span style=\"color: #000080;\">\u518d\u767a\uff08\u518d\u71c3\uff09\u3092\u8003\u3048\u308b \uff1b\u7de9\u548c\u30b1\u30a2\u3082\u9078\u629e\u80a2\u3067\u3059<\/span><\/h3>\n<div>\n<ul>\n<li>2015\u5e74\u306e\u7b2c3\u76f8\u8a66\u9a13\u306e\u5831\u544a\u3067\u3082\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593 PFS \u306f4-7\u30f6\u6708\u307b\u3069\u3067\u3059\u304b\u3089\uff0c<span style=\"color: #000080;\"><strong>\u534a\u6570\u4ee5\u4e0a\u306e\u60a3\u8005\u3055\u3093\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u7d42\u4e86\u3057\u30661\u5e74\u4ee5\u5185\u3067\u518d\u71c3<\/strong><\/span>\u3057\u307e\u3059<\/li>\n<li>\u81a0\u82bd\u816b\u306e10\u5e74\u751f\u5b58\u5272\u5408\u306f0%\u306b\u8fd1\u3044\u3067\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u521d\u671f\u6cbb\u7642\u304c\u6210\u529f\u3057\u3066\u3082\u3044\u3064\u304b\u518d\u767a\u3059\u308b\u3068\u8003\u3048\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u518d\u767a\u3059\u308b\u3068\u5e73\u5747\u7684\u306a\u4f59\u547d\uff08\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\uff09\u306f1\u5e74\u4ee5\u5185\u3067\u3059<\/li>\n<li>\u518d\u767a\u306b\u5bfe\u3059\u308b\u6cbb\u7642\u6cd5\u306f\u78ba\u7acb\u3055\u308c\u3066\u3044\u307e\u305b\u3093<\/li>\n<li>\u533b\u5e2b\u304b\u3089\u306f\uff0c\u958b\u982d\u624b\u8853\uff0c\u3055\u307e\u3056\u307e\u306a\u7a2e\u985e\u306e\u6297\u304c\u3093\u5264\uff08\u5316\u5b66\u7642\u6cd5\uff09\uff0c\u30ed\u30e0\u30b9\u30c1\u30f3 CCNU\uff0c\u30cb\u30c9\u30e9\u30f3\uff0c\u30a2\u30d0\u30b9\u30c1\u30f3\uff0c\u30a4\u30f3\u30bf\u30fc\u30d5\u30a7\u30ed\u30f3\uff0c\u30b5\u30a4\u30d0\u30fc\u30ca\u30a4\u30d5\uff0c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u306a\u3069\u306e\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\uff0c\u30a6\u30a3\u30eb\u30b9\u7642\u6cd5\uff0c\u514d\u75ab\u6cbb\u7642\uff08\u30ef\u30af\u30c1\u30f3\u7642\u6cd5\uff09\u306a\u3069\u306a\u3069\u304c\u52e7\u3081\u3089\u308c\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093<\/li>\n<li>\u3082\u3046\u4e00\u5ea6\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\uff08\u518d\u7167\u5c04\uff09\u3053\u3068\u304c\u3067\u304d\u308b\u518d\u767a\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u518d\u624b\u8853\u3092\u884c\u3046\u3053\u3068\u306f\u3042\u307e\u308a\u306a\u3044\u3068\u8003\u3048\u3066\u304f\u3060\u3055\u3044<\/li>\n<li>\u79d1\u5b66\u7684\u6839\u62e0\u306f\u5225\u3068\u3057\u3066\uff0c\u5b9f\u969b\u306e\u81e8\u5e8a\u306e\u5834\u3067\u306f\uff0c<span style=\"color: #000080;\"><strong>\u518d\u767a\u816b\u760d\u304cMRI\u3067\u307f\u3066\u5883\u754c\u304c\u660e\u77ad\u3067\uff0c\u6458\u51fa\u3059\u308c\u3070\u75c7\u72b6\u306e\u5bdb\u89e3\u304c\u5f97\u3089\u308c\u308b\u3053\u3068\u304c\u671f\u5f85\u3067\u304d\u308b\u30b1\u30fc\u30b9\u3067\u306f\uff0c\u300c\u307e\u308c\u306b\u300d\u624b\u8853\u6458\u51fa\u304c\u884c\u308f\u308c\u307e\u3059<\/strong><\/span><\/li>\n<li>\u7c73\u56fd\u3067\u306f\uff0c\u591a\u304f\u306e\u60a3\u8005\u3055\u3093\u304c\u65b0\u305f\u306a\u85ac\u5264\u306e\u81e8\u5e8a\u8a66\u9a13 clinical trial \u306b\u53c2\u52a0\u3057\u307e\u3059\u304c\uff0c\u65e5\u672c\u3067\u306f\u96e3\u3057\u3044\u3067\u3059<\/li>\n<li>\u6cbb\u9a13\u3068\u3044\u3046\u306e\u306f\u65b0\u3057\u3044\u85ac\u5264\uff08\u5316\u5b66\u7642\u6cd5\uff09\u306a\u3069\u304c\uff0c\u81a0\u82bd\u816b\u306e\u518d\u767a\u306b\u6709\u52b9\u304b\u3069\u3046\u304b\u308f\u304b\u3089\u306a\u3044\u306e\u3067\u60a3\u8005\u3055\u3093\u3067\u8a66\u9a13\u3092\u3059\u308b\u3068\u3044\u3046\u610f\u5473\u3067\u3059<\/li>\n<li>\u300c\u65b0\u3057\u3044\u300d\u3068\u3044\u3046\u3053\u3068\u3068\u300c\u6709\u52b9\u300d\u3060\u3068\u3044\u3046\u3053\u3068\u306f\u7570\u306a\u308b\u306e\u3067\u6c17\u3092\u3064\u3051\u3066\u304f\u3060\u3055\u3044<\/li>\n<li>\u4f8b\u3048\u3070\u6700\u8fd1\u304b\u306a\u308a\u671f\u5f85\u3055\u308c\u305f\u30aa\u30d7\u30b8\u30fc\u30dc\u306f\uff0c2017\u5e74\u306b\u518d\u767a\u81a0\u82bd\u816b\u306b\u306f\u6709\u52b9\u6027\u304c\u306a\u3044\u3053\u3068\u304c\u7b2c3\u76f8\u8a66\u9a13\u3067\u308f\u304b\u308a\u307e\u3057\u305f<\/li>\n<li>\u307e\u305a\uff0c\u3053\u308c\u4ee5\u4e0a\u3055\u3089\u306b\u8ffd\u52a0\u6cbb\u7642\u3059\u308b\u304b\u3069\u3046\u304b\uff0c\u305d\u308c\u3068\u3082<span style=\"color: #000080;\"><strong>\u7de9\u548c\u30b1\u30a2\u3092\u9078\u3076\u306e\u304b<\/strong><\/span>\u3092\u8003\u3048\u307e\u3057\u3087\u3046<\/li>\n<li><span style=\"color: #333333;\">\u81a0\u82bd\u816b\u306f\u9ad8\u9f62\u8005\u306b\u591a\u304f\uff0c\u521d\u671f\u6cbb\u7642\u3067\u306f\u624b\u8853\u306860\u30b0\u30ec\u30a4\u306e\u653e\u5c04\u7dda\u6cbb\u7642\uff0c\u3055\u3089\u306b\u518d\u767a\u816b\u760d\u306b\u3088\u3063\u3066\uff0c\u8a8d\u77e5\u75c7\uff08\u9ad8\u6b21\u8133\u6a5f\u80fd\u969c\u5bb3\uff09\u306b\u306a\u3063\u3066\u3044\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u304b\u3089\uff0c\u3069\u3046\u3057\u305f\u3089\u3088\u3044\u304b\u672c\u4eba\u306b\u306f\u5224\u65ad\u3067\u304d\u306a\u3044\u3053\u3068\u3082\u591a\u3044\u3067\u3059<\/span><\/li>\n<li><strong><span style=\"color: #000080;\">\u30a2\u30d0\u30b9\u30c1\u30f3\u3092\u4f7f\u7528\u3059\u308b\u3068\u4e00\u6642\u7684\u306a\u75c7\u72b6\u306e\u5bdb\u89e3\u3092\u5f97\u3089\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/span><\/strong>\uff0c\u3067\u3082\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u306f\u306a\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>MGMT\u306e\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u304c\u3042\u308b\u4f8b\u3067\u306f\u30c6\u30e2\u30c0\u30fc\u30eb\u306e\u518d\u6295\u4e0e rechallenge<\/strong><\/span>\u3092\u3057\u307e\u3059<\/li>\n<li>\u4ed6\u306e\u5316\u5b66\u7642\u6cd5\u3068\u3057\u3066\u306f<span style=\"color: #000080;\"><strong>\u30cb\u30c8\u30ed\u30bd\u30a6\u30ec\u30a2<\/strong><\/span>\u304c\u7528\u3044\u3089\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\uff0c\u30cb\u30c9\u30e9\u30f3\uff0c\u30ed\u30e0\u30b9\u30c1\u30f3\u306a\u3069\u3067\u3059<\/li>\n<li>\u3067\u3082\u3053\u308c\u3089\u306e\u8ffd\u52a0\u6cbb\u7642\u306e\u6210\u529f\u7387\u306f\u4f4e\u3044\u3067\u3059\uff0c\u30ed\u30e0\u30b9\u30c1\u30f3\u306e6\u30f6\u6708PFS\u306715-25%\u304f\u3089\u3044\u3067\u3059<\/li>\n<li>\u884c\u3046\u3068\u3057\u3066\u3082\u8eab\u4f53\u3084\u751f\u6d3b\uff0c\u5927\u304d\u306a\u91d1\u92ad\u7684\u306a\u8ca0\u62c5\u306b\u306a\u3089\u306a\u3044\u3088\u3046\u306b\u3057\u307e\u3059<\/li>\n<\/ul>\n<h4>\u518d\u767a\u3057\u305f\u3089\u307e\u305f\u624b\u8853\u3059\u308b\u3053\u3068\u306b\u3088\u3063\u3066\u751f\u547d\u4e88\u5f8c\u304c\u306e\u3073\u308b\u304b\uff1f<\/h4>\n<ul>\n<li>2017\u5e74\u6642\u70b9\u3067\u3082\u3055\u307e\u3056\u307e\u306a\u610f\u898b\u304c\u3042\u308a\u307e\u3059\u304c\u6a19\u6e96\u7684\u306a\u6307\u91dd\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u306f\u3063\u304d\u308a\u3057\u305f\u5229\u70b9\u304c<span style=\"color: #333333;\">\u898b\u3048\u306a\u3044\u3068\u304d\u306f<span style=\"color: #000080;\"><strong>\u539f\u5247\u7684\u306b\u306f\u518d\u624b\u8853\u306f\u3057\u307e\u305b\u3093<\/strong><\/span><\/span><\/li>\n<li>\u6b27\u7c73\u3067\u306f\uff0c\u624b\u8853\u306f\u518d\u767a\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093\u306e20-30%\u3067\u884c\u308f\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u65e5\u672c\u3067\u306f\u518d\u767a\u81a0\u82bd\u816b\u306b\u5bfe\u3059\u308b\u624b\u8853\u306e\u983b\u5ea6\u304c\u9ad8\u3059\u304e\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093<\/li>\n<li>\u300c\u75c7\u72b6\u3092\u60aa\u5316\u3055\u305b\u306a\u3044\u300d\u3068\u3044\u3046\u6761\u4ef6\u4e0b\u3067\u5927\u90e8\u5206\u306e\u5bb9\u7a4d\u306e\u816b\u760d\u6458\u51fa\u304c\u3067\u304d\u3066\uff0c\u6570\u30ab\u6708\u4ee5\u4e0a\u306e\u6709\u610f\u306a\u751f\u6d3b\u304c\u671f\u5f85\u3067\u304d\u308b\u3068\u304d\u306b\u8003\u616e\u3057\u307e\u3059<\/li>\n<li>\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u816b\u760d\u75c5\u5909\u304c\u5168\u6458\u51fa\u3067\u304d\u308b\u3068\u5224\u65ad\u3055\u308c\u308b\u6642\u306b\u306e\u307f\u884c\u3044\u307e\u3059<\/li>\n<\/ul>\n<div>\n<p>Suchorska B, et al.: Complete resection of contrast-enhancing tumor volume is associated with improved survival in recurrent glioblastoma-results from the DIRECTOR trial. Neuro Oncol 2016<br \/>\n\u81a0\u82bd\u816b\u306e\u521d\u56de\u518d\u767a\u3067\u624b\u8853\u304c\u884c\u308f\u308c\u305f71\u4f8b\u306e\u89e3\u6790\u3067\u3059\u3002\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u75c5\u5909\u304c\u5b8c\u5168\u6458\u51fa\u3055\u308c\u305f\u60a3\u8005\u3055\u3093(N = 40) \u3068\u3067\u304d\u306a\u304b\u3063\u305f\u60a3\u8005\u3055\u3093 (N = 19) \u3067\u306f\uff0c\u518d\u767a\u5f8c\u306e\u751f\u5b58\u671f\u9593PRS (post-recurrence survival\u304c\uff0c\u305d\u308c\u305e\u308c12.9\u30f6\u6708\u30686.5\u30f6\u6708\u3067\u6709\u610f\u5dee\u304c\u3042\u308a\uff0c\u751f\u5b58\u306e\u8cea\u3082\u826f\u304b\u3063\u305f\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u9006\u306b\uff0c<span style=\"color: #333333;\">\u4e0d\u5b8c\u5168\u6458\u51fa\u3067\u7d42\u308f\u3063\u305f\u60a3\u8005\u3055\u3093\u306ePRS\u304c\u624b\u8853\u3092\u53d7\u3051\u306a\u304b\u3063\u305f\u60a3\u8005\u3055\u3093\u3088\u308a\u77ed\u304b\u3063\u305f<\/span>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n<h4>\u518d\u767a\u3057\u305f\u3089\u307e\u305f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u306e\u304b<\/h4>\n<ul>\n<li>\u539f\u5247\u3068\u3057\u3066\u518d\u7167\u5c04\u306f\u884c\u3044\u307e\u305b\u3093\u304c\uff0c\u3067\u304d\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u7406\u7531\u306f\uff0c\u52b9\u679c\u304c\u5f97\u3089\u308c\u306a\u3044\u3053\u3068\u304c\u307b\u3068\u3093\u3069\u3060\u304b\u3089\u3067\u3059<\/li>\n<li>\u300c\u7a00\u306b\u300d\u5c0f\u3055\u306a\u30bf\u30fc\u30b2\u30c3\u30c8\u3092\u5236\u5fa1\u3059\u308b\u3053\u3068\u3067\u4e88\u5f8c\u304c\u671f\u5f85\u3067\u304d\u308b\u3068\u304d\u306b\u306f\uff0c\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642 SRS (single dose 15-20Gy)\u00a0\u3092\u9078\u629e\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u5c11\u5206\u5272\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u306f30-36Gy (5-6Gy\/day)\u304c\u7528\u3044\u3089\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u3044\u305a\u308c\u3082\uff0c\u518d\u7167\u5c04\u3057\u305f\u90e8\u4f4d\u306b\u306f\u9ad8\u7387\u306b\u8133\u58ca\u6b7b\u304c\u751f\u3058\u307e\u3059<\/li>\n<\/ul>\n<h4 align=\"left\">\u518d\u767a\u3057\u305f\u6642\u306b\u65b0\u85ac\u3092\u8a66\u3059\u3053\u3068\u304c\u3067\u304d\u308b\u304b\uff1f<\/h4>\n<p>\u81a0\u82bd\u816b\u306b\u5bfe\u3059\u308b\u81e8\u5e8a\u8a66\u9a13\uff08\u6cbb\u9a13\uff09\u3068\u3044\u3046\u306e\u304c\u4e16\u754c\u4e2d\u3067\u5e38\u306b\u884c\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u85ac\u5264\u306e\u6bd2\u6027\u3092\u8abf\u3079\u308b\u69d8\u306a\u7b2c1\u76f8\u8a66\u9a13\u304b\u3089\uff0c\u52b9\u679c\u306e\u78ba\u5b9f\u6027\u3092\u78ba\u304b\u3081\u308b\u7b2c3\u76f8\u8a66\u9a13\u307e\u3067\u3042\u308a\u307e\u3059\u3002<br \/>\n<strong><a href=\"http:\/\/blog.braintumor.org\/potential-glioblastoma-treatments-entering-the-pivotal-phase-of-evaluation\/\">National Brain Tumor Siciety<br \/>\n<\/a><a href=\"https:\/\/www.cancer.gov\/about-cancer\/treatment\/clinical-trials\/search\/results?protocolsearchid=6205688\">National Cancer Institute<br \/>\n<\/a><\/strong>\u3068\u3044\u3046\u3088\u3046\u306a\u60a3\u8005\u3055\u3093\u5411\u3051\u306e\u81e8\u5e8a\u8a66\u9a13\u60c5\u5831\u3092\u63d0\u4f9b\u3057\u3066\u3044\u308b\u30da\u30fc\u30b8\u3092\u898b\u308b\u3068\uff0c\u5e38\u306b\u6700\u65b0\u306e\u6cbb\u7642\u6cd5\u958b\u767a\u306e\u6cbb\u9a13\u60c5\u5831\u304c\u8f09\u3063\u3066\u3044\u307e\u3059\u3002<br \/>\n\u6b8b\u5ff5\u306a\u304c\u3089\u65e5\u672c\u8a9e\u3067\u306e\u60c5\u5831\u63d0\u4f9b\u306f\u3042\u308a\u307e\u305b\u3093\u3057\uff0c\u65e5\u672c\u72ec\u81ea\u306e\u3082\u306e\u306f\u306a\u304f\u3066\u6b27\u7c73\u304c\u4e2d\u5fc3\u3067\u3059\u3002<br \/>\n\u3053\u306e50\u5e74\u9593\u3067\u6570\u767e\u3092\u8d85\u3048\u308b\u6cbb\u7642\u6cd5\u304c\u63d0\u6848\u3055\u308c\u307e\u3057\u305f\u304c\uff0c\u5b9f\u969b\u306b\u60a3\u8005\u3055\u3093\u306e\u751f\u5b58\u671f\u9593\u304c\u5ef6\u9577\u3067\u304d\u308b\u3068\u8a3c\u660e\u3055\u308c\u305f\u85ac\u5264\u306f\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3060\u3051\u3067\u3057\u305f\u3002\u3067\u3059\u304b\u3089\uff0c\u3042\u307e\u308a\u304a\u91d1\u3092\u304b\u3051\u305f\u308a\u9060\u65b9\u3078\u884c\u3063\u3066\u5927\u5207\u306a\u6642\u9593\u3092\u4f7f\u3063\u3066\u3057\u307e\u3046\u3053\u3068\u306f\u304a\u52e7\u3081\u3067\u304d\u307e\u305b\u3093\u3002<\/p>\n<p align=\"left\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-8945 size-thumbnail\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/smalllake-200x200.jpg\" alt=\"smalllake\" width=\"200\" height=\"200\" \/><\/p>\n<\/div>\n<\/div>\n<h5>\u3053\u308c\u304b\u3089\u4e0b\u306f\u304b\u306a\u308a\u5c02\u9580\u5bb6\u306e\u305f\u3081\u306e\u77e5\u8b58\u3067\u3059<\/h5>\n<p>&nbsp;<\/p>\n<h4>\u00a0WHO 2016\u5e74\u3000\u81a0\u82bd\u816b\u306e\u5206\u985e\u3000\u3059\u3079\u3066\u30b0\u30ec\u30fc\u30c9\uff14\u3067\u3059<\/h4>\n<h5 align=\"left\"><span style=\"color: #000080;\"><strong>Glioblastoma, IDH wild-type\u3000IDH\u5909\u7570\u306e\u306a\u3044\u81a0\u82bd\u816b<\/strong><\/span><\/h5>\n<h5 align=\"left\">\u00a0 \u00a0Giant cell glioblastoma\u3000\u5de8\u7d30\u80de\u6027\u81a0\u82bd\u816b<\/h5>\n<h5 align=\"left\">\u3000Gliosarcoma\u3000\u81a0\u8089\u816b<\/h5>\n<h5 align=\"left\">\u3000<a href=\"\/sawamura\/blog\/glioma\/epitheloid-glioblastoma\/\">Epithelioid glioblastoma\u3000\u985e\u4e0a\u76ae\u81a0\u82bd\u816b<\/a><\/h5>\n<h5><strong><span style=\"color: #000080;\">Glioblastoma, IDH mutant\u00a0 IDH\u5909\u7570\u306e\u3042\u308b\u81a0\u82bd\u816b\uff08\u661f\u7d30\u80de\u816b\uff09<\/span><\/strong><\/h5>\n<h5>Glioblastoma \uff08\u907a\u4f1d\u5b50\u8a3a\u65ad\u304c\u3055\u308c\u3066\u306a\u3044\u7d44\u7e54\u8a3a\u65ad\u3060\u3051\u306e\u3082\u306e\uff09<\/h5>\n<p>\u3053\u308c\u3089\u306e\u7570\u578b\u3067\u6cbb\u7642\u65b9\u6cd5\u306f\u304a\u306a\u3058\u3067\u3059\u304c\uff0c<strong><span style=\"color: #ff0000;\">IDH\u5909\u7570\u306e\u3042\u308b\u81a0\u82bd\u816b\u306e\u307f\u306f\uff0c\u30b0\u30ec\u30fc\u30c93\uff08\u9000\u5f62\u6210\u6027\u661f\u7d30\u80de\u816b\uff09\u3068\u3057\u3066\u6cbb\u7642<\/span><\/strong><span style=\"color: #333333;\">\u3059\u308b\u65b9\u5411\u306b\u3042\u308a\u307e\u3059<\/span>\u3002\u307e\u305f2021\u5e74\u306b\u304a\u3044\u3066\u306f\uff0cIDH-mutant astrocytoma grade 4\u3068\u547c\u79f0\u3055\u308c\u307e\u3059\u3002<\/p>\n<hr \/>\n<h1><a href=\"\/sawamura\/blog\/pathocase\/%e8%86%a0%e8%8a%bd%e8%85%ab%e3%81%ae%e7%97%85%e7%90%86-pathology-of-glioblastoma\/\">\u81a0\u82bd\u816b\u306e\u75c5\u7406\uff08\u5225\u30da\u30fc\u30b8\u306b\u3042\u308b\u306e\u3067\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/h1>\n<hr \/>\n<h4>\u6cbb\u7642\u5f8c\u306e\u8a55\u4fa1\u3068\u518d\u767a<\/h4>\n<ul>\n<li>\u6cbb\u7642\u62b5\u6297\u6027\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3082\u52b9\u304b\u305a\u306b\u9032\u884c\u60aa\u5316\u3057\u3066\u3057\u307e\u3046\u4f8b\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u591a\u304f\u306e\u60a3\u8005\u3055\u3093\u3067\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u4e00\u6642\u7684\u306a\u5bdb\u89e3\u671f\u304c\u5f97\u3089\u308c\u307e\u3059<\/li>\n<li>\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u304c\u6a19\u6e96\u6cbb\u7642\u3068\u306a\u3063\u3066\u304b\u3089\uff0c\u6cbb\u7642\u5f8c12\u9031\u4ee5\u5185\u306b\u751f\u3058\u308b<span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"\/sawamura\/blog\/glioma\/pseudoprogression\/\">\u30b9\u30fc\u30c9\u30fb\u30d7\u30ed\u30b0\u30ec\u30c3\u30b7\u30e7\u30f3<\/a><\/strong><\/span>\u304c\u554f\u984c\u3068\u306a\u308a\u307e\u3057\u305f<\/li>\n<li>\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u75c5\u5909\u304c\u5897\u5927\u3057\u3066\u8133\u6d6e\u816b\u3082\u4e00\u898b\u60aa\u5316\u3059\u308b\u306e\u3067\u3059\u304c\u307e\u305f\u5bdb\u89e3\u3057\u307e\u3059<\/li>\n<li>2016\u5e74\u6642\u70b9\u3067\uff0c\u30b9\u30fc\u30c9\u30fb\u30d7\u30ed\u30b0\u30ec\u30c3\u30b7\u30e7\u30f3\u3068\u518d\u767a\uff08\u518d\u71c3\uff09\u3092\u6b63\u78ba\u306b\u898b\u5206\u3051\u308b\u691c\u67fb\u6cd5\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u73fe\u5b9f\u7684\u306b\u306f\u983b\u56de\u306bMRI\u691c\u67fb\u3092\u3057\u3066\u518d\u71c3\u304b\u3069\u3046\u304b\u3092\u898b\u5206\u3051\u307e\u3059<\/li>\n<li><a href=\"\/sawamura\/blog\/glioma\/avastine\/\"><strong><span style=\"color: #000080;\">\u30a2\u30d0\u30b9\u30c1\u30f3\u306e\u6295\u4e0e<\/span><\/strong><\/a>\u3067\u816b\u760d\u304c\u4e00\u6642\u7684\u306b\u7e2e\u5c0f\u3059\u308b\u3053\u3068\u3082\u771f\u306e\u8a55\u4fa1\u306b\u306f\u3064\u306a\u304c\u308a\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #333333;\">\u5b66\u8853\u7684\u306a\u6cbb\u7642\u52b9\u679c\u306f<strong><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"\/sawamura\/blog\/glioma\/sum\/\">RANO criteria<\/a><\/span>\u00a0<\/strong><\/span>\u3092\u7528\u3044\u307e\u3059<\/li>\n<li>T1 Gd, MRI T2\/FLAIR, \u65b0\u75c5\u5909\u306e\u6709\u7121\uff0c\u30b9\u30c6\u30ed\u30a4\u30c9\u306e\u91cf\uff0c\u81e8\u5e8a\u75c7\u72b6\u3067\u8a55\u4fa1\u3059\u308b\u3082\u306e\u3067\uff0c\u5358\u7d14\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u81a0\u82bd\u816b\u3067\u306f complete responce CR\u3068\u3044\u3046\u7d50\u679c\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u5b9f\u969b\u306b\u306f\u5c02\u9580\u5bb6\u3067\u3082\u8a55\u4fa1\u306f\u96e3\u3057\u304f\uff0c\u30a2\u30d0\u30b9\u30c1\u30f3\u3092\u6295\u4e0e\u3059\u308b\u3068MRI\u3067\u81a0\u82bd\u816b\u75c5\u5909\u304c\u5c0f\u3055\u304f\u306a\u3063\u3066\u6d6e\u816b\u3082\u5f15\u3044\u3066\u826f\u304f\u306a\u3063\u3066\u3044\u308b\u3068\u3044\u3046\u6240\u898b\u306f\u4e00\u6642\u7684\u52b9\u679c\u3067\u3042\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u3053\u3068\uff0c\u30c6\u30e2\u30c0\u30fc\u30eb\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u30663\u30f6\u6708\u4ee5\u5185\u306b\u8457\u540d\u306a\u75c5\u5909\u62e1\u5927\u304c\u3042\u3063\u3066\u3082\u30b9\u30fc\u30c9\u30fb\u30d7\u30ed\u30b0\u30ec\u30c3\u30b7\u30e7\u30f3\u304b\u3082\u3057\u308c\u306a\u3044\u306e\u3067\u30a2\u30d0\u30b9\u30c1\u30f3\u6295\u4e0e\u3057\u3066\u6211\u6162\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u304c\u5927\u5207\u3067\u3059<\/li>\n<\/ul>\n<h4><strong><span style=\"color: #000080;\">primary\u00a0<\/span><\/strong><strong style=\"background-color: #f4f9ff;\"><span style=\"color: #000080;\">(de novo)\u00a0<\/span><\/strong><strong style=\"background-color: #f4f9ff;\"><span style=\"color: #000080;\">glioblastoma\u3068secondary glioblastoma<\/span><\/strong><\/h4>\n<ul>\n<li>\u81a0\u82bd\u816b\u306b\u306f2\u7a2e\u985e\u3042\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>9\u5272\u304f\u3089\u3044\u306e\u81a0\u82bd\u816b\u306f\uff0c\u4e3b\u3068\u3057\u3066\u9ad8\u9f62\u8005\u306b\u767a\u751f\u3059\u308b<span style=\"color: #ff0000;\">\u30d7\u30e9\u30a4\u30de\u30ea\u30fc\u30bf\u30a4\u30d7 (\u30c7\u30fb\u30ce\u30dc<\/span><\/strong><\/span><span style=\"color: #ff0000;\"><strong>\u30bf\u30a4\u30d7\uff09<\/strong><\/span>\u3067\u3059<\/li>\n<li>de novo\u3068\u306f\uff0c\u3044\u304d\u306a\u308a\u764c\u304c\u767a\u751f\u3059\u308b\u3053\u3068\u3092\u610f\u5473\u3057\u307e\u3059<\/li>\n<li>\u00a0<span style=\"color: #333333;\">\u6b8b\u308a\u306e10%\u304f\u3089\u3044\u306e\u81a0\u82bd\u816b\u306f\uff0c\u4f4e\u60aa\u5236\u5ea6\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\uff08\u30b0\u30ec\u30fc\u30c92\uff09\u304b\u9000\u5f62\u6210\u6027\u7d30\u80de\u816b\uff08\u30b0\u30ec\u30fc\u30c93\uff09\u304b\u3089\u60aa\u6027\u5316\u3057\u3066\u751f\u3058\u308b\u306e\u3067\uff0c\u3053\u308c\u3092<strong><span style=\"color: #ff0000;\">\u30bb\u30ab\u30f3\u30c0\u30ea\u30fc\u30bf\u30a4\u30d7<\/span><\/strong>\u3068\u3044\u3044\u307e\u3059\u3002<\/span><\/li>\n<li><span style=\"color: #333333;\">\u661f\u7d30\u80de\u816b\u306e\u60aa\u6027\u8ee2\u5316 transformation\u3068\u3082\u3044\u3044\u307e\u3059\u304c\uff0c\u5b9f\u969b\u306b\u306f\u591a\u3044\u3082\u306e\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/span><\/li>\n<li><span style=\"color: #000080;\"><strong><span style=\"color: #000080;\">\u30bb\u30ab\u30f3\u30c0\u30ea\u30fc\u30bf\u30a4\u30d7<\/span>\u306e\u5e74\u9f62\u5c64\u306f\u82e5\u3044<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u30bb\u30ab\u30f3\u30c0\u30ea\u30fc\u30bf\u30a4\u30d7\u306f\uff0c\u524d\u982d\u8449\u306b\u591a\u304f\u3066\uff0c\u7d44\u7e54\u50cf\u3067\u58ca\u6b7b\u306e\u91cf\u304c\u5c11\u306a\u3044\uff0c\u30b0\u30ec\u30fc\u30c92\u306e\u661f\u7d30\u80de\u816b\u304c\u6df7\u3058\u3063\u3066\u3044\u308b\u3068\u3044\u3046\u7279\u5fb4\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u30bb\u30ab\u30f3\u30c0\u30ea\u30fc\u30bf\u30a4\u30d7\u3067\u306f<span style=\"color: #ff0000;\"><strong>IDH1\u3068\u3044\u3046\u907a\u4f1d\u5b50\u306e\u5909\u7570<\/strong><\/span>\u304c\u898b\u3089\u308c\u307e\u3059<\/li>\n<li>\u30bb\u30ab\u30f3\u30c0\u30ea\u30fc\u30bf\u30a4\u30d7\u306e\u65b9\u304c\u6cbb\u7642\u304c\u6709\u52b9\u3067\u4e88\u5f8c\u304c\u826f\u3044\u3053\u3068\u304c\u77e5\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u4e88\u5f8c\u304c\u826f\u3044\u3068\u3044\u3063\u3066\u3082\uff0c\u661f\u7d30\u80de\u816b\u306b\u5bfe\u3057\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u3063\u305f\u5f8c\u306b\u751f\u3058\u305f\u30bb\u30ab\u30f3\u30c0\u30ea\u30fc\u30bf\u30a4\u30d7 GBM \u306e\u751f\u547d\u4e88\u5f8c\u306f\u9577\u304f\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<\/ul>\n<div>\n<h5 align=\"left\"><span style=\"color: #000080;\"><strong>IDH wildtype \u30d7\u30e9\u30a4\u30de\u30ea\u30fc<\/strong><\/span><\/h5>\n<p>\u81a0\u82bd\u816b\u306e\u307b\u3068\u3093\u306990%\u304f\u3089\u3044\u306f\u3053\u308c\u3067\u3059\u3002\u5e74\u9f62\u4e2d\u592e\u502462\u6b73\u304f\u3089\u3044\u3067\uff0c\u7a81\u7136\u767a\u751f\u3057\u307e\u3059\u3002\u6570\u30f6\u6708\u524d\u306bMRI\u6b63\u5e38\u3060\u3063\u305f\u306e\u306b\u3068\u3044\u3046\u30bf\u30a4\u30d7\u3067\u3059\u3002\u7537\u6027\u306b\u591a\u304f\u3066\uff0c\u30c6\u30f3\u30c8\u4e0a\u306b\u767a\u751f\u3057\u307e\u3059\u3002\u30ac\u30fc\u30e9\u30f3\u30c9\u5f62\u72b6\uff08Garland shape; \u816b\u760d\u306e\u5468\u56f2\u304c\u7e01\u53d6\u308a\u3055\u308c\u308b\u3088\u3046\u306b\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\uff09\u3092\u793a\u3057\u3066\uff0c\u816b\u760d\u5185\u90e8\u306e\u58ca\u6b7b\u304c\u5927\u304d\u3044\u3067\u3059\u3002\u624b\u8853\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3092\u3057\u3066\u306e\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f15\u30f6\u6708\u3067\u3059\u3002TERT promotor\u5909\u7570\u304c72%\uff0cEGFR\u5897\u5e45\u304c35%\uff0cPTEN\u5909\u7570\u304c24%\u306b\u307f\u3089\u308c\u307e\u3059\u3002<\/p>\n<\/div>\n<h5 align=\"left\">IDH mutant \u30bb\u30ab\u30f3\u30c0\u30ea\u30fc<\/h5>\n<p>10%\u304f\u3089\u3044\u3067\uff0c\u661f\u7d30\u80de\u816b grade II or III \u304c\u60aa\u6027\u5316\u3059\u308b\u3082\u306e\u3067\u3059\u3002\u5e74\u9f62\u4e2d\u592e\u5024\u306f44\u6b73\u3068\u82e5\u3044\u3002\u624b\u8853\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u304c\u3067\u304d\u30661\uff0c\u4e2d\u592e\u5024 31\u30f6\u6708\u304f\u3089\u3044\u306e\u751f\u5b58\u671f\u9593\u3067\u3059\u3002\u753b\u50cf\u3067\u306f\uff0c\u524d\u982d\u8449\u306b\u591a\u304f\u307f\u3089\u308c\u816b\u760d\u5185\u58ca\u6b7b\u306f\u5c11\u306a\u3081\u3002<em>TP 53<\/em>\u5909\u7570\u304c81%\uff0c<em>ATRX<\/em>\u5909\u7570\u304c71%\u3068\u9ad8\u7387\u3067\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastmasy1-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-16821\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastmasy1-1-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastmasy1-1-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastmasy1-1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastmasy1-1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-16820\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastmasy2-291x300.jpg\" alt=\"\" width=\"291\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastmasy2-291x300.jpg 291w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastmasy2-550x567.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastmasy2-768x792.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/glioblastmasy2.jpg 850w\" sizes=\"auto, (max-width: 291px) 100vw, 291px\" \/><\/p>\n<p>40\u6b73\u304f\u3089\u3044\u306e\u6210\u4eba\u306b\u767a\u751f\u3057\u305f\u3082\u306e\u3067\uff0c\u3053\u306e\u5927\u304d\u3055\u3067\u3059\u304c\u5c40\u6240\u75c7\u72b6\u306f\u306a\u304f\u982d\u75db\u306e\u307f\u3067\u3059\u3002\u7d44\u7e54\u8a3a\u65ad\u3067\u306f\uff0c\u30b3\u30a2\u306f\u81a0\u82bd\u816b\u3067\u3059\u304c\uff0c\u5468\u56f2\u306f\u30b0\u30ec\u30fc\u30c92\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306e\u8a3a\u65ad\u3067\u3057\u305f\u3002\u5168\u6458\u51fa\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u30674\u5e74\u9593\u7121\u75c7\u72b6\u3067\u3057\u305f\u3002\u3053\u308c\u306f\u53e4\u3044\u4f8b\u306a\u306e\u3067\u3059\u304c\uff0c\u73fe\u5728\u3067\u306f\u81a0\u82bd\u816b\u306b\u5206\u985e\u3055\u308c\u306a\u3044\u3082\u306e\u306a\u306e\u3067\u3057\u3087\u3046\u3002<\/p>\n<h5><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/glioma\/malignanttransform\/\">\u30bb\u30ab\u30f3\u30c0\u30ea\u30fc\u30fb\u30b0\u30ea\u30aa\u30d6\u30e9\u30b9\u30c8\u30fc\u30de: secondary glioblastoma\uff08\u30b0\u30ea\u30aa\u30fc\u30de\u306e\u60aa\u6027\u8ee2\u5316)\u306e\u5b9f\u4f8b\u306f\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af<\/a><\/h5>\n<h4>giant cell glioblastoma \u5de8\u7d30\u80de\u6027\u81a0\u82bd\u816b WHO grade 4<\/h4>\n<p><strong><span style=\"color: #000080;\">\u307e\u308c\u306b\u5c0f\u5150\u3082\u307f\u3089\u308c\u308b<\/span><\/strong>\u3082\u306e\u3067\uff0cde novo\u3067\u767a\u751f\u3057\u307e\u3059\u3002\u75c5\u7406\u7d44\u7e54\u3067\u591a\u6838\u5de8\u7d30\u80de\u304c\u305f\u304f\u3055\u3093\u307f\u3048\u308b\u3082\u306e\u3067\u3059\u3002<em>TP53<\/em>\u5909\u7570\uff0cAURKB\u767a\u73fe\u304c\u3042\u308a\u307e\u3059\u304c\uff0c<em>EGFR<\/em>\u5897\u5e45\u304c\u7a00\u3067\u3059\u3002MRI\u753b\u50cf\u3067\u306f\uff0c\u5883\u754c\u304c\u660e\u77ad\u3067\u76ae\u8cea\u4e0b\u306b\u3042\u308a\uff0c<span style=\"color: #000080;\"><strong>\u8ee2\u79fb\u6027\u8133\u816b\u760d\u306e\u753b\u50cf\u306b\u306b\u3066\u3044\u307e\u3059<\/strong><\/span>\u3002\u901a\u5e38\u306e\u81a0\u82bd\u816b\u3088\u308a\u306f\uff0c\u5c11\u3057\u3060\u3051\u751f\u547d\u4e88\u5f8c\u304c\u826f\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002giosarcoma\u3068\u540c\u69d8\u306b\u5168\u6458\u3067\u304d\u308b\u3053\u3068\u304c\u591a\u3044\u304b\u3089\u3067\u3059\u3002<\/p>\n<h4 align=\"left\">Gliosarcoma \u81a0\u8089\u816b\u3068\u00a0Epithelioid glioblastoma \u985e\u8868\u76ae\u6027\u81a0\u82bd\u816b WHO grade 4<\/h4>\n<p><span style=\"color: #000080;\">\u5c0f\u5150\u304b\u3089\u82e5\u5e74\u6210\u4eba\u306b\u3082\u767a\u751f\u3059\u308b\u81a0\u82bd\u816b<\/span>\u3067\uff0cde novo\u3067\u3059\u3002\u81a0\u82bd\u816b\u306e variant\u306a\u306e\u3067\u3059\u304c\uff0cMRI\u753b\u50cf\u3092\u307f\u308b\u3068\u81a0\u82bd\u816b\u3067\u306f\u306a\u3044\u3088\u3046\u306b\u898b\u3048\u3066\u3057\u307e\u3063\u3066\uff0c\u624b\u8853\u5f8c\u306b\u81a0\u82bd\u816b\u3060\u3063\u305f\u306e\u304b\u3068\u601d\u3046\u3053\u3068\u304c\u3057\u3070\u3057\u3070\u3067\u3059\u3002\u7406\u7531\u306f<span style=\"color: #000080;\"><strong>\u816b\u760d\u306e\u5883\u754c\u304c\u660e\u77ad<\/strong><\/span>\u3067\u304f\u308a\u3093\u3068\u898b\u3048\u308b\u304b\u3089\u3067\u3059\u00a0(sharp demarcation)\u3002\u3044\u308f\u3086\u308bPNET\u307f\u305f\u3044\u306b\u898b\u3048\u307e\u3059\u3002\u8133\u8868\u306b\u767a\u751f\u3057\u305f\u6642\u306b\u306f\uff0c\u786c\u819c\u306b\u63a5\u3057\u3066\u786c\u819c\u8840\u7ba1\u3092\u5f15\u304d\u8fbc\u3093\u3067<strong><span style=\"color: #000080;\">\u60aa\u6027\u9ac4\u819c\u816b\u306b\u898b\u3048\u305f\u308a<\/span><\/strong>\u3057\u307e\u3059\u3002\u5b8c\u5168\u6458\u51fa\u3067\u304d\u308b\u30c1\u30e3\u30f3\u30b9\u304c\u3042\u308b\u3082\u306e\u3067\u3059\u3002<\/p>\n<h4>glioblastoma with primitive neuronal component WHO grade 4<\/h4>\n<p>glioblastoma with PNET-like component\u3068\u3057\u3066\u5831\u544a\u3055\u308c\u3066\u3044\u305f\u4f8b\u3067\u3059\u3002\u795e\u7d4c\u7d30\u80de\u7cfb\u3078\u306e\u5206\u5316\u3092\u793a\u3059\u672a\u5206\u5316\u306a\u7d30\u80de\u304c\u307f\u3089\u308c\u307e\u3059\u3002\u5927\u304d\u306a\u7279\u5fb4\u306f\uff0c\u9ac4\u6db2\u64ad\u7a2e\u3059\u308b\u53ef\u80fd\u6027\u304c\u3068\u3066\u3082\u9ad8\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u81e8\u5e8a\u7684\u306b\u306fPNET\u306e\u3088\u3046\u306a\u3082\u306e\u3067\u3059\u3002<\/p>\n<div>\n<h4 align=\"left\"><strong>\u5206\u5b50\u30de\u30fc\u30ab\u30fc<\/strong><\/h4>\n<\/div>\n<h5 align=\"left\"><span style=\"color: #ff0000;\"><strong><i>IDH1\/2 <\/i><\/strong><span style=\"color: #000080;\">: \u751f\u547d\u4e88\u5f8c\u3092\u3042\u308b\u7a0b\u5ea6\u4e88\u60f3\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\uff0c\u8a3a\u65ad\u57fa\u6e96\u3067\u3059\u304b\u3089\u5fc5\u305a\u8abf\u3079\u307e\u3059\uff0c\u81a0\u82bd\u816b\u3067\u306f\u5909\u7570\u306f\u3042\u308a\u307e\u305b\u3093<\/span><\/span><\/h5>\n<h5 align=\"left\"><span style=\"color: #ff0000;\"><strong><i>nuclear ATRX\u00a0<\/i><\/strong><span style=\"color: #000080;\">: \u6b20\u5931\u304c\u3042\u308c\u3070\u661f\u7d30\u80de\u7cfb\u816b\u760d astrocytic lineage tumor \u3068\u8a3a\u65ad\u3067\u304d\u307e\u3059<\/span><\/span><\/h5>\n<h5 align=\"left\"><strong><span style=\"color: #ff0000;\">1p\/19q<\/span>\uff1a\u9000\u5f62\u6210\u6027\u4e4f\u7a81\u8d77\u81a0\u816b\u3068\u306e\u9451\u5225\u306b\u5fc5\u9808\u3067\u3059<\/strong><\/h5>\n<h5 align=\"left\"><span style=\"color: #ff0000;\"><i>MGMT<\/i><span style=\"color: #000080;\">\u00a0<span style=\"color: #ff0000;\">promotor methylation<\/span> : \u6cbb\u7642\u53cd\u5fdc\u6027\u304c\u4e88\u6e2c\u3067\u304d\u307e\u3059\u304b\u3089\u4e00\u90e8\u306e\u8a66\u9a13\u3067\u6cbb\u7642\u6cd5\u9078\u629e\u306b\u5fdc\u7528\u3055\u308c\u3066\u3044\u307e\u3059\uff0c\u7279\u306b\u9ad8\u9f62\u8005\u3067\u306f\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u4f7f\u7528\u3059\u308b\u304b\u3069\u3046\u304b\u306e\u6307\u6a19\u306b\u3057\u307e\u3059<\/span><\/span><\/h5>\n<h5 align=\"left\"><strong><span style=\"color: #ff0000;\"><i>EGFR,\u00a0EGFRvIII<\/i><\/span>\uff1a\u81a0\u82bd\u816b\u306e\u534a\u6570\u304f\u3089\u3044\u3067\u5897\u5e45\u3057\u3066\u3044\u307e\u3059<\/strong><\/h5>\n<h5><span style=\"color: #ff0000;\"><i>T<\/i><em>ERT<\/em><\/span>\uff1apromoter mutation\u304c\u81a0\u82bd\u816b\u306e7\u5272\u307b\u3069\u3067\u898b\u3089\u308c\u307e\u3059\uff0c\u3057\u304b\u3057\uff0c\u307b\u3068\u3093\u3069\u306e\u4e4f\u7a81\u8d77\u81a0\u816b\u306b\u3082\u5909\u7570\u304c\u3042\u308a\u307e\u3059<\/h5>\n<h5><em><span style=\"color: #ff0000;\"><strong>+7\/\u201310 cytogenetic signature<\/strong><\/span><\/em>\uff1a\u81a0\u82bd\u816b\u306e\u30de\u30fc\u30ab\u30fc\u3068\u3044\u3048\u307e\u3059<\/h5>\n<h5 align=\"left\"><strong><i>p53<\/i><\/strong><\/h5>\n<h5 align=\"left\"><strong><i>PTEN mutation<\/i> or deletion<\/strong><\/h5>\n<h5 align=\"left\"><strong><i>PDGFR<\/i><\/strong><\/h5>\n<h5 align=\"left\"><strong><i>PIK3CA<\/i>\u00a0<\/strong><\/h5>\n<p align=\"left\">\u4ee5\u4e0b\u306e\u5206\u5b50\u30de\u30fc\u30ab\u30fc\u304c\u6ce8\u76ee\u3055\u308c\u3066\u81e8\u5e8a\u8a66\u9a13\u306e\u4e2d\u3067\u8abf\u3079\u3089\u308c\u3066\u3044\u307e\u3059\uff0c\u8981\u3059\u308b\u306b\u57fa\u790e\u7814\u7a76\u306e\u30bf\u30fc\u30b2\u30c3\u30c8\u3067\u3059\u304c\uff0c2021\u5e74\u6642\u70b9\u3067\u3001<span style=\"color: #000080;\"><strong>\u3053\u308c\u3089\u304c\u89e3\u3063\u305f\u304b\u3089\u3068\u3044\u3063\u3066\u60a3\u8005\u3055\u3093\u306b\u5f79\u306b\u7acb\u3064\u3068\u3044\u3046\u8a33\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/strong><\/span>\u3002\u81e8\u5e8a\u7684\u306a\u89b3\u70b9\u304b\u3089\u306f\uff0cMGMT status\u3092\u307f\u308b\u3053\u3068\u304c\u6709\u7528\u3067\u3042\u308b\u3068\u8003\u3048\u308b\u7814\u7a76\u8005\u306f\u3054\u304f\u4e00\u90e8\u3068\u3044\u3048\u307e\u3059\u3002\u300cMGMT methylation\u304f\u3089\u3044\u306f\u75c5\u7406\u8a3a\u65ad\u306e\u6642\u306b\u307f\u3066\u304a\u3044\u3066\u3082\u3044\u3044\u304b\u306a\uff1f\u300d\u304f\u3089\u3044\u3067\u3059\u3002<\/p>\n<h5 align=\"left\"><strong><em>Proneural type<\/em><\/strong><\/h5>\n<h5 align=\"left\"><strong><em>Neural type<\/em><\/strong><\/h5>\n<h5 align=\"left\"><strong><em>Classical type<\/em><\/strong><\/h5>\n<h5 align=\"left\"><strong><em>Mesenchymal type<\/em><\/strong><\/h5>\n<p align=\"left\">\u907a\u4f1d\u5b50\u5909\u7570\u767a\u73fe\u3092\u3082\u3068\u306b\u4e88\u5f8c\u3068\u6cbb\u7642\u52b9\u679c\u3092\u307f\u308b\u305f\u3081\u306b\u7d30\u5206\u985e\u3055\u308c\u305f\u3082\u306e\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>proneural type<\/strong><\/span>\u3068<strong><span style=\"color: #000080;\">mesenchymal type<\/span><\/strong>\u3067\u306fIDH1 wild-type\u3067\u3042\u308b\u524d\u8005\u306e\u65b9\u304c\u6cbb\u7642\u53cd\u5fdc\u6027\u304c\u3088\u3044\u3068\u3055\u308c\u307e\u3059\u30022023\u5e74\u306e\u6642\u70b9\u3067\u306f\u3053\u308c\u304c\u5206\u304b\u3063\u305f\u3044\u3063\u3066\u3082\u60a3\u8005\u3055\u3093\u306b\u5f79\u306b\u7acb\u3064\u65b0\u305f\u306a\u6cbb\u7642\u6cd5\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<hr \/>\n<h1 align=\"left\">\u6587\u732e\u60c5\u5831<\/h1>\n<h4>65\u6b73\u4ee5\u4e0a\u306e\u521d\u767a\u81a0\u82bd\u816b\u306b\u5bfe\u3059\u308b\u5c11\u5206\u5272\u30fb\u77ed\u671f\u9593\u967d\u5b50\u7dda\u6cbb\u7642\u306e\u52b9\u679c<\/h4>\n<p>Vora S: Short-course hypofractionated proton beam therapy, incorporating\u00a0<sup>18<\/sup>F-DOPA PET and contrast-enhanced MRI targeting, for patients aged 65 years and older with newly diagnosed glioblastoma: a single-arm phase 2 trial. Lancet Oncol 2024<br \/>\nMayo\u30af\u30ea\u30cb\u30c3\u30af\u3067\u884c\u308f\u308c\u305f\u81e8\u5e8a\u7b2c2\u76f8\u8a66\u9a13\u3067\u3059\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u30bf\u30fc\u30b2\u30c3\u30c8\u306f\uff0c\u00a0<sup>18<\/sup>F-DOPA PET \u3068\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u3067\u5897\u5f37\u3055\u308c\u308b\u90e8\u5206\u306b\u7d5e\u3063\u3066\u6c7a\u3081\u3089\u308c\u307e\u3057\u305f\u3002\u967d\u5b50\u7dda\u304c\u4f7f\u7528\u3055\u308c\uff0c\uff15\u56de\u304b\u308910\u56de\u306e\u5c11\u5206\u5272\u3067\u7167\u5c04\u3055\u308c\u3066\u3044\u307e\u3059\u300265\u4f8b\u306e\u60a3\u8005\u3055\u3093\u304c\u767b\u9332\u3055\u308c\uff0c1\u5e74\u751f\u5b58\u7387\u306f56%\uff0c\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f13.1\u30f6\u6708\u3067\u3057\u305f\u3002\u904e\u53bb\u306e\u81e8\u5e8a\u7b2c3\u76f8\u8a66\u9a13\u306e\u751f\u5b58\u671f\u95936-9\u30f6\u6708\u3068\u6bd4\u8f03\u3059\u308c\u3070\u3068\u3066\u3082\u826f\u3044\u6210\u7e3e\u3067\uff0c\u6cbb\u7642\u5f8c\u306e\u751f\u6d3b\u306e\u8cea\u3082\u826f\u597d\u3067\u3042\u308b\u3068\u5831\u544a\u8005\u306f\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002\u3067\u3059\u304c\uff0c\u75c7\u4f8b\u6570\u3082\u3068\u3066\u3082\u5c11\u306a\u304f\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u3082\u7121\u4f5c\u70ba\u8a66\u9a13\u3067\u306f\u306a\u3044\u3057\u77ed\u3044\u306e\u3067\uff0c\u7d50\u8ad6\u306f\u4e0d\u660e\u3067\u3059\u3002<\/p>\n<h4>\u624b\u8853\u306b\u3088\u308b\u6458\u51fa\u5ea6\u3068\u4e88\u5f8c\u306e\u65b0\u5206\u985e<\/h4>\n<p class=\"heading-title\">Karschnia P: Prognostic validation of a new classification system for extent of resection in glioblastoma: A report of the RANO resect group. Neuro Oncol 2023<br \/>\nRANO\u30b0\u30eb\u30fc\u30d7\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002744\u4f8b\u306e\u81a0\u82bd\u816b\u304c\u624b\u8853\u6458\u51fa\u3092\u53d7\u3051\u3066\uff0c\u8853\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e\u6a19\u6e96\u6cbb\u7642\u304c\u52a0\u3048\u3089\u308c\u307e\u3057\u305f\u3002<br \/>\nClass 1: &#8220;supramaximal CE resection&#8221;\u00a0extensive <span style=\"color: #000080;\"><strong>resection of non-CE tumor (\u22645 cm3<\/strong><\/span> residual non-CE tumor)<br \/>\nClass 2: maximal CE resection<br \/>\nClass 3: submaximal CE resection<br \/>\nClass 4: biospy<br \/>\nCE\u3068\u306f\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u90e8\u5206\u3067\u3059\u3002\u3055\u3089\u306b\uff0cT2\/FLAIR\u306e\u9ad8\u4fe1\u53f7\u90e8\u5206\u30925cc\u4ee5\u4e0b\u307e\u3067\u6458\u51fa\u3059\u308b\u3068\uff0c&#8221;supramaximal CE resection&#8221;\u3068\u547c\u3073\uff0c\u6700\u5927\u306e\u624b\u8853\u6cbb\u7642\u52b9\u679c\uff08\u4e88\u5f8c\u306e\u5ef6\u9577\uff09\u304c\u5f97\u3089\u308c\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n<h4>survivin\u306e\u81e8\u5e8a\u7b2c2\u76f8\u8a66\u9a13\u306e\u7d50\u679c\u304c\u6709\u671b<\/h4>\n<p class=\"chaptertitle\">Ahluwalia MS: Phase IIa Study of SurVaxM Plus Adjuvant Temozolomide for Newly Diagnosed Glioblastoma. J Clin Oncol 2022<br \/>\n\u81a0\u82bd\u816b\u304c\u5f37\u304f\u767a\u8a00\u3057\u3066\u3044\u308bsurivivin\u3068\u3044\u3046\u30bf\u30f3\u30d1\u30af\u306b\u5bfe\u3059\u308b\u88dc\u52a9\u514d\u75ab\u7642\u6cd5\u3067\u3059\u300263\u4eba\u306e\u521d\u767a\u81a0\u82bd\u816b\u60a3\u8005\u3055\u3093\u306b\u5bfe\u3059\u308b\u81e8\u5e8a\u7b2c2\u76f8\u8a66\u9a13\u3067\u3059\u3002\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u52a0\u3048\u3066\uff0c<span style=\"color: #000080;\"><strong>\u30da\u30d7\u30c1\u30c9\u30ef\u30af\u30c1\u30f3SurVaxM<\/strong><\/span> (500\u03bcg once every 2 weeks)\u304csargramostim (GMCSF)\u304c\u76ae\u4e0b\u6295\u4e0e\u3055\u308c\u307e\u3057\u305f\u3002\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3068SurVaxM\u306f\u816b\u760d\u518d\u71c3\u304c\u751f\u3058\u308b\u307e\u3067\u7d99\u7d9a\u3055\u308c\u307e\u3057\u305f\u30026\u30f6\u6708\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f95% (60\u4f8b\uff09PFS\u4e2d\u592e\u5024\u306f11\u30f6\u6708\uff0c\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f25.9\u30f6\u6708\u3067\u3057\u305f\u3002<\/p>\n<h4>\u81e8\u5e8a\u8a66\u9a13\u306b\u5165\u308c\u306a\u3044\u60a3\u8005\u3055\u3093\u304c\u60f3\u50cf\u3088\u308a\u591a\u3044<\/h4>\n<p class=\"wi-article-title article-title-main\"><span class=\"al-author-name-more js-flyout-wrap\">Skaga E:\u00a0<\/span>Real-world validity of randomized controlled phase III trials in newly diagnosed glioblastoma: to whom do the results of the trials apply?\u00a0Neuro-Oncology Advances, 2021<br \/>\n\u304b\u306d\u3066\u304b\u3089\u8a00\u308f\u308c\u3066\u3044\u305f\u3053\u3068\u3067\uff0c\u30ce\u30eb\u30a6\u30a7\u30fc\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u81a0\u82bd\u816b\u306e\u751f\u547d\u4e88\u5f8c\u3068\u304b\u6cbb\u7642\u8a55\u4fa1\u306f\uff0c\u81e8\u5e8a\u7b2c\uff13\u76f8\u8a66\u9a13\u306e\u7d50\u679c\u3067\u8a18\u8f09\u3055\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059\u3002\u3067\u3082\u305d\u3082\u305d\u3082\uff0c\u305d\u306e\u81e8\u5e8a\u8a66\u9a13\u306b\u767b\u9332\u53ef\u80fd\u306a eligible \u60a3\u8005\u3055\u3093\u306f\uff0c5\u5272\u306b\u6e80\u305f\u306a\u3044\u305d\u3046\u3067\u3059\u3002\u3067\u3059\u304b\u3089\u73fe\u5b9f\u7684\u306b\u306f\uff0c\u8a3a\u65ad\u6642\u306b\u7de9\u548c\u30b1\u30a2\u3092\u9078\u3076\u3079\u304d\u60a3\u8005\u3055\u3093\u306f\u3068\u3066\u3082\u591a\u3044\u3067\u3059\u3002\u307e\u305f\u81a0\u82bd\u816b\u306e\u4e88\u5f8c\u3092\u8003\u3048\u308b\u5834\u5408\u307f\u308b\u30c7\u30fc\u30bf\u306f\u81a0\u82bd\u816b\u3068\u3057\u3066\u306f\u72b6\u614b\u306e\u826f\u3044\u60a3\u8005\u3055\u3093\u3092\u307f\u3066\u3044\u308b\u3068\u8003\u3048\u307e\u3059\u3002<\/p>\n<h4>\uff16\u30b3\u30fc\u30b9\u4ee5\u4e0a\u306e\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u7dad\u6301\u7642\u6cd5\u306b\u6709\u52b9\u6027\u306f\u306a\u3044<\/h4>\n<p>Balana, C: A phase II randomized, multicenter, open-label trial of continuing adjuvant temozolomide beyond six cycles in pati ents with glioblastoma (GEINO 14-01). Neuro Oncol 2020<br \/>\nGBM 159\u4f8b\u3067\u7121\u4f5c\u70ba\u8a66\u9a13\u3055\u308c\u307e\u3057\u305f\u3002temozolomide\u3092\uff16\u30b3\u30fc\u30b9\u4ee5\u4e0a\u7d99\u7d9a\u3057\u3066\u3082\uff0cPFS\u3068OS\u306b\u5ef6\u9577\u306f\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u6709\u5bb3\u4e8b\u8c61\u304c\u307e\u3059\u3060\u3051\u306a\u306e\u30676\u30b3\u30fc\u30b9\u3067\u6b62\u3081\u308b\u3079\u304d\u3068\u306e\u7d50\u8ad6\u3067\u3059\u3002<\/p>\n<h4>\u82e5\u3044\u5e74\u9f62\u5c64\u3067\u306f\u975e\u9020\u5f71\u90e8\u5206\u306e\u7a4d\u6975\u7684\u6458\u51fa\u304c\u751f\u5b58\u671f\u9593\u3092\u5ef6\u9577\u3059\u308b<\/h4>\n<p><span class=\"highlight\">Molinaro AM: Association<\/span> of <span class=\"highlight\">Maximal<\/span> <span class=\"highlight\">Extent<\/span> of <span class=\"highlight\">Resection<\/span> of <span class=\"highlight\">Contrast-Enhanced<\/span> and <span class=\"highlight\">Non-Contrast-Enhanced<\/span><span class=\"highlight\">Tumor<\/span> With <span class=\"highlight\">Survival<\/span> Within <span class=\"highlight\">Molecular<\/span> <span class=\"highlight\">Subgroups<\/span> of <span class=\"highlight\">Patients<\/span> With <span class=\"highlight\">Newly<\/span> <span class=\"highlight\">Diagnosed<\/span> <span class=\"highlight\">Glioblastoma<\/span>. <span role=\"menubar\">JAMA Oncol.<\/span> 2020<br \/>\nUCSF, Mayo, Cleaveland\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002<br \/>\n\u82e5\u3044\u5e74\u9f62\u5c64\u306e\u81a0\u82bd\u816b\u3067\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u90e8\u5206 CE\u3068\u9020\u5f71\u3055\u308c\u306a\u3044\u9ad8\u4fe1\u53f7\u90e8\u5206 NCE\u3092\u7a4d\u6975\u7684\u306b\u6458\u51fa\u3057\u305f\u5834\u5408\uff0cIDH\u304cwild type\u3067\u3082\u5168\u751f\u5b58\u671f\u9593 OS\u306f37\u30f6\u6708\u306b\u9054\u3057\u307e\u3057\u305f\u3002\u4e00\u65b9\uff0cNSE\u3092\u6b8b\u305b\u307016.5\u30f6\u6708\u3067\u3057\u305f\u300237\u30f6\u6708\u3068\u3044\u3046\u306e\u306f mutant type\u306e\u751f\u5b58\u671f\u9593\u306b\u5339\u6575\u3057\u307e\u3059\u3002\u307e\u305fMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306e\u6709\u7121\u3067\u3053\u306e\u751f\u5b58\u671f\u9593\u306b\u5909\u308f\u308a\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<br \/>\n\u3057\u304b\u3057\uff0c\u9ad8\u9f62\u8005\u3067\u306f\u3053\u306e\u5dee\u306f\u306a\u304f\uff0c\u9006\u306bCE\u90e8\u5206\u306e\u7a4d\u6975\u7684\u6458\u51fa\u306e\u307f\u3067\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u304c\u3042\u308a\u307e\u3059\uff0c\u3057\u304b\u3057\u4e2d\u592e\u5024\u306f12\u30f6\u6708\u306b\u3059\u304e\u307e\u305b\u3093\u3002<\/p>\n<h4>\u8853\u5f8c5\u9031\u9593\u304f\u3089\u3044\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u958b\u59cb\u3057\u3066\u3082\u751f\u547d\u4e88\u5f8c\u306f\u60aa\u304f\u306f\u306a\u3089\u306a\u3044<\/h4>\n<p class=\"heading-title\"><span class=\"authors-list-item \">Press RH:\u00a0<\/span>Optimal Timing of Chemoradiotherapy After Surgical Resection of Glioblastoma: Stratification by Validated Prognostic Classification. Cancer 2020<br \/>\n2018\u5e74\u306eNeuroOncol\u306e\u8ad6\u6587\u3068\u540c\u3058\u3088\u3046\u306a\u7d50\u8ad6\u3067\u3059\u300230,414\u4eba\u306e\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093\u304c\u89e3\u6790\u3055\u308c\u307e\u3057\u305f\u3002\u4eca\u307e\u3067\u306f\u8853\u5f8c3\u9031\u9593\u304f\u3089\u3044\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u958b\u59cb\u3059\u3079\u304d\u3060\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3057\u305f\u304c\uff0c\u305d\u3046\u3067\u306f\u306a\u304f\u3066\uff0c\u8853\u5f8c1\u22123\u9031\u4ee5\u5185\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u958b\u59cb\u3055\u308c\u305f\u65b9\u304c\uff0c\u82e5\u5e72\u4e88\u5f8c\u304c\u60aa\u304b\u3063\u305f\u3068\u3044\u3046\u9006\u306e\u7d50\u8ad6\u3067\u3057\u305f\u3002\u8853\u5f8c5\u9031\u9593\u904e\u304e\u304f\u3089\u3044\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u958b\u59cb\u3057\u3066\u3082\uff0c\u751f\u5b58\u671f\u9593\u306e\u77ed\u7e2e\u306f\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u3067\u3082\uff0c\u3053\u308c\u306b\u306f\u30d0\u30a4\u30a2\u30b9\u304c\u3042\u308a\u307e\u3059\uff0c\u8853\u5f8c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u6025\u3050\u6642\u306b\u306fprogression\u304c\u6025\u306a\u60a3\u8005\u3055\u3093\u304c\u591a\u304f\u542b\u307e\u308c\u308b\u3053\u3068\u3067\u3059\u3002\u4e88\u5f8c\u304c\u60aa\u305d\u3046\u306a\u81a0\u82bd\u816b\u60a3\u8005\u3055\u3093\u304c\u8853\u5f8c\u65e9\u671f\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u3088\u308a\u591a\u304f\u542b\u307e\u308c\u3066\u3044\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002\u65e9\u304f\u958b\u59cb\u3067\u304d\u308b\u6642\u306b\u306f\u65e9\u304f\u3057\u305f\u65b9\u304c\u3044\u3044\u306e\u3067\u3057\u3087\u3046\u3002<\/p>\n<h4><strong>\u30ed\u30e0\u30b9\u30c1\u30f3 CCNU<\/strong> \u3068\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e\u4f75\u7528<\/h4>\n<p><span lang=\"EN-US\">Herrlinger U: Lomustine-temozolomide combination therapy versus standard temozolomide therapy in patients with newly diagnosed glioblastoma with methylated MGMT promoter (CeTeG\/NOA-09): a randomised, open-label, phase 3 trial.\u00a0<\/span><span class=\"jrnl\"><span lang=\"EN-US\">Lancet<\/span><\/span><span lang=\"EN-US\">. 2019<br \/>\n<span style=\"color: #000080;\"><span style=\"color: #333399;\">\u30c9\u30a4\u30c4\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002<\/span><strong>MGMT promotor\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u304c\u3042\u308aKPS70\uff05\u4ee5\u4e0a\u306e\u521d\u767a\u81a0\u82bd\u816b<\/strong><\/span>129\u4eba\u304c\u7121\u4f5c\u70ba\u306b\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306b\uff0cTMZ\u304bTMZ\/CCNU\u306e\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306731\u30f6\u6708\uff0c\u30ed\u30e0\u30b9\u30c1\u30f3\u3092\u52a0\u3048\u308b\u306848\u30f6\u6708\u3068\u6709\u610f\u306b\u5ef6\u9577\u3057\u307e\u3057\u305f\u3002\u304b\u306a\u308a\u826f\u3044\u6210\u7e3e\u3067\u3042\u308a\uff0c\u30ed\u30e0\u30b9\u30c1\u30f3\u3092\u52a0\u3048\u305f\u3053\u3068\u306b\u3088\u308b\u526f\u4f5c\u7528\u3082\u9ad8\u5ea6\u306e\u3082\u306e\u306f\u3042\u308a\u307e\u305b\u3093\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u3053\u308c\u304c\u65b0\u305f\u306a\u6a19\u6e96\u6cbb\u7642\u306b\u306a\u308b\u306e\u304b\u306f\uff0c\u3082\u3046\u5c11\u3057\u5927\u898f\u6a21\u306a\u81e8\u5e8a\u7b2c\uff13\u76f8\u8a66\u9a13\u306e\u7d50\u679c\u3092\u5f85\u305f\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u30ed\u30e0\u30b9\u30c1\u30f3\u306f\u6b27\u7c73\u3067\u306f\u4f7f\u7528\u3067\u304d\u307e\u3059\u304c\u65e5\u672c\u3067\u306f\u4f7f\u7528\u304c\u3067\u304d\u307e\u305b\u3093\u3002\u307e\u305f2018\u5e74\u304b\u3089\u85ac\u4fa1\u304c50\u500d\u3082\u306e\u9ad8\u5024\u306b\u306a\u3063\u3066\u3057\u307e\u3044\u307e\u3057\u305f\u3002<\/span><\/p>\n<h4>\u30ad\u30a4\u30c8\u30eb\u30fc\u30c0\uff1a\u65b0\u305f\u306a\u514d\u75ab\u6cbb\u7642<\/h4>\n<p><span class=\"highlight\">Cloughesy TF, et al.: Neoadjuvant<\/span> <span class=\"highlight\">anti-PD-1<\/span> <span class=\"highlight\">immunotherapy<\/span> <span class=\"highlight\">promotes<\/span> a <span class=\"highlight\">survival<\/span> <span class=\"highlight\">benefit<\/span> with <span class=\"highlight\">intratumoral<\/span> and <span class=\"highlight\">systemic<\/span><span class=\"highlight\">immune<\/span> <span class=\"highlight\">responses<\/span> in <span class=\"highlight\">recurrent<\/span> <span class=\"highlight\">glioblastoma<\/span>.\u00a0<span role=\"menubar\">Nat Med.<\/span> 2019<br \/>\n\u30ad\u30a4\u30c8\u30eb\u30fc\u30c0 (Keytruda)\u306f\uff0c\u30da\u30e0\u30d6\u30ed\u30ea\u30ba\u30de\u30d6\uff08Pembrolizumab)\u3068\u3044\u3046\u6297\u4f53\u3067\uff0cPD-1\u963b\u5bb3\u5264\u3068\u3044\u308f\u308c\u307e\u3059\u3002\u65e5\u672c\u3067\u3082\u4fdd\u967a\u53ce\u8f09\u3055\u308c\u300c\u304c\u3093\u5316\u5b66\u7642\u6cd5\u5f8c\u306b\u5897\u60aa\u3057\u305f\u9032\u884c\u30fb\u518d\u767a\u306e\u9ad8\u983b\u5ea6\u30de\u30a4\u30af\u30ed\u30b5\u30c6\u30e9\u30a4\u30c8\u4e0d\u5b89\u5b9a\u6027\uff08MSI-High\uff09\u3092\u6709\u3059\u308b\u56fa\u5f62\u764c\uff08\u6a19\u6e96\u7684\u306a\u6cbb\u7642\u304c\u56f0\u96e3\u306a\u5834\u5408\u306b\u9650\u308b\uff09\u300d\u306b\u4f7f\u7528\u8a31\u53ef\u304c\u3042\u308a\u307e\u3059\u3002<br \/>\n35\u4eba\u306e\u518d\u767a\u81a0\u82bd\u816b\u3078\u306e\u6295\u4e0e\u5831\u544a\u304c\u30cd\u30a4\u30c1\u30e3\u30fc\u306b\u767a\u8868\u3055\u308c\u307e\u3057\u305f\u3002\u624b\u8853\u3067\u6458\u51fa\u3067\u304d\u308b\u81a0\u82bd\u816b\u304c\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u304c\u6761\u4ef6\u3067\u3059\u3002\u7121\u4f5c\u70ba\u306b\u60a3\u8005\u3055\u3093\u304c\u5206\u3051\u3089\u308c\uff0c\u624b\u8853\u524d\u306b\u30ad\u30a4\u30c8\u30eb\u30fc\u30c0 (neoadjuvant pembrolizumab) \u3092\u6295\u4e0e\u3057\u305f\u60a3\u8005\u3055\u3093\u3067\u6709\u610f\u306a\u5168\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\uff08\u4e2d\u592e\u5024\u3067417\u65e5\uff09\u304c\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u6458\u51fa\u3057\u305f\u816b\u760d\u5185\u3067\u306f\uff0cupregulation of T cell\u2013 and interferon-\u03b3-related gene expression\u304c\u3042\u308a\uff0cdownregulation of cell-cycle-related gene expression \u304c\u898b\u3089\u308c\u307e\u3057\u305f\u3002\u6297\u816b\u760d\u6d3b\u6027\u3092\u3082\u3064T\u7d30\u80de\u7cfb\u306e\u514d\u75ab\u8ce6\u6d3b\u3068\u816b\u760d\u5897\u6b96\u306e\u6291\u5236\u304c\u3042\u3063\u305f\u3089\u3057\u3044\u3068\u306e\u7d50\u679c\u3067\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u816b\u760d\u7d44\u7e54\u3068\u672b\u68a2\u8840\u5185\u3067\u751f\u3058\u305f\u73fe\u8c61\u306f\u305d\u3046\u306a\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u3057\u304b\u3057\uff0c\u672c\u5f53\u306b\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093\u306e\u751f\u547d\u4e88\u5f8c\u3092\u6539\u5584\u3067\u304d\u308b\u304b\u3069\u3046\u304b\u306f\u307e\u3060\u4e0d\u660e\u3067\u3059\u3002<\/p>\n<h4>\u8853\u5f8c\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u82e5\u5e72\u9045\u308c\u3066\u3082\u6cbb\u7642\u6210\u7e3e\u306b\u5f71\u97ff\u306f\u306a\u3044<\/h4>\n<p><span class=\"authors-list-item \">Blumenthal DT:\u00a0<\/span>Short Delay in Initiation of Radiotherapy for Patients With Glioblastoma-Effect of Concurrent Chemotherapy: A Secondary Analysis From the NRG Oncology\/Radiation Therapy Oncology Group Database. NeuroOncol 2018<br \/>\n\u4eca\u307e\u3067\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u624b\u8853\u5f8c\u3067\u304d\u308b\u9650\u308a\u65e9\u304f\u958b\u59cb\u3057\u305f\u65b9\u304c\u826f\u3044\u3068\u3044\u308f\u308c\u3066\u304d\u307e\u3057\u305f\u3002\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u30931,395\u4eba\u306e\u5f8c\u65b9\u8996\u7684\u89e3\u6790\u3067\uff0c\u624b\u8853\u5f8c4\u9031\u9593\u3092\u3059\u304e\u3066\u9045\u3081\u306b\uff0c\u653e\u5c04\u7dda\u3068\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u6cbb\u7642\u304c\u884c\u308f\u308c\u305f\u60a3\u8005\u3055\u3093\u306e\u751f\u5b58\u671f\u9593\u306f\uff0c4\u9031\u9593\u672a\u6e80\u306b\u6cbb\u7642\u958b\u59cb\u3055\u308c\u305f\u7fa4\u3068\u6bd4\u8f03\u3057\u3066\u5dee\u304c\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n<h4>\u6cbb\u7642\u306e\u5f8c\u306e\u5fa9\u8077<\/h4>\n<p>Stamoni D, et al.: Returning to work after multimodal treatment in glioblastoma patients. Nurusurg Focus 2018<br \/>\n\u30d5\u30e9\u30f3\u30b9\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u5c31\u52b4\u53ef\u80fd\u5e74\u9f62\uff08\u5e73\u574748\u6b73\uff09\u306e\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093125\u4eba\u306e\u4e88\u5f8c\u8ffd\u8de1\u3067\u3059\u3002\u6cbb\u7642\u5f8c\u306b21\u4eba (18%) \u306e\u60a3\u8005\u3055\u3093\u304c\u50cd\u3051\u3066\u3044\u307e\u3057\u305f\u304c\uff0c\u307b\u3068\u3093\u3069\u306f\u30d1\u30fc\u30c8\u30bf\u30a4\u30e0\u3067\u3057\u305f\u3002<\/p>\n<h4>\u30a4\u30f3\u30bf\u30fc\u30d5\u30a7\u30ed\u30f3\u306f\u6709\u52b9\u3067\u306f\u306a\u3044<\/h4>\n<p>Wakabayashi T, et al,:\u00a0JCOG0911 INTEGRA study: a randomized screening phase II trial of interferon\u03b2 plus temozolomide in comparison with temozolomide alone for newly diagnosed glioblastoma.\u00a0J Neurooncol\u00a02018<br \/>\n\u540d\u53e4\u5c4b\u5927\u5b66\u304c\u4e2d\u5fc3\u3068\u306a\u3063\u3066\u9577\u304f\u65e5\u672c\u3067\u884c\u308f\u308c\u305f\u8a66\u9a13\u306e\u7d50\u679c\u3067\u3059\u3002\u30a4\u30f3\u30bf\u30fc\u30d5\u30a7\u30ed\u30f3\u306e\u4e0a\u4e57\u305b\u52b9\u679c\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n<h4>\u518d\u767a\u7a2e\u81a0\u82bd\u816b\u306b\u30ed\u30e0\u30b9\u30c1\u30f3\u3068\u4f75\u7528\u3059\u308b\u3068\u308f\u305a\u304b\u306a\u304c\u3089PFS\u306e\u5ef6\u9577\u304c\u3042\u308b<\/h4>\n<p>Wick W, et al.:\u00a0Lomustine and Bevacizumab in Progressive Glioblastoma.\u00a0N Engl J Med.\u00a02017<br \/>\nPhase III EORTC 26101\u306e\u7d50\u679c\u5831\u544a\u3067\u3059\u3002\u81a0\u82bd\u816b\u306e\u518d\u767a\u306b\u30ed\u30e0\u30b9\u30c1\u30f3 CCNU\u5358\u72ec\u3068\u30a2\u30d0\u30b9\u30c1\u30f3\u306e\u4f75\u7528\u304c\u8a66\u9a13\u3055\u308c\u307e\u3057\u305f\u3002\u30ed\u30e0\u30b9\u30c1\u30f3\u5358\u72ec\u306ePFS\u306f1.5\u30f6\u6708\uff0c\u30ed\u30e0\u30b9\u30c1\u30f3\u3068\u30a2\u30d0\u30b9\u30c1\u30f3\u3092\u4f7f\u7528\u3059\u308b\u30684.2\u30f6\u6708\u3068\u3044\u3046\u7d50\u679c\u3067\u3059\u3002<br \/>\n\u308f\u305a\u304b\u306a\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u3067\u3059\u3002\u3053\u306e\u7d50\u679c\u3092\u6301\u3063\u3066\u7c73\u56fd\u3067\u306f\u518d\u767a\u81a0\u82bd\u816b\u3078\u306e\u4f7f\u7528\u304c\u8a8d\u53ef\u3055\u308c\u307e\u3057\u305f\uff0c\u3057\u304b\u3057\uff0c\u3053\u308c\u306fCCNU\u3068\u306e\u4f75\u7528\u306a\u306e\u3067\uff0c\u65e5\u672c\u3067\u306f\u3067\u304d\u306a\u3044\u6cbb\u7642\u3067\u3059\u3002<\/p>\n<h4>\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u30927\u30b3\u30fc\u30b9\u4ee5\u4e0a\u7d99\u7d9a\u3057\u3066\u3082\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u306f\u5f97\u3089\u308c\u306a\u3044<\/h4>\n<p>Blumenthal D, Gorila T, Gilbert MR, et al. Is more better? The impact of extended adjuvant temozolomide in newly-diagnosed glioblastoma: a secondary analysis of EORTC and NRG Oncology\/ RTOG. Neuro Oncol 2017<br \/>\n\u904e\u53bb\u306b\u884c\u308f\u308c\u305f\u5927\u898f\u6a21\u8a66\u9a13\u3067\u81a0\u82bd\u816b2214\u4f8b\u304c\u89e3\u6790\u3055\u308c\u307e\u3057\u305f\u30026\u30b3\u30fc\u30b9\u306e\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u7dad\u6301\u7642\u6cd5\u306e\u6642\u70b9\u3067\u7121\u5897\u60aa\u3067\u3042\u3063\u305f624\u4f8b\u306e\u3046\u3061\uff0c291\u4f8b\u3067\u7dad\u6301\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u304c\u7d99\u7d9a\u3055\u3048\u308c\uff0c333\u4f8b\u3067\u306f\u4e2d\u65ad\u3055\u308c\u307e\u3057\u305f\u3002\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u7d99\u7d9a\u4f8b\u3067\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u304c\u3042\u308b\u3068\u3044\u3046\u4e8b\u5b9f\u306f\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u7d50\u8ad6\u3068\u3057\u3066\u306f\uff0c\u81a0\u82bd\u816b\u306e\u521d\u767a\u4f8b\u3067\u306f\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306f6\u30b3\u30fc\u30b9\u3067\u6253\u3061\u5207\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u3057\u304b\u3057\u3053\u306e\u4e2d\u3067\uff0cMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u304c\u3042\u308b\u7fa4\u3067\u306f\u3084\u3084\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u304c\u9577\u3044\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n<p>Gramatzki D, et al. Limited role for extended maintenance temozolomide for newly diagnosed glioblastoma. Neurology 2017<br \/>\n142\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e\u3046\u306161\u4eba\u3067\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u304c7\u30b3\u30fc\u30b9\u4ee5\u4e0a\u6295\u4e0e\u3055\u308c\u307e\u3057\u305f\u30027\u30b3\u30fc\u30b9\u4ee5\u4e0a\u306e\u6295\u4e0e\u3067\uff0c\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u3082\u5168\u751f\u5b58\u671f\u9593\u3082\u4f38\u3073\u306a\u304b\u3063\u305f\u3068\u3044\u3046\u7d50\u8ad6\u3067\u3059\u3002MGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306e\u3042\u308b\u60a3\u8005\u3055\u3093\u3067\u3082\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e\u9577\u671f\u6295\u4e0e\u306e\u52b9\u679c\u306f\u8a8d\u3081\u3089\u308c\u306a\u3044\u3068\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<p>2017\u5e74\u306e\u3053\u306e2\u3064\u306e\u5927\u304d\u306a\u8ad6\u6587\u306f\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e7\u30b3\u30fc\u30b9\u4ee5\u4e0a\u306e\u6295\u4e0e\u3092\u5426\u5b9a\u3057\u307e\u3057\u305f\u3002\u3057\u304b\u3057\uff0cMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306e\u3042\u308b\u4f8b\u3067\u306f\u73fe\u5b9f\u7684\u306b12\u30b3\u30fc\u30b9\u4ee5\u4e0a\u306e\u6295\u4e0e\u304c\u884c\u308f\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3057\u3087\u3046\u3002\u72b6\u614b\u304c\u826f\u304f\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u554f\u984c\u306a\u304f\u670d\u7528\u3057\u3066\u3044\u308b\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093\u3067\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u4e2d\u65ad\u3059\u308b\u3068\uff0c\u6025\u6fc0\u306a\u816b\u760d\u5897\u60aa\u3092\u307f\u308b\u3053\u3068\u304c\u7d4c\u9a13\u7684\u306b\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u3092\u8133\u816b\u760d\u306e\u5c02\u9580\u5bb6\u306f\u77e5\u3063\u3066\u3044\u308b\u304b\u3089\u3067\u3059\u3002<\/p>\n<h4>ABT414\u306e\u81e8\u5e8a\u8a66\u9a13<\/h4>\n<p>Reardon DA, et al.: Efficacy and safety results of\u00a0ABT-414\u00a0in combination with radiation and temozolomide in newly diagnosed\u00a0glioblastoma. Neuro Oncol,\u00a02016<br \/>\n\u4e00\u90e8\u306e\u81a0\u82bd\u816b\u306f\u5909\u7570\u578bEGFR\u3068\u3044\u3046\u30bf\u30f3\u30d1\u30af\u3092\u767a\u73fe\u3057\u3066\u3044\u307e\u3059\u3002\u305d\u308c\u306b\u304f\u3063\u3064\u304f\u6297\u4f53 ABT-806\u306b\u816b\u760d\u7d30\u80de\u306e\u5206\u88c2\u3092\u963b\u5bb3\u3059\u308bMMAF\u3068\u3044\u3046\u6297\u304c\u3093\u5264\u3092\u304f\u3063\u3064\u3051\u3066\uff0c\u9759\u8108\u5185\u304b\u3089\u6295\u4e0e\u3059\u308b\u6cbb\u7642\u6cd5\u3067\uff0cMMAF-antibody-conjugates\u3068\u3044\u3044\u307e\u3059\u30022017\u5e745\u6708\u6642\u70b9\u3067\uff0c<span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"https:\/\/clinicaltrials.gov\/show\/NCT02573324\">\u7c73\u56fd\u3067\u306f\u7b2c2\u76f8\u8a66\u9a13<\/a><\/span>\u304c\u3042\u308a\uff0c\u518d\u767a\u3057\u305f<span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"https:\/\/clinicaltrials.gov\">\u30b0\u30ec\u30fc\u30c9III\u3068IV\u306e\u60aa\u6027\u795e\u7d4c\u81a0\u816b\u3078\u306e\u7b2c1\u76f8\u6cbb\u9a13<\/a><\/span>\u306f\u65e5\u672c\u3067\u3082\u884c\u308f\u308c\u3066\u3044\u307e\u3059\u3002\u53c2\u52a0\u6761\u4ef6\u306f\u5909\u7570\u578bEGFR\u5897\u5e45\u304c\u3042\u308b\u81a0\u82bd\u816b\u3067\u3042\u308b\u3053\u3068\u304c\u75c5\u7406\u5b66\u7684\u306b\u8a3c\u660e\u3067\u304d\u308b\u60a3\u8005\u3055\u3093\u3067\uff0c\u30c6\u30e2\u30c0\u30fc\u30eb\u3092\u4f75\u7528\u3057\u307e\u3059\u3002<\/p>\n<h4 align=\"left\">\u518d\u767a\u81a0\u82bd\u816b\u306b<strong>\u30aa\u30d7\u30b8\u30fc\u30dc Opdivo (nivolumab)\u306f\u6709\u52b9\u3067\u306f\u306a\u3044<\/strong><\/h4>\n<p align=\"left\">2017\u5e74\u306b\uff0c\u6ce8\u76ee\u306e\u518d\u767a\u81a0\u82bd\u816b\u306b\u5bfe\u3059\u308bOpdivo (nivolumab\uff0cPD-1 checkpoint\u6291\u5236\u5264)\u306e\u7b2c\uff13\u76f8\u8a66\u9a13 CheckMate-143\u306e\u7d50\u679c\u304c\u308f\u304b\u308a\u307e\u3057\u305f\u3002\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u306f\u5f97\u3089\u308c\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n<h4 align=\"left\">\u9ad8\u9f62\u8005\u3067\u3082\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u52a0\u3048\u308b\u3068\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u304c\u3042\u308b<\/h4>\n<p>Perry JR, et al.: Short-Course Radiation plus Temozolomide in Elderly Patients with Glioblastoma. N Engl J Med 2017; 376:1027-1037<br \/>\n65\u6b73\u3042\u308b\u3044\u306f70\u6b73\u4ee5\u4e0a\u306e\u9ad8\u9f62\u8005\u306b\u306f\u77ed\u671f\u9593\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u3046\u3068\u3044\u3046\u306e\u304c\u4e00\u822c\u7684\u3067\u3059\u300265\u6b73\u4ee5\u4e0a\u306e562\u4eba\u306e\u60a3\u8005\u3055\u3093\uff08\u5e74\u9f62\u4e2d\u592e\u502473\u6b73\uff09\u306b\uff0c40\u30b0\u30ec\u30a415\u5206\u5272\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u307f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u52a0\u3048\u308b\u7b2c\uff13\u76f8\u8a66\u9a13\u304c\u884c\u308f\u308c\u307e\u3057\u305f\u3002\u5168\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f\u653e\u5c04\u7dda\u5358\u72ec\u30677.6\u30f6\u6708\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u52a0\u3048\u308b\u30689.3\u30f6\u6708\u3067\u3057\u305f\u3002\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u306f\u305d\u308c\u305e\u308c5.3\u30f6\u6708\u30683.9\u30f6\u6708\u3067\u3059\u3002MGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306e\u3042\u308b\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u4f75\u7528\u306713.5\u30f6\u6708\u3067\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u3088\u304f\u3088\u304f\u8003\u3048\u308b\u3068\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u3066\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u52a0\u3048\u3066\u3082\uff0c\u816b\u760d\u304c\u518d\u71c3\u3057\u306a\u3044\u307e\u3067\u306e\u671f\u9593\u306f5\u30f6\u6708\u306b\u3057\u304b\u306a\u308a\u307e\u305b\u3093\u3002\u901a\u5e38\u306e\u30aa\u30f3\u30b3\u30ed\u30b8\u30fc\u306e\u6982\u5ff5\u304b\u3089\u306f\uff0c\u7de9\u548c\u30b1\u30a2\u3068\u3044\u3046\u306e\u304c\u9078\u629e\u80a2\u3068\u3057\u3066\u6709\u529b\u3068\u306a\u308b\u306f\u305a\u3067\uff0c\u3053\u308c\u3089\u306e\u6cbb\u7642\u3092\u3059\u308b\u304b\u3069\u3046\u304b\u3068\u3044\u3046\u3053\u3068\u304c\u6cbb\u7642\u958b\u59cb\u306e\u524d\u306b\u691c\u8a0e\u3055\u308c\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002<\/p>\n<div>\n<h4 align=\"left\">\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u304c\u52b9\u304b\u306a\u3044\u81a0\u82bd\u816b\u306b\u30a2\u30d0\u30b9\u30c1\u30f3\u3068\u30a4\u30ea\u30ce\u30c6\u30ab\u30f3\uff1f<\/h4>\n<p>Herrlinger U, et al.: Bevacizumab Plus Irinotecan Versus Temozolomide in Newly Diagnosed O6-Methylguanine-DNA Methyltransferase Nonmethylated Glioblastoma: The Randomized GLARIUS Trial. J Clin Oncol 2016<br \/>\n\u30e8\u30fc\u30ed\u30c3\u30d1\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002MGMT\u975e\u30e1\u30c1\u30eb\u5316\u306e\u81a0\u82bd\u816b\u306f\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306b\u62b5\u6297\u6027\u3067\u3042\u308b\u4e8b\u304c\u77e5\u3089\u308c\u3066\u3044\u307e\u3059\u3002\u305d\u306e\u3088\u3046\u306a\u60a3\u8005\u3055\u3093182\u4eba\u3067\uff0c\u30a2\u30d0\u30b9\u30c1\u30f3\u00a0(10 mg\/kg every 2 weeks)\u3068\u30a4\u30ea\u30ce\u30c6\u30ab\u30f3\u4f75\u7528\u00a0(\u7dad\u6301\u7642\u6cd5 125 mg\/m2\u00a0every 2 weeks)\u00a0\u3068\u653e\u5c04\u7dda\u6cbb\u7642\uff0c\u3042\u308b\u3044\u306f\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u6cbb\u7642\u6210\u7e3e\u304c\u6bd4\u8f03\u3055\u308c\u307e\u3057\u305f\u30026\u30f6\u6708\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408PFS\u306f\u305d\u308c\u305e\u308c79%\u306843%\u3067\u3057\u305f\u3002PFS\u4e2d\u592e\u5024\u306f\uff0c9.7\u30f6\u6708\u30686.0\u30f6\u6708\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>MGMT\u306e\u30e1\u30c1\u30eb\u5316\u304c\u306a\u3044\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u62b5\u6297\u6027\u306e\u81a0\u82bd\u816b\u306b\u306f\uff0c\u30a2\u30d0\u30b9\u30c1\u30f3\u3068\u30a4\u30ea\u30ce\u30c6\u30ab\u30f3\u306e\u7d44\u307f\u5408\u308f\u305b\u306e\u65b9\u304c\u816b\u760d\u9032\u884c\u3092\u6291\u5236\u3059\u308b\u529b\u304c\u5f37\u3044<\/strong><\/span>\u3068\u3044\u3046\u5831\u544a\u3067\u3059\u3002\u3057\u304b\u3057\u3084\u306f\u308a\uff0c<strong><span style=\"color: #ff0000;\">\u5168\u751f\u5b58\u5272\u5408\u306f16.6\u30f6\u6708\u306817.5\u30f6\u6708\u3067\u3042\u308a\u6709\u610f\u5dee\u304c\u3042\u308a\u307e\u305b\u3093<\/span><\/strong>\u3067\u3057\u305f\u3002\u307e\u305fQOL\u3092\u5909\u3048\u308b\u3053\u3068\u3082\u3067\u304d\u307e\u305b\u3093\u3067\u3057\u305f\u3002MGMT\u975e\u30e1\u30c1\u30eb\u5316\u3092\u8a3c\u660e\u3057\u3066\u30a4\u30ea\u30ce\u30c6\u30ab\u30f3\u3092\u4f7f\u7528\u3057\u3066\u3082\u5ef6\u547d\u306f\u3067\u304d\u306a\u3044\u3057\u751f\u5b58\u306e\u8cea\u3082\u6539\u5584\u3057\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n<\/div>\n<h4>IDH-1\u306e\u5909\u7570\u306e\u306a\u3044\u81a0\u82bd\u816b\u306b\u306f\u30a2\u30d0\u30b9\u30c1\u30f3\u306e\u6709\u52b9\u6027\u304c\u3042\u308b<\/h4>\n<p>Sandmann, T, et al. Patients with proneural glioblastoma may derive overall survival benefit from the addition of bevacizumab to first-line radiotherapy and temozolomide: retrospective analysis of the AVAglio trial. <i>J Clin Oncol. <\/i>2015<br \/>\n\u81a0\u82bd\u816b\u3092\u9593\u8449\u7cfb (mesenchymal type)\u3068\u524d\u795e\u7d4c (proneural type)\u306b\u5206\u3051\u305f\u5834\u5408\uff0c<span class=\"highlight\">proneural<\/span>\u00a0IDH1 wild-type\u306e\u521d\u671f\u6cbb\u7642\u3067\u306f\u30a2\u30d0\u30b9\u30c1\u30f3\u3092\u4f7f\u7528\u3059\u308b\u3068\u5168\u751f\u5b58\u671f\u9593 OS \u304c\u5ef6\u9577\u3059\u308b\u00a0(17.1\u30f6\u6708 vs \u30d7\u30e9\u30bb\u30dc 12.8\u30f6\u6708) \u3068\u3044\u3046\u7d50\u679c\u3067\u3059\u3002\u50c5\u304b\u306a\u5dee\u306a\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u304c\u3002<\/p>\n<h4>\u72b6\u614b\u304c\u60aa\u3044\u3042\u308b\u3044\u306f\u9ad8\u9f62\u8005\u306e\u81a0\u82bd\u816b\u306b\u306f\u77ed\u671f\u9593\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u9069\u5207<\/h4>\n<p>Roa W, et al.: International Atomic Energy Agency Randomized Phase III Study of Radiation Therapy in Elderly and\/or Frail Patients With Newly Diagnosed Glioblastoma Multiforme. J Clin Oncol. 2015<br \/>\n\u7121\u4f5c\u70ba\u7b2c\uff13\u76f8\u8a66\u9a13\u3067\u3059\u3002\u72b6\u614b\u304c\u3042\u307e\u308a\u3088\u304f\u306a\u3044\u3042\u308b\u3044\u306f65\u6b73\u4ee5\u4e0a\u306e\u60a3\u8005\u3055\u3093(frail = age \u2265 50 years and KPS of 50% to 70%; elderly and frail = age \u2265 65 years and KPS of 50% to 70%; elderly = age \u2265 65 years and KPS of 80% to 100%)\u306b\uff0c25\u30b0\u30ec\u30a45\u65e5\u9593\u3042\u308b\u3044\u306f40\u30b0\u30ec\u30a415\u65e5\u9593\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u884c\u308f\u308c\u307e\u3057\u305f\u3002\u4e21\u8005\u306e\u9593\u306bOS\u3082PFS\u3082QOL\u3082\u6709\u610f\u5dee\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u5bfe\u8c61\u3068\u306a\u308b\u60a3\u8005\u3055\u3093\u306b\u306f\u6cbb\u7642\u671f\u9593\u77ed\u7e2e\u306e\u305f\u3081\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u30921\u9031\u9593\u3067\u7d42\u3048\u308b\u3068\u3044\u3046\u7d50\u8ad6\u3067\u3059\u3002<\/p>\n<h4 align=\"left\">\u30d0\u30eb\u30ac\u30f3\u30b7\u30af\u30ed\u30d3\u30eb<\/h4>\n<p align=\"left\">S\u00f6derberg-Naucl\u00e9r, et al.:\u00a0Survival in Patients with Glioblastoma Receiving Valganciclovir. N Engl J Med 369: 985-986, 2013<br \/>\n\u30ab\u30ed\u30ea\u30f3\u30b9\u30ab\u5927\u5b66\u304b\u3089\u306e\u5831\u544a\u3067\u306f\uff0c\u307b\u307c\u5168\u3066\u306e\u81a0\u82bd\u816b 99% \u306b\u30b5\u30a4\u30c8\u30e1\u30ac\u30ed\u30a6\u30a3\u30eb\u30b9 CMV\u306e\u611f\u67d3\u306e\u75d5\u8de1 CMV atigen \u304c\u3042\u308b\u305d\u3046\u3067\u3059\u3002\u5f37\u3044\u611f\u67d3\u304c\u307f\u3089\u308c\u308b\u81a0\u82bd\u816b\u306e\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f13\u30f6\u6708\uff0c\u5f31\u3044\u611f\u67d3\u4f8b\u3067\u306f33\u30f6\u6708\u3067\u3059\u3002\u30b5\u30a4\u30c8\u30e1\u30ac\u30ed\u30a6\u30a3\u30eb\u30b9\u306e\u6cbb\u7642\u85ac\u3067\u3042\u308b Valganciclovir\uff08\u30d0\u30eb\u30ac\u30f3\uff0c\u6297\u30a6\u30a3\u30eb\u30b9\u85ac\uff09\u3092\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093\u306b\u6295\u4e0e\u3057\u305f\u3089\uff0c\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u304c25\u30f6\u6708\u3067\u3042\u3063\u305f\u3068\u5831\u544a\u3055\u308c\u307e\u3057\u305f\u3002\u975e\u5e38\u306b\u6a29\u5a01\u3042\u308b\u79d1\u5b66\u8a8c\u306b\u3073\u3063\u304f\u308a\u3059\u308b\u307b\u3069\u3059\u3070\u3089\u3057\u3044\u6cbb\u7642\u6210\u7e3e\u304c\u767a\u8868\u3055\u308c\u305f\u3068\u8a00\u3048\u307e\u3059\u3002<br \/>\n\u3067\u3059\u304c\uff0c\u3059\u3050\u306b\u53cd\u8ad6\u304c\u3042\u308a\u307e\u3057\u305f\u3002Hellstrand K\u3089\u306f\uff0cCMV antigen\u304c\u691c\u51fa\u3055\u308c\u305f\u3068\u3057\u3066\u3082\uff0c\u307b\u307c\u5168\u3066\u306e\u81a0\u82bd\u816b\u3067CMV\u304creplicate\u3057\u3066\u3044\u306a\u3044\u3068\u8a00\u3044\u307e\u3059\u3002Valganciclovir\u306fCMV\u306ereplecate\u3092\u963b\u5bb3\u3059\u308b\u85ac\u5264\u3067\u3059\u304b\u3089\uff0creplecate\u304c\u306a\u3044\u3068\u3059\u308c\u3070\u52b9\u304b\u306a\u3044\u306f\u305a\u3067\u3059\uff1f\uff1f<br \/>\nCMV\u306f\u81a0\u82bd\u816b\u306e\u767a\u751f\u539f\u56e0\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u304c\uff0c\u5897\u6b96\u3092\u4fc3\u3059\u3088\u3046\u306a\u4f55\u304b\u306e\u50cd\u304d (possible oncomodulatory role)\u3092\u3057\u3066\u3044\u308b\u306e\u3067\u306f\u306a\u3044\u304b\u3068\u63a8\u5b9a\u3055\u308c\u3066\u3044\u307e\u3059\u3002Valganciclovir\u306e\u81e8\u5e8a\u7684\u306a\u6709\u7528\u6027\u306f\u78ba\u8a8d\u3055\u308c\u306a\u3044\u307e\u307e\u3067\u3059\u3002<\/p>\n<h4>\u518d\u767a\u306b\u5bfe\u3059\u308b\u30ed\u30e0\u30b9\u30c1\u30f3 CCNU \u306e\u52b9\u679c<\/h4>\n<p>Batchelor TT, et al. Phase III randomized trial comparing the efficacy of cediranib as monotherapy, and in combination with lomustine, versus lomustine alone in patients with recurrent glioblastoma. J Clin Oncol 2013<br \/>\nVEGFR-1,2,3\u306b\u5bfe\u3059\u308b\u7d4c\u53e3\u963b\u5bb3\u5264cediranib\u3068CCNU\uff08\u30ed\u30e0\u30b9\u30c1\u30f3\uff09\u306e\u4f75\u7528\u52b9\u679c\u3092\u8a66\u3057\u305f\u7b2c\uff13\u76f8\u8a66\u9a13\u3067\u3059\u3002\u518d\u767a\u81a0\u82bd\u816b325\u4f8b\u306e\u5927\u898f\u6a21\u8a66\u9a13\u3067\u3059\u3002cediranib\u306e\u6709\u52b9\u6027\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u30ed\u30e0\u30b9\u30c1\u30f3\u6295\u4e0e\u306b\u3088\u308b6\u30f6\u6708PFS\u306f15-25%\u3068\u8a55\u4fa1\u3055\u308c\u3066\u3044\u307e\u3059\u30025\u4eba\u306b\u4e00\u4eba\u304f\u3089\u3044\u306e\u60a3\u8005\u3055\u3093\u304c\u30ed\u30e0\u30b9\u30c1\u30f3\u306b\u3088\u3063\u3066\u6570\u30f6\u6708\u306e\u5bdb\u89e3\u5ef6\u9577\u304c\u3042\u308b\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/p>\n<h4>60\u6b73\u4ee5\u4e0a\u306e\u81a0\u82bd\u816b\u60a3\u8005\u3055\u3093\u3078\u306e\u6cbb\u7642<\/h4>\n<p>Maimstrom A, et al.: Temozolomide versus standard 6-week radiotherapy versus hypofractionated radiotherapy in patients with glioblastoma: Nordic randomized, phase 3 trial. Lancet Oncol 13; Epub, 2012<br \/>\n\u30e8\u30fc\u30ed\u30c3\u30d1\u3067\u306e\u5171\u540c\u7814\u7a76\u3067\u3059\u300260\u6b73\u4ee5\u4e0a\u306e\u81a0\u82bd\u816b\u60a3\u8005\u3055\u3093291\u4eba\u304c\uff0c\u30c6\u30e2\u30c0\u30fc\u30eb\u5358\u72ec\u6cbb\u7642(200mg\/m2, days 1-5 of every 28 days) \uff0c\u4f4e\u5206\u5272\u7167\u5c04(34 Gy in 3.4 Gy fractions over 2 weeks), \u6a19\u6e96\u7684\u7167\u5c04 (60 Gy in 2 Gy fractions over 6 weeks)\u306e\u3044\u305a\u308c\u304b\u306e\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u305d\u308c\u305e\u308c\u306e\u751f\u5b58\u671f\u9593\u306f8.3\u30f6\u6708\uff0c7.5\u30f6\u6708\uff0c6\u30f6\u6708\u3067\u3057\u305f\u300270\u6b73\u4ee5\u4e0a\u306b\u9650\u3063\u3066\u3082\u540c\u69d8\u306e\u50be\u5411\u3067\u3042\u3063\u305f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002MGMT promotor methylation\u304c\u3042\u3063\u305f\u60a3\u8005\u3055\u3093\u3067\u7279\u306b\u30c6\u30e2\u30c0\u30fc\u30eb\u306e\u6709\u52b9\u6027\u306f\u826f\u597d\u3067\u3057\u305f\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0c<span style=\"color: #ff0000;\"><strong>\u7279\u306b70\u6b73\u4ee5\u4e0a\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\u6a19\u6e96\u7684\u306a60\u30b0\u30ec\u30a4\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u3079\u304d\u3067\u306a\u3044<\/strong><\/span>\u3068\u3057\u3066\u3044\u307e\u3059\u3002\u305d\u306e\u65b9\u304c\u4f59\u547d\u304c\u6709\u610f\u306b\u77ed\u304f\u306a\u308b\u304b\u3089\u3067\u3059\u3002\u3053\u306e\u8ad6\u6587\u306e\u30a4\u30f3\u30d1\u30af\u30c8\u306f\u5927\u304d\u3044\u3068\u8a00\u3048\u307e\u3059\u3002<br \/>\n<strong><span style=\"color: #000080;\">\u75c5\u7406\u8a3a\u65ad\u3067MGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u304c\u3042\u308b\u9ad8\u9f62\u8005\u306f\u30c6\u30e2\u30c0\u30fc\u30eb\u6cbb\u7642<\/span><br \/>\n<span style=\"color: #000080;\"> \u305d\u3046\u3067\u306a\u3051\u308c\u307034\u30b0\u30ec\u30a410\u5206\u5272\u3092\u6a19\u6e96\u7684\u306a\u6cbb\u7642\u30aa\u30d7\u30b7\u30e7\u30f3\u3068\u3059\u308b\u3079\u304d<\/span><br \/>\n<\/strong>\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/p>\n<h4>65\u6b73\u4ee5\u4e0a\u306e\u81a0\u82bd\u816b\u60a3\u8005\u3055\u3093\u306e\u6cbb\u7642\uff1aMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u3067\u9078\u629e\u3059\u308b<\/h4>\n<p>Wick W, et al.: Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomized, phase 3 trial. Lancet Oncol 13; 707-715, 2012<br \/>\n65\u6b73\u4ee5\u4e0a\u306e\u60a3\u8005\u3055\u3093\uff08\u81a0\u82bd\u816b\u3068\u9000\u5f62\u6210\u6027\u661f\u7d30\u80de\u816b\uff09373\u4eba\u304c\uff0c\u30c6\u30e2\u30c0\u30fc\u30eb\u5358\u72ec\u6cbb\u7642(100mg\/m2, days 1-7\/week, 1 week off cycles) \u3042\u308b\u3044\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u5358\u72ec\u6cbb\u7642(60Gy\/30fr)\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u7fa4\u306e\u5168\u751f\u5b58\u671f\u9593\u306f8.6\u30f6\u6708\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u7fa4\u306e\u60a3\u8005\u3055\u3093\u306f9.6\u30f6\u6708\u3067\u3057\u305f\u3002\u9aa8\u9ac4\u6291\u5236\u306a\u3069\u306e\u526f\u4f5c\u7528\u306f\u30c6\u30e2\u30c0\u30fc\u30eb\u7fa4\u3067\u660e\u3089\u304b\u306b\u591a\u304b\u3063\u305f\u3068\u8a18\u8f09\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u8457\u8005\u306f\uff0c<span style=\"color: #ff0000;\"><strong>MGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u304c\u3042\u308c\u3070\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5358\u72ec\u6cbb\u7642\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u52a3\u308b\u3082\u306e\u3067\u306f\u306a\u3044<\/strong><\/span>\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002MGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306e\u3042\u308b\u9ad8\u9f62\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3067\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9(\uff15\u65e5\u9593\u6295\u4e0e\uff09\u309212\u30f6\u6708\u6295\u4e0e\u3057\u307e\u3059\u304c\uff0c\u305d\u308c\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u6210\u7e3e\u306f\u5909\u308f\u3089\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3092\u5831\u544a\u3057\u305f\u8ad6\u6587\u3067\u3059\u3002<\/p>\n<h4>\u518d\u767a\u81a0\u82bd\u816b\u306e\u518d\u624b\u8853\u306f\u306f\u3063\u304d\u308a\u3057\u305f\u5229\u76ca\u304c\u4e88\u60f3\u3055\u308c\u308b\u6642\u3060\u3051\u306b\u884c\u3046<\/h4>\n<p>Clarke JL, et al.: Is surgery at progression a prognostic marker for improved 6-month progression-free survival or overall survival for patients with recurrent glioblastoma? Neuro Oncol 13: 2011<br \/>\n\u5317\u7c73\u30671998\u5e74\u304b\u30892008\u5e74\u306b\u6cbb\u7642\u3055\u308c\u305f758\u4eba\u306e\u518d\u767a\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093\u304c\u7d71\u8a08\u5b66\u7684\u306b\u89e3\u6790\u3055\u308c\u307e\u3057\u305f\u3002\u7d50\u679c\u3068\u3057\u3066\uff0c\u518d\u767a\u306e\u6642\u306b\u816b\u760d\u306e\u6458\u51fa\u8853\u3092\u53d7\u3051\u3066\u3082\u53d7\u3051\u306a\u304f\u3066\u3082\uff0c6\u30f6\u6708\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u3068\u5168\u751f\u5b58\u5272\u5408\u306f\u5909\u308f\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<span style=\"color: #000080;\"><strong>\u518d\u624b\u8853\u3092\u3059\u308b\u3053\u3068\u306b\u3088\u3063\u3066\u816b\u760d\u306e\u5236\u5fa1\u3082\u5ef6\u547d\u3082\u5f97\u3089\u308c\u306a\u3044\u3068\u3044\u3046\u7d50\u8ad6\u3067\u3059<\/strong><\/span>\u3002<br \/>\n\u300c\u89e3\u8aac\u300d<span style=\"color: #000080;\"><strong>\u518d\u767a\u3057\u305f\u81a0\u82bd\u816b\u306b\u518d\u958b\u982d\u624b\u8853\u3092\u3059\u308b\u610f\u7fa9\u306f\u4f4e\u3044<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u65e5\u672c\u3067\u306f\u518d\u767a\u81a0\u82bd\u816b\u306b\u5bfe\u3059\u308b\u624b\u8853\u306e\u983b\u5ea6\u304c\u9ad8\u3059\u304e\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u306e\u3067\u8b66\u544a\u3068\u3057\u3066\u6349\u3048\u308b\u3079\u304d\u3067\u3057\u3087\u3046\u3002\u3057\u304b\u3057\uff0c\u5168\u3066\u306e\u60a3\u8005\u3055\u3093\u306b\u518d\u624b\u8853\u306f\u7121\u52b9\u3068\u3044\u3046\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u4e2d\u306b\u306f\u518d\u767a\u3057\u305f\u816b\u760d\u306e\u5927\u90e8\u5206\u304c\u5b89\u5168\u306b\u6458\u51fa\u3067\u304d\u3066\uff0c\u305d\u306e\u518d\u624b\u8853\u3092\u3059\u308b\u3053\u3068\u306b\u3088\u3063\u3066\u5316\u5b66\u7642\u6cd5\u3092\u52a0\u3048\u308b\u6642\u9593\u7684\u4f59\u88d5\u304c\u3067\u304d\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002 \u3067\u3082\uff0c<span style=\"color: #000080;\"><strong>\u518d\u624b\u8853\u306f\u60a3\u8005\u3055\u3093\u306b\u3068\u3063\u3066\u660e\u3089\u304b\u306b\u5229\u76ca\u304c\u3042\u308b\u3068\u4e88\u60f3\u3067\u304d\u305f\u6642\u306e\u307f\u306b\u884c\u306a\u3046\u3079\u304d<\/strong><\/span>\u3053\u3068\u3067\u3059\u3002\u305d\u306e\u5f8c2014\u5e74\uff0c\u540c\u3058\u96d1\u8a8c\u306b\u30a4\u30bf\u30ea\u30a2\u306eNava F.\u304c764\u4f8b\u306e\u89e3\u6790\u7d50\u679c\u3092\u767a\u8868\u3057\u307e\u3057\u305f\u304c\uff0c\u518d\u767a\u306b\u5bfe\u3059\u308b\u518d\u624b\u8853\u306f\u751f\u5b58\u306b\u5bc4\u4e0e\u3057\u306a\u304b\u3063\u305f\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4>\u518d\u767a\u81a0\u82bd\u816b\u3078\u30a2\u30d0\u30b9\u30c1\u30f3\u306e\u52b9\u679c<\/h4>\n<p>Friedman HS, et al. Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. J Clin Oncol 27:4733\u201340, 2009<br \/>\n2009\u5e74Friedman\u3089\u306b\u3088\u3063\u3066\uff0c\u518d\u767a\u306e\u81a0\u82bd\u816b\u306b\u30a2\u30d0\u30b9\u30c1\u30f3\u3092\u5358\u72ec\u3067\u4f7f\u7528\u3057\u305f\u5834\u5408\u306b\uff0c6\u30f6\u6708\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u304c42.6%\u3067\u3042\u308b\u3068\u5831\u544a\u3055\u308c\u307e\u3057\u305f\u3002\u3053\u308c\u306f\uff0c\u76f4\u63a5\u7684\u306a\u816b\u760d\u5897\u6b96\u6291\u5236\u306e\u307f\u306a\u3089\u305a\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306epseudoprogression\u306e\u6539\u5584\u3068\u3044\u3046\u753b\u50cf\u6240\u898b\u3092\u542b\u3093\u3060\u8a55\u4fa1 (pseudoresponse) \u3067\u3057\u3087\u3046\u3057\uff0c\u826f\u3059\u304e\u308b\u6210\u7e3e\u3067\u3059\u3002\u3057\u304b\u3057\uff0c<strong><span style=\"color: #000080;\">\u518d\u767a\u3057\u305f\u81a0\u82bd\u816b\u306e\u81e8\u5e8a\u7684\u5897\u60aa\u3092\u30a2\u30d0\u30b9\u30c1\u30f3\u304c\u4e00\u5b9a\u671f\u9593\u6291\u3048\u308b<\/span><\/strong>\u3068\u3044\u3046\u306e\u306f\u660e\u3089\u304b\u306a\u4e8b\u5b9f\u3068\u306a\u308a\u307e\u3057\u305f\u3002<br \/>\n\u305d\u306e\u5f8c\u306e\u5831\u544a\u3092\u9451\u307f\u3066\uff0c\u60a3\u8005\u3055\u3093\u5074\u304b\u3089\u306f\u518d\u767a\u306e\u81a0\u82bd\u816b\u306b\u30a2\u30d0\u30b9\u30c1\u30f3\u3092\u5358\u72ec\u3067\u4f7f\u7528\u3057\u305f\u5834\u5408\u306b\u306f\uff0c4\u5272\u304f\u3089\u3044\u306e\u78ba\u7387\uff084\/10\u304f\u3089\u3044\u306e\u60a3\u8005\u3055\u3093\uff09\u3067\u6570\u30f6\u6708\u9593\u306f\u9032\u884c\u3092\u6291\u5236\u3067\u304d\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u3068\u8003\u3048\u3066\u304f\u3060\u3055\u3044\u3002<\/p>\n<h3 class=\"style2\"><a href=\"\/sawamura\/blog\/glioma\/childglioblastoma\/\"><span style=\"color: #000080;\">\u5c0f\u5150\u306e\u81a0\u82bd\u816b\u306f\u5225\u30da\u30fc\u30b8\u306b\u3042\u308b\u306e\u3067\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af<\/span><\/a><\/h3>\n<p>&nbsp;<\/p>\n<hr \/>\n<p style=\"text-align: center;\"><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/owlgliob.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-1731\" title=\"owlgliob\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/owlgliob.jpg\" alt=\"\" width=\"561\" height=\"709\" \/><\/a><\/p>\n<h4><strong>20\u5e74\u4ee5\u4e0a \u751f\u5b58\u3057\u305f\u3068\u3044\u3046\u60a3\u8005\u3055\u3093\u304b\u3089\u306e\u624b\u7d19<\/strong><\/h4>\n<p>\u8d85\u9577\u671f\u751f\u5b58\u8005\u304c\u3044\u308b\u304b\u3069\u3046\u304b\u3068\u3044\u3046\u3053\u3068\u304c\u5b66\u4f1a\u3067\u8b70\u8ad6\u306b\u306a\u308a\u307e\u3059\u30022000\u5e74\u9803\u306b\u8133\u816b\u760d\u5b66\u4f1a\u306710\u5e74\u4ee5\u4e0a\u751f\u5b58\u3057\u3066\u3044\u308b\u60a3\u8005\u3055\u3093\u3092\u8abf\u67fb\u3057\u305f\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u7d50\u5c40\u898b\u3064\u304b\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u75c5\u7406\u8a3a\u65ad\u3092\u898b\u76f4\u3057\u305f\u3089\u5b9f\u306f\u81a0\u82bd\u816b\u3067\u306f\u306a\u304b\u3063\u305f\u3068\u304b\u3067\u3059\u3002<br \/>\n\u4e0b\u306e\u75c5\u7406\u5199\u771f\u306f\uff0c\u3042\u308b\u60a3\u8005\u3055\u3093\u304b\u3089\u79c1\u306b\u9001\u3089\u308c\u305f\u3082\u306e\u3067\u3059\u300220\u4ee3\u3067\u524d\u982d\u8449\u306e\u81a0\u82bd\u816b\u306b\u306a\u3063\u3066\u304b\u308921\u5e74\u7d4c\u3063\u3066\u751f\u5b58\u3057\u3066\u304a\u3089\u308c\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u30022\u5ea6\u306e\u958b\u982d\u8853\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u5316\u5b66\u7642\u6cd5\uff08\u8907\u6570\u56de\uff09\u3092\u53d7\u3051\u3066\u304a\u3089\u308c\u307e\u3059\u3002\u60a3\u8005\u3055\u3093\u306b\u75c5\u7406\u8a3a\u65ad\u304c\u9593\u9055\u3063\u3066\u3044\u308b\u306e\u3067\u306f\u306a\u3044\u304b\u3068\u8fd4\u4e8b\u3092\u3057\u305f\u3089\uff0c\u4e0b\u306b\u3042\u308b\u753b\u50cf\u3092\u9001\u3063\u3066\u304f\u3060\u3055\u3044\u307e\u3057\u305f\u3002\u75c5\u7406\u8a3a\u65ad\u306f\uff0c\u4e00\u898b\u3057\u305f\u3068\u3053\u308d\u306f\u591a\u5f62\u81a0\u82bd\u816b \u30b0\u30ea\u30d6\u30e9\u306b\u9593\u9055\u3044\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u3067\u3082\uff0c\u30fc\u30fc\u30fc<br \/>\n\uff08\u4e0b\u306e\u753b\u50cf\u306f\u60a3\u8005\u3055\u3093\u306e\u8a31\u53ef\u3092\u5f97\u3066\u63b2\u8f09\u3055\u305b\u3066\u3044\u305f\u3060\u304d\u307e\u3057\u305f\uff09<\/p>\n<p><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm20years2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-large wp-image-2980\" title=\"gbm20years\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm20years2-550x381.jpg\" alt=\"\" width=\"550\" height=\"381\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm20years2-550x381.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm20years2-300x208.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/gbm20years2.jpg 800w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/a><\/p>\n<p><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATendvas.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-2985\" title=\"ATendvas\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATendvas-300x273.jpg\" alt=\"\" width=\"300\" height=\"273\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATendvas-300x273.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATendvas.jpg 528w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATki67.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-2986\" title=\"ATki67\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATki67-300x293.jpg\" alt=\"\" width=\"300\" height=\"293\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATki67-300x293.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATki67-550x537.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATki67.jpg 643w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>bizarre! \u7570\u69d8\u306a\u7d30\u80de\u304c\u6df7\u5728\u3057\u3066\u3044\u307e\u3059\u3002\u6838\u591a\u578b\u304c\u76ee\u7acb\u3061\uff0c\u591a\u6838\u5de8\u7d30\u80de\u3082\u6df7\u3058\u308b\u5178\u578b\u7684\u306a\u81a0\u82bd\u816b\u306e\u50cf\u3067\u3059\u3002\u4e0b\u306e\u5de6\u306e\u753b\u50cf\u306f\u8840\u7ba1\u5185\u76ae\u306e\u80a5\u539a endovascular proliferation\u304c\u3042\u308a\uff0c\u4e0b\u306e\u53f3\u306eKi-67\u67d3\u8272\u3067\u306f\u6838\u6fc3\u67d3\u50cf\u304c\u591a\u304f\u6838\u5206\u88c2\u80fd\u304c\u9ad8\u3044\u3053\u3068\u3092\u793a\u3057\u307e\u3059\u3002\u3057\u304b\u3057\uff0c&#8212;&#8212;<\/p>\n<p><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATgfap.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-2987\" title=\"ATgfap\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATgfap-300x280.jpg\" alt=\"\" width=\"300\" height=\"280\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATgfap-300x280.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATgfap-550x514.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATgfap.jpg 654w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATvasc.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-2988\" title=\"ATvasc\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATvasc-300x293.jpg\" alt=\"\" width=\"300\" height=\"293\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATvasc-300x293.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATvasc-550x538.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATvasc.jpg 645w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u5de6\u306eGFAP\u67d3\u8272\u3067\u306f\u4e00\u90e8\u306e\u7d30\u80de\u304c\u67d3\u8272\u3055\u308c\u307e\u305b\u3093\uff0c\u53f3\u306eHE\u67d3\u8272\u3067\u306f\u8c4a\u5bcc\u306a\u8840\u7ba1\u5897\u6b96\u306e\u9593\u306b\u7a7a\u7832 perinuclear halo \u3092\u6709\u3057\u305f\u7d30\u80de\u5897\u6b96\u304c\u898b\u3089\u308c\u307e\u3059\u3002\u3055\u3089\u306b\uff0c&#8211;<\/p>\n<p><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/AToligcom.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-2989\" title=\"AToligcom\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/AToligcom-300x297.jpg\" alt=\"\" width=\"300\" height=\"297\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/AToligcom-300x297.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/AToligcom-550x546.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/AToligcom.jpg 688w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATperiph.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-2990\" title=\"ATperiph\" src=\"\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATperiph-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATperiph-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATperiph-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATperiph-550x549.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-content\/uploads\/2013\/01\/ATperiph.jpg 704w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u816b\u760d\u306e\u90e8\u5206\u50cf\u3068\u3057\u3066\u660e\u3089\u304b\u306b\u4e4f\u7a81\u8d77\u81a0\u816b\u304c\u6df7\u5728\u3057\u3066\u3044\u307e\u3059\u3002\u307e\u305f\uff0c\u3069\u306e\u90e8\u5206\u3092\u307f\u3066\u3082\u58ca\u6b7b necrosis\u304c\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n<p>\u5f93\u3063\u3066\uff0c\u5f53\u6642\u306e\u8a3a\u65ad\u3067\u306f\uff0c\u3053\u306e\u816b\u760d\u306e\u5f62\u614b\u75c5\u7406\u8a3a\u65ad\u306f\uff0c<span style=\"color: #000080;\"><strong>\u9000\u5f62\u6210\u6027\u4e4f\u7a81\u8d77\u661f\u7d30\u80de\u816b anaplastic oligoastrocytoma WHO grade III\u00a0<\/strong><\/span>\u3068\u306a\u308a\u307e\u3059\u30022018\u5e74\u6642\u70b9\u3067\u306f\uff0c\u3082\u3057iDH\u5909\u7570\u304c\u3042\u3063\u305f\u3068\u4eee\u5b9a\u3059\u308b\u3068\uff0csecondary glioblastoma (IDH-mutated glioblastoma)\u3068\u3055\u308c\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002<\/p>\n<h4>\u307e\u3081\u77e5\u8b58\uff08\u8853\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3068\uff09<\/h4>\n<p>\u6642\u306f1978\u5e74\uff0c\u79c1\u304c\u8133\u795e\u7d4c\u5916\u79d1\u533b\u306b\u306a\u308d\u3046\u304b\u306a\u3068\u8ff7\u3063\u3066\u3044\u305f\u9803\u306b\u9061\u308a\u307e\u3059\u3002Anderson AP\u5148\u751f\u304c\uff0c108\u4eba\u306e\u81a0\u82bd\u816b\u306e\u60a3\u8005\u3055\u3093\u3092\uff0c\u624b\u8853\u3060\u3051\u306e\u7fa4\uff0c\u624b\u8853\u3068\u653e\u5c04\u7dda\u3067\u6cbb\u7642\u3059\u308b\u7fa4\u306b\u5206\u3051\u307e\u3057\u305f\u3002\uff11\u5e74\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u305f\u60a3\u8005\u3055\u3093\u306e19%\u304c\u751f\u5b58\u3057\u3066\u3044\u307e\u3057\u305f\u304c\uff0c\u53d7\u3051\u306a\u304b\u3063\u305f\u60a3\u8005\u3055\u3093\u306f\u5168\u54e1\u304c\u4ea1\u304f\u306a\u3063\u3066\u3044\u307e\u3057\u305f\u3002(Acta Radiol Oncol Radiat Phys Biol. 17: 475-484, 1978)<br \/>\n\u5f53\u6642\u306f\u624b\u8853\u3057\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u3057\u3066\u3082\uff11\u5e74\u9593\u751f\u304d\u5ef6\u3073\u3089\u308c\u306a\u304b\u3063\u305f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u307e\u305f\uff0c\u624b\u8853\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3067\u304d\u306a\u3044\u6642\u306b\u306f\uff0c\u81a0\u82bd\u816b\u306e\u958b\u982d\u624b\u8853\u306b\u307b\u3068\u3093\u3069\u610f\u5473\u304c\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3092\u660e\u3089\u304b\u306b\u3057\u305f\u6b74\u53f2\u7684\u306a\u8ad6\u6587\u3067\u3059\u3002<\/p>\n<h4>\u307e\u3081\u77e5\u8b58\uff08BCNU\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u52b9\u679c\uff09<\/h4>\n<p align=\"left\"><strong><span style=\"color: #ff0000;\">Walker MD<\/span><\/strong>, et al.: Evaluation of BCNU and\/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg 49: 333-343, 1978<br \/>\nWalker MD, et al.: Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med. 303: 1323-1329, 1980<br \/>\n1970\u5e74\u304b\u308980\u5e74\u4ee3\u306b\u304b\u3051\u3066\uff0cWalker\u535a\u58eb\u304c\u30b0\u30ea\u30aa\u30fc\u30de\u306e\u88dc\u52a9\u7642\u6cd5\u306e\u7814\u7a76\u3067\u4e16\u754c\u3092\u30ea\u30fc\u30c9\u3057\u3066\u3044\u307e\u3057\u305f\u3002 \u5927\u898f\u6a21\u7121\u4f5c\u70ba\u81e8\u5e8a\u8a66\u9a13 prospective randomized study\u3068\u3044\u3046\u7d71\u8a08\u5b66\u3092\u5fdc\u7528\u3059\u308b\u79d1\u5b66\u7684\u306a\u7814\u7a76\u3067\u3059\u3002\u3053\u306e\u9803\u306e\u65e5\u672c\u3067\u306f\uff0c\u7814\u7a76\u306e\u6982\u5ff5\u3055\u3048\u3082\u7406\u89e3\u3055\u308c\u3066\u3044\u307e\u305b\u3093\u3067\u3057\u305f \uff08\uff4f_\uff4f ;\uff09<br \/>\n<strong><span style=\"color: #ff0000;\">BCNU \u30ab\u30eb\u30e0\u30b9\u30c1\u30f3<\/span><\/strong>\u3068\u3044\u3046\u6297\u304c\u3093\u5264\u304c\u6709\u52b9\u3067\u3042\u308d\u3046\u3068\u3044\u3046\u4eee\u8aac\u306e\u3082\u3068\u306b\u306a\u3055\u308c\u305f\u7814\u7a76\u3067\u3057\u305f\u304c\uff0c\u7d50\u679c\u7684\u306bBCNU\u306e\u6709\u52b9\u6027\u306f\u7d71\u8a08\u5b66\u7684\u306b\u306f\u8a3c\u660e\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u8ad6\u6587\u4e2d\u3067\u306fBCNU\u304c\u6709\u52b9\u304b\u3082\u3057\u308c\u306a\u3044\u3068\u3044\u3046\u7d50\u8ad6\u306e\u66f8\u304d\u65b9\u3067\uff0cBCNU\u304c\u3053\u306e\u5f8c\u3082\u9577\u304d\u306b\u308f\u305f\u308a\u4f7f\u7528\u3055\u308c\u308b\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u4e00\u65b9\u3067\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u7d71\u8a08\u5b66\u7684\u306b\u6709\u610f\u306a\u6709\u52b9\u6027\u3092\u793a\u3057\u307e\u3057\u305f\u3002<br \/>\n1980\u5e74\u4ee3\u306e\u5f8c\u534a\u306b\uff0c\u540c\u69d8\u306e\u7814\u7a76\u3092\u7c73\u56fd\u3067\u3057\u3066\u3044\u305fLevin\u535a\u58eb\u304c\u30e8\u30fc\u30ed\u30c3\u30d1\u3067\u516c\u6f14\u3057\u305f\u6642\u306b\uff0c&#8221;Chemotherapy is useless\u00a0for glioma.&#8221;\u3000\u300c\u30b0\u30ea\u30aa\u30fc\u30de\u306b\u5316\u5b66\u7642\u6cd5\u306f\u5f79\u306b\u7acb\u305f\u306a\u3044\u300d\u3068\u767a\u8a00\u3057\u305f\u306e\u3092\u805e\u3044\u3066\u9a5a\u3044\u305f\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n<h4 align=\"left\">\u307e\u3081\u77e5\u8b58\uff08\u767a\u751f\u8981\u56e0\u306f\uff1f\uff09<\/h4>\n<ul>\n<li>\u7c73\u56fd\u3067\uff0c10\u4e07\u4eba\u3042\u305f\u308a3\u4eba\u306e\u767a\u751f\u7387\u3067\u3059<\/li>\n<li>\u767d\u4eba\u306b\u306f\u9ed2\u4eba\u306e2\u500d\u304f\u3089\u3044\u306e\u767a\u751f\u3059\u308b\u3068\u3055\u308c\u307e\u3059\uff0c\u30a2\u30b8\u30a2\u7cfb\u306f\u767d\u4eba\u3088\u308a\u5c11\u3057\u4f4e\u3044<\/li>\n<li>\u7537\u6027\u306f\u5973\u6027\u306e1.5\u500d\u304f\u3089\u3044\u306e\u767a\u751f\u7387\u3067\u3059<\/li>\n<li>\u9ad8\u9f62\u8005\u306b\u591a\u3044\u306e\u3067\uff0c\u8001\u5e74\u4eba\u53e3\u306e\u5897\u52a0\u306b\u3088\u3063\u3066\u767a\u751f\u6570\u304c\u5897\u3048\u307e\u3059<\/li>\n<li>\u30ea\u30b9\u30af\u56e0\u5b50\u306f\uff0c\u8133\u3078\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u4ee5\u5916\u306b\u306f\u77e5\u3089\u308c\u3066\u3044\u307e\u305b\u3093<\/li>\n<li>\u74b0\u5883\u56e0\u5b50\u306f\u7121\u95a2\u4fc2\u3067\u3059<\/li>\n<li>\u907a\u4f1d\u7d20\u56e0\u306f\uff0cLynch\u75c7\u5019\u7fa4 (<em>MSH2, MLH1, MSH6<\/em>, and <em>PMS2<\/em>) \u3068Li-Fraumeni\u75c7\u5019\u7fa4 (<em>TP53)<\/em>\u3067\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u6bcd\u5b50\uff0c\u89aa\u5b50\u3067\u907a\u4f1d\u3059\u308b\u3068\u306f\u8003\u3048\u307e\u305b\u3093<\/li>\n<\/ul>\n<h4>\u307e\u3081\u77e5\u8b58\uff08\u653e\u5c04\u7dda\u8a98\u767a\u81a0\u82bd\u816b\u3000radiation-induced gliblastoma\uff09<\/h4>\n<ul>\n<li>\u653e\u5c04\u7dda\u3092\u6d74\u3073\u308b\u3068\u69d8\u3005\u306a\u30ac\u30f3\u304c\u767a\u751f\u3059\u308b\u3053\u3068\u306f\u77e5\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u81a0\u82bd\u816b\u3082\u88ab\u66dd ionizing radiaiton \u306b\u3088\u3063\u3066\u767a\u751f\u3057\u3046\u308b\u816b\u760d\u3067\u3059<\/li>\n<li>\u3067\u3082\u6bd4\u8f03\u7684\u5927\u304d\u306a\u7dda\u91cf\u3067\uff0c30\u30b0\u30ec\u30a4\u4ee5\u4e0a\u304c\u8a98\u767a\u7dda\u91cf\u3068\u3055\u308c\u307e\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\uff0c\u6570\u5e74\u5f8c\u304b\u308930\u5e74\u304f\u3089\u3044\u5f8c\u3067\u767a\u751f\u3057\u307e\u3059<\/li>\n<li>\u5c0f\u5150\u8133\u816b\u760d\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306e\uff12\u6b21\u304c\u3093\u3068\u3057\u3066\u81a0\u82bd\u816b\u306f\u591a\u3044\u3082\u306e\u3067\u3059<\/li>\n<li>\u907a\u4f1d\u5b50\u7570\u5e38\u306f\u901a\u5e38\u306e\u81a0\u82bd\u816b\u3068\u5909\u308f\u308a\u307e\u305b\u3093\u3057\uff0c\u6cbb\u7642\u6cd5\u3082\u540c\u3058\u3067\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u4e88\u5f8c\u306f\u901a\u5e38\u306e\u81a0\u82bd\u816b\u3088\u308a\u60aa\u3044\u3082\u306e\u3067\u3059\uff0c\u306a\u305c\u306a\u3089\u3059\u3067\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3055\u308c\u305f\u60a3\u8005\u3055\u3093\u306b\u767a\u751f\u3059\u308b\u306e\u3067\uff0c\u5341\u5206\u306a\u518d\u7167\u5c04\u304c\u3067\u304d\u306a\u3044\u3053\u3068\u304c\u591a\u304b\u3063\u305f\u308a\uff0c\u767a\u751f\u90e8\u4f4d\u304c\u8133\u5e79\u90e8\u3067\u3042\u3063\u305f\u308a\u3059\u308b\u304b\u3089\u3067\u3059<\/li>\n<\/ul>\n<h4>\u5c06\u6765\u306e\u3053\u3068\u3067\u3059\u304c\uff0c\u81a0\u82bd\u816b\u3092\u6cbb\u3059\u305f\u3081\u306e\u30ad\u30fc\u30ef\u30fc\u30c9<\/h4>\n<p><span style=\"color: #000080;\"><strong>\u81a0\u82bd\u816b GBM \u306e\u6700\u5927\u306e\u7279\u5fb4\u306f\uff0c\u816b\u760d\u7d30\u80de\u306e\u9ad8\u3044\u6d78\u6f64\u80fd invasion \u3067\u3059<\/strong><\/span><\/p>\n<ul>\n<li>\u79c1\u306e\u5e2b\u5320\u306b\u3042\u305f\u308bDr. Nicolas de Tribolet\u306f\uff0cGBM\u306f\u5168\u8133\u306e\u75c5\u6c17\u3067\u3042\u308b\u3068\u3044\u3044\u307e\u3057\u305f\u3002\u5f7c\u304c\u8a00\u308f\u3093\u3068\u3057\u3066\u3044\u308b\u3053\u3068\u306f\uff0cGBM\u3092\u5c40\u6240\u306e\u816b\u760d\u3068\u3057\u3066\u6349\u3048\u3066\u306f\u3044\u3051\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u7c21\u5358\u306b\u8a00\u3048\u3070\uff0cMRI\u753b\u50cf\u3067\u307f\u3048\u308b\u3068\u3053\u308d\u3092\u6458\u51fa\u3082\u6c7a\u3057\u3066\u6cbb\u308b\u75c5\u6c17\u3067\u306f\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/li>\n<li>\u305d\u306e\u3068\u304a\u308a\u3067\uff0c\u4e16\u754c\u4e2d\u3067\u7cbe\u4e00\u676f\u306e\u958b\u982d\u624b\u8853\u306b\u3088\u308b\u816b\u760d\u6458\u51fa\u8853\u304c\u884c\u308f\u308c\u308b\u306e\u3067\u3059\u304c\uff0cGBM\u306e10\u5e74\u751f\u5b58\u5272\u5408\u306f\u307b\u307c0%\u3067\u3059\u3002\u6b8b\u5ff5\u306a\u304c\u3089\u73fe\u6642\u70b9\u3067\u306f\u6cbb\u7652\u3068\u3044\u3046\u3053\u3068\u306f\u671f\u5f85\u3067\u304d\u306a\u3044\u60aa\u6027\u816b\u760d\u3067\u3059\u3002<\/li>\n<li>\u9006\u306b\uff0c \u3069\u306e\u3088\u3046\u306a\u7121\u7406\u306a\u624b\u8853\u3092\u3057\u3066\u3082\u6cbb\u7652\u3068\u3044\u3046\u3053\u3068\u304c\u306a\u3044\u306e\u3067\u3042\u308c\u3070\uff0c\u816b\u760d\u3092\u3067\u304d\u308b\u3060\u3051\u305f\u304f\u3055\u3093\u53d6\u3063\u305f\u65b9\u304c\u6cbb\u308b\u78ba\u7387\u304c\u4e0a\u304c\u308b\u3068\u3044\u3046\uff0c\u8133\u5916\u79d1\u533b\u306e\u8aac\u660e\u306f\u6b63\u3057\u304f\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u624b\u8853\u306f\u5bdb\u89e3\u3092\u5f97\u308b\u624b\u6bb5\u306b\u904e\u304e\u306a\u3044\u306e\u3067\u3059\u3002\u591a\u304f\u306e\u8133\u5916\u79d1\u533b\u306e\u5148\u751f\u304c\u3053\u306e\u70b9\u3092\u52d8\u9055\u3044\u3057\u3066\u3044\u307e\u3059 \u00a0<span style=\"color: #000080;\"><strong>surgery is palliative, never curative !<\/strong><\/span><\/li>\n<li>\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u3082\u624b\u8853\u6458\u51fa\u3082\u4e2d\u6027\u5b50\u6355\u6349\u7642\u6cd5 BNCT\u3082\u30ae\u30ea\u30a2\u30c7\u30eb\u3082\u5149\u7dda\u529b\u5b66\u7642\u6cd5 PDT\u3082\uff0c\u5168\u8133\u306b\u6709\u52b9\u3067\u3042\u308b\u3068\u3044\u3046\u6cbb\u7642\u6cd5\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u304b\u3089\uff0c\u6c7a\u3057\u3066GBM\u3092\u6cbb\u3059\u6cbb\u7642\u6cd5\u3068\u306f\u306a\u3089\u306a\u3044\u306e\u3067\u3059\u3002<\/li>\n<li>\u307e\u305f\u4ed6\u306e\u304c\u3093\u816b\u3068\u6bd4\u8f03\u3059\u308c\u3070\uff0c\u81a0\u82bd\u816b\u306f\u8ee2\u79fb\u305b\u305a\u7de9\u5f90\u5897\u5927\u6027\u3067G0\/1\u671f\u306e\u7d30\u80de\u5272\u5408\u304c\u9ad8\u3044\u3082\u306e\u3067\u3059\u304b\u3089\uff0c\u6297\u816b\u760d\u85ac\u306b\u6c42\u3081\u3089\u308c\u308b\u3082\u306e\u306f\u9ad8\u3044\u8840\u4e2d\u6fc3\u5ea6\u3067\u306f\u306a\u304f\uff0c\u52b9\u679c\u6301\u7d9a\u6027\u3067\u3059\u3002<\/li>\n<li>GBM\u3092\u6cbb\u3059\u3068\u3044\u3046\u3053\u3068\u3092\u671f\u5f85\u3059\u308b\u306e\u3067\u3042\u308c\u3070\uff0c\u3084\u306f\u308a\u4f55\u304b\u306e\u85ac\u5264\u306e\u767b\u5834\u3092\u5f85\u3064\u3057\u304b\u306a\u3044\u306e\u3067\u3057\u3087\u3046\u304c\uff0c<span style=\"color: #ff0000;\"><strong><span style=\"color: #000080;\">\u305d\u308c\u306f\u30d4\u30eb\uff08\u7d4c\u53e3\u85ac\uff09\u3067\u3057\u3087\u3046\u3000\u304f(^.^)\u30ce<\/span>\u00a0<\/strong><\/span><\/li>\n<\/ul>\n<h4>\u6587\u732e<\/h4>\n<div>\n<ul>\n<li>Asklund T, et al.: Brain tumors in Sweden: data from a population-based registry 1999\u20132012. Acta Oncol 2015<\/li>\n<li>Blumenthal D, et al. Is more better? The impact of extended adjuvant temozolomide in newly-diagnosed glioblastoma: a secondary analysis of EORTC and NRG Oncology\/ RTOG. Neuro Oncol 2017<\/li>\n<li><span class=\"highlight\">Chaichana KL et al.:\u00a0<\/span>Establishing percent resection and residual volume thresholds affecting survival and recurrence for patients with newly diagnosed intracranial <span class=\"highlight\">glioblastoma<\/span>.\u00a0<span role=\"menubar\">Neuro Oncol.<\/span> 2014<\/li>\n<li>Chinot OL, et al.: Bebacizmab plus radiotherapy-temozolomide for newly diagnosed gliomblastoma. N Engl J Med 370: 709-722, 2014<\/li>\n<li>Clarke JL, et al.: Is surgery at progression a prognostic marker for improved 6-month progression-free survival or overall survival for patients with recurrent glioblastoma? Neuro Oncol. 13:1118-1124, 2011<\/li>\n<li><span class=\"highlight\">Ellingson BM, et al.:\u00a0<\/span>Validation of post-operative residual contrast enhancing tumor volume as an independent prognostic factor for overall survival in newly diagnosed glioblastoma.\u00a0<span role=\"menubar\">Neuro Oncol.<\/span> 2018<\/li>\n<li>Fukushima S, et al.: A case of more than 20 years survival with glioblastoma, and development of cavernous angioma as a delayed complication of radiotherapy. Neuropathology 33, 2013<\/li>\n<li>Gilbert MR, et al.: A randomized trial of bevacizmab for newly diagnosed glioblastoma.\u00a0 N Engl J Med 370: 699-708, 2014<\/li>\n<li>Gilles FH, et al.: Limitations of the World Health Organization classification of childhood supratentorial astrocytic tumors. Children Brain Tumor Consortium. Cancer 88: 1477-1483, 2000<\/li>\n<li>Gramatzki D, et al. Limited role for extended maintenance temozolomide for newly diagnosed glioblastoma. Neurology 2017<\/li>\n<li>Herrlinger U, et al.: Bevacizumab Plus Irinotecan Versus Temozolomide in Newly Diagnosed O6-Methylguanine-DNA Methyltransferase Nonmethylated Glioblastoma: The Randomized GLARIUS Trial. J Clin Oncol 2016 [Epub]<\/li>\n<\/ul>\n<ul>\n<li>Hou LC, Veeravagu A, Hsu AR, Tse VC. Recurrent glioblastoma multiforme: a review of natural history and management options.\u00a0<em>Neurosurg Focus<\/em>2006;20:E5.<\/li>\n<li>Jaeckle KA, et al.: Correlation of enzyme-inducing anticonvulsant use with outcome of patients with glioblastoma. Neurology. 73: 1207-1213, 2009<\/li>\n<li>Karremann M, et al.: Pediatric giant cell glioblastoma: New insights into a rare tumor entity. Neuro-Oncol 11: 323-329, 2009<\/li>\n<li>Karsy M, et al.: A practical review of prognostic correlations of molecular biomarkers in glioblastoma.\u00a0Neurosurgical Focus\u00a03: Page E4, 2015<\/li>\n<li><span class=\"refLabel\">Keime-Guibert et al.:<\/span><span class=\"reference\"><span class=\"reference\"><span class=\"refAuthors\">\u00a0<\/span><span class=\"refTitle\">Radiotherapy for glioblastoma in the elderly.\u00a0<\/span><span class=\"refSeriesTitle\">N Engl J Med\u00a0<\/span><span class=\"refSeriesVolume\">356<\/span>:\u00a0<span class=\"refPages\">1527\u20131535, 2007<\/span><\/span><\/span><\/li>\n<li>Kreth FW, et al. Gross total but not incomplete resection of glioblastoma prolongs survival in the era of radiochemotherapy. Ann Oncol 2013<\/li>\n<\/ul>\n<\/div>\n<div>\n<ul>\n<li>Lai A, et al.: Phase II study of bevacizumab plus temozolomide during and after radiation therapy for patients with newly diagnosed glioblastoma multiforme. J Clin Oncol 29: 142-148, 2011<\/li>\n<li>Li J, et al.: Validation and simplification of the Radiation Therapy Oncology Group recursive partitioning analysis classification for glioblastoma. Int J Radiat Oncol Biol Phys 81:623-30, 2011<\/li>\n<li>Louis DN, et al.: The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathologica 131: 803-820, 2016<\/li>\n<li>Marko NF, et al.: Extent of resection of glioblastoma revisited: personalized survival modeling facilitates more accurate survival prediction and supports a maximum-safe-resection approach to surgery. J Clin Oncol 32:774-782, 2014<\/li>\n<li>Nava F, et al.: Survival effect of first- and second-line treatments for patients with primary glioblastoma: a cohort study from a prospective registry, 1997-2010. Neuro Oncol 16, 2014<\/li>\n<li>Ohgaki H. Epidemiology of brain tumors.\u00a0Methods Mol Biol\u00a0472: 323\u201342, 2009<\/li>\n<li>Parsons DW, et al. An integrated genomic analysis of human glioblastoma<\/li>\n<li>Perry JR, et al.: Short-Course Radiation plus Temozolomide in Elderly Patients with Glioblastoma. N Engl J Med 2017; 376:1027-1037<br \/>\nmultiforme. Science 321: 1807-1812, 2008<\/li>\n<li>Roa W, et al.: International Atomic Energy Agency Randomized Phase III Study of Radiation Therapy in Elderly and\/or Frail Patients With Newly Diagnosed Glioblastoma Multiforme. J Clin Oncol. 2015<\/li>\n<li>Robinson GW, et al.: Complete clinical regression of a BRAF V600E-mutant pediatric glioblastoma multiforme after BRAF inhibitor therapy. BMC Cancer. 2014<\/li>\n<li>Sanders RP, et al.: High-grade astrocytoma in very young children. Pediatr Blood Cancer 49: 888-93, 2007<\/li>\n<\/ul>\n<ul>\n<li>Sanai N, et al.: An extent of resection threshold for newly diagnosed glioblastomas. J Neurosurg 115:3-8, 2011<\/li>\n<li>Schuster J, et al.: A phase II, multicenter trial of rindopepimut (CDX-110) in newly diagnosed glioblastoma: the ACT III study. Neuro Oncol: 2015 Jan\u00a0 [Epub]<\/li>\n<li>Stupp R, Hegi ME, Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial.\u00a0<em>Lancet Oncol<\/em>\u00a02009;10:459\u201366<\/li>\n<li>Verhaak RG, et al.: Integrated genomic analysis identifies clinically relevant subtypes of glioblastoma characterized by abnormalities in PDGFRA, IDH1, EGFR, and NF1. Cancer Cell 17:98-110, 2010<\/li>\n<li>Wakabayashi T, et al,:\u00a0JCOG0911 INTEGRA study: a randomized screening phase II trial of interferon\u03b2 plus temozolomide in comparison with temozolomide alone for newly diagnosed glioblastoma.\u00a0J Neurooncol\u00a02018<\/li>\n<li>Walker MD, et al.: Evaluation of BCNU and\/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg 49: 333-343, 1978<\/li>\n<li>Walker MD, et al.: Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med. 303: 1323-1329, 1980<\/li>\n<\/ul>\n<\/div>\n<hr \/>\n","protected":false},"excerpt":{"rendered":"<p>WHO \u30b0\u30ec\u30fc\u30c9\uff14\u306e\u60aa\u6027\u816b\u760d \u30b0\u30ea\u30aa\u30d6\u30e9\u30b9\u30c8\u30fc\u30de\uff0c\u696d\u754c\u7528\u8a9e\u3067\u30b0\u30ea\u30d6\u30e9\u3068\u3044\u3044\u307e\u3059 \u82f1\u8a9e\u3067\u306f GBM (glioblastoma multiforme)\u00a0\u30b8\u30fc\u30d3\u30fc\u30a8\u30e0\u3068\u3044\u3044\u307e\u3059 \u8133\u306e\u795e\u7d4c\u7d30\u80de\u3092\u652f\u3048\u308b\u795e\u7d4c\u81a0\u7d30\u80de\uff08\u661f\u7d30\u80de\uff0c\u672a\u5206\u5316 [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16],"tags":[],"class_list":["post-1563","post","type-post","status-publish","format-standard","hentry","category-glioma"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-json\/wp\/v2\/posts\/1563","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-json\/wp\/v2\/comments?post=1563"}],"version-history":[{"count":287,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-json\/wp\/v2\/posts\/1563\/revisions"}],"predecessor-version":[{"id":23342,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-json\/wp\/v2\/posts\/1563\/revisions\/23342"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-json\/wp\/v2\/media?parent=1563"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-json\/wp\/v2\/categories?post=1563"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/blog\/wp-json\/wp\/v2\/tags?post=1563"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}