{"id":171,"date":"2012-04-19T02:14:13","date_gmt":"2012-04-18T17:14:13","guid":{"rendered":"\/sawamura\/wp\/?p=171"},"modified":"2025-12-29T16:36:00","modified_gmt":"2025-12-29T07:36:00","slug":"ependy","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/ependy\/","title":{"rendered":"\u4e0a\u8863\u816b\uff08\u3058\u3087\u3046\u3044\u3057\u3085\uff09ependymoma"},"content":{"rendered":"<h5>\u5b50\u3069\u3082\u3068\u82e5\u3044\u6210\u4eba\u306b\u591a\u3044\u8133\u816b\u760d\u3067\u3059<\/h5>\n<h5>\u3067\u304d\u305f\u5834\u6240\u304c\u6cbb\u7642\u3068\u4e88\u5f8c\u306b\u5f71\u97ff\u3057\u307e\u3059<\/h5>\n<h5>\u624b\u8853\u3067\u53d6\u308a\u5207\u308c\u305f\u6642\u306b\u6cbb\u308b\u816b\u760d\u3067\u3059<\/h5>\n<h5>\u5ef6\u9ac4\u306e\u5468\u308a\u306e\u3082\u306e\u306f\u53d6\u308a\u5207\u308c\u306a\u3044\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/h5>\n<h4>\u3067\u304d\u308b\u5834\u6240\u3067\u6cbb\u308b\u898b\u8fbc\u307f\u304c\u9055\u3044\u307e\u3059\uff1a\u3000\u30c6\u30f3\u30c8\u306e\u4e0a\u3068\u4e0b\u3067\u307e\u305a\u533a\u5225\u3059\u308b<\/h4>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-10061 size-large\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/infrasupra-550x413.jpg\" alt=\"\" width=\"550\" height=\"413\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/infrasupra-550x413.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/infrasupra-300x225.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/infrasupra.jpg 720w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><span style=\"color: #333333;\">\u5927\u8133\u3068\u5c0f\u8133\u3092\u308f\u3051\u308b\u786c\u819c\u3092\u30c6\u30f3\u30c8\u3068\u3044\u3044\u307e\u3059<br \/>\n<\/span><span style=\"color: #333333;\">\u5927\u8133\u306f\u30c6\u30f3\u30c8\u4e0a\uff0c\u5c0f\u8133\u3068\u7b2c4\u8133\u5ba4\u306f\u30c6\u30f3\u30c8\u4e0b\uff08\u5f8c\u982d\u7aa9\uff09<\/span><\/p>\n<div class=\"setumei\">\n<h5>1. <span style=\"color: #ff0000;\">\u30c6\u30f3\u30c8\u4e0a <span style=\"color: #000080;\">\u4e0a\u8863\u816b<\/span><\/span><\/h5>\n<p><span style=\"color: #000080;\"><strong>\u00a0\u5927\u8133<\/strong><\/span>\u306b\u3067\u304d\u308b\u3082\u306e\u3067<a href=\"\/sawamura\/braintumors\/malignancy\/\"><strong><span style=\"color: #000080;\">\u30b0\u30ec\u30fc\u30c9\uff12\u30683<\/span><\/strong><\/a>\u304c\u3042\u308a\u307e\u3059<\/p>\n<h5>2. <span style=\"color: #ff0000;\">\u30c6\u30f3\u30c8\u4e0b\uff08\u5f8c\u982d\u7aa9\uff09\u00a0<span style=\"color: #000080;\">\u4e0a\u8863\u816b<\/span><\/span><\/h5>\n<p><span style=\"color: #000080;\"><span style=\"color: #333333;\">\u00a0<\/span><strong>\u7b2c4\u8133\u5ba4\uff0c\u5c0f\u8133\uff0c\u8133\u5e79\u90e8<\/strong><\/span>\u306b\u3067\u304d\u308b\u3082\u306e\u3067<strong><span style=\"color: #000080;\">\u30b0\u30ec\u30fc\u30c92\u30683<\/span><\/strong>\u304c\u3042\u308a\u307e\u3059\uff0c\u3053\u308c\u304c\u4e00\u756a\u591a\u3044<\/p>\n<h5>3. \u810a\u9ac4 \u4e0a\u8863\u816b<\/h5>\n<p><strong><span style=\"color: #000080;\">\u810a\u9ac4\u5185\u90e8<\/span><\/strong>\u306b\u3067\u304d\u307e\u3059\uff0c<strong><span style=\"color: #000080;\">\u30b0\u30ec\u30fc\u30c92<\/span><\/strong>\u3067\u3059\uff0c\u3067\u3082\u5b9f\u8cea\u7684\u306b\u306f\u307b\u3068\u3093\u3069\u30b0\u30ec\u30fc\u30c91\u306b\u8fd1\u3044\u3002\u6210\u4eba\u3067\u306f\u8133\u3068\u810a\u9ac4\u4e0a\u8863\u816b\u304c\u540c\u6578\u304f\u3089\u3044<\/p>\n<h5>\u3053\u3053\u304b\u3089\u4e0b\u306e\u8a18\u8ff0\u306f\u8133\u306e\u4e0a\u8863\u816b\u3067\u3059<\/h5>\n<h4><span style=\"color: #000000;\">\u5927\u307e\u304b\u306a\u3053\u3068<\/span><\/h4>\n<ul>\n<li>\u65e5\u672c\u3067\u5e74\u9593100\u4f8b\u304f\u3089\u3044\u306e\u307e\u308c\u306a\u816b\u760d\u3067\u3059<\/li>\n<li>\u5c0f\u5150\u8133\u816b\u760d\u306e10\uff05\u304f\u3089\u3044\u3067\uff0c\u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b\u306b\u6b21\u3044\u3067\u591a\u3044\u3067\u3059<\/li>\n<li>\uff13\u6b73\u672a\u6e80\u306b\u9650\u308c\u3070\uff0c\u8133\u816b\u760d\u306e30%\u304f\u3089\u3044\u304c\u4e0a\u8863\u816b\u3067\u3059<\/li>\n<li>\u5c0f\u5150\u306e\u4e0a\u8863\u816b\u306e3\u5206\u306e2\u306f\u30c6\u30f3\u30c8\u4e0b\uff08\u5f8c\u982d\u7aa9\uff09\u306b\u767a\u751f\u3057\u307e\u3059\uff0c<strong><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/fourthventricletumo\/\">\u7b2c\uff14\u8133\u5ba4<\/a>\u306e\u5468\u56f2\u306e\u58c1<\/span><\/strong>\u306b\u767a\u751f\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u5074\u8133\u5ba4\u3084\u5927\u8133\u306e\u5185\u90e8\u306b\u3067\u304d\u308b\u3082\u306e\u306f\uff0c\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b\u3067\u3059<\/li>\n<li>\u30b0\u30ec\u30fc\u30c92\u306e\u4e0a\u8863\u816b\u3067\u306f\uff0c\u624b\u8853\u3067\u5168\u90e8\u3068\u308c\u308c\u3070\u6cbb\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #000000;\"><strong><span style=\"color: #000080;\">\u30b0\u30ec\u30fc\u30c92\u3067\u3082\u5168\u6458\u51fa\u3067\u304d\u306a\u3044\u3068\u751f\u547d\u4e88\u5f8c\u304c\u60aa\u3044\u306e\u3067\u826f\u6027\u816b\u760d\u3068\u306f\u3044\u3048\u307e\u305b\u3093<\/span><\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>\uff13\u5206\u306e\uff11\u306f\u60aa\u6027\u5ea6\u304c\u9ad8\u3044\u30b0\u30ec\u30fc\u30c93\uff08\u304b\u3064\u3066\u306e\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\uff09<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u5e7c\u5150\uff08\u5e74\u9f62\u4e2d\u592e\u50243\u6b73\uff09\u306e\u7b2c4\u8133\u5ba4\u306b\u3067\u304d\u308b<span style=\"color: #000080;\"><strong>EPN-PFA<\/strong><\/span>\u3068\uff0c\u5c0f\u5150\uff08\u5e74\u9f62\u4e2d\u592e\u50249\u6b73\uff09\u306e\u5927\u8133\u306b\u3067\u304d\u308b\u00a0<span style=\"color: #000080;\"><strong><i>ZFTA<\/i><\/strong><strong>\u907a\u4f1d\u5b50\u878d\u5408<\/strong><\/span>\u304c\u3042\u308b\u4e0a\u8863\u816b\u306f\uff0c\u60aa\u6027\u5ea6\u304c\u9ad8\u304f\u3066\u6cbb\u308a\u306b\u304f\u3044\u3082\u306e\u3067\u3059<\/li>\n<li>\u5c0f\u5150\u306e\u7b2c\uff14\u8133\u5ba4\u4e0a\u8863\u816b\u306f<strong><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/medullo\/\">\u9ac4\u82bd\u816b<\/a><\/span><\/strong>\u3068\u4f3c\u3066\u3044\u308b\u306e\u3067\u3068\u304d\u3069\u304d\u9593\u9055\u3048\u3089\u308c\u307e\u3059<\/li>\n<li>\u4e0a\u8863\u816b\u304c\u6cbb\u308b\u78ba\u7387\u306f60\uff05\u304f\u3089\u3044\u3067\u3059<\/li>\n<li>\u9006\u306b\uff0c\u6b7b\u4ea1\u7387\u306f40%\u304f\u3089\u3044\u3067\u3059<\/li>\n<li>\u3069\u306e\u3088\u3046\u306a\u4e0a\u8863\u816b\u3067\u3082\uff0c<span style=\"color: #ff0000;\"><strong>\u6cbb\u308b\u304b\u3069\u3046\u304b\u306f\u624b\u8853\u3067\u5168\u6458\u51fa\u3067\u304d\u305f\u304b\u3069\u3046\u304b<\/strong><\/span>\u306b\u304b\u304b\u308a\u307e\u3059\uff082022\u5e74\u6642\u70b9\u3067\u306e\u4e16\u754c\u7684\u306a\u30b3\u30f3\u30bb\u30f3\u30b5\u30b9\uff09<\/li>\n<li>\u521d\u56de\u624b\u8853\u3067\u53d6\u308a\u304d\u308c\u306a\u3044\u6642\u306f\uff0c2\u56de\u76ee\u306e\u958b\u982d\u624b\u8853\u3082\u3057\u305f\u307b\u3046\u304c\u3044\u3044\u3067\u3059<\/li>\n<li>\u53d6\u308a\u304d\u308c\u306a\u3044\u5834\u5408\u306b\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3059<\/li>\n<li>\u624b\u8853\u3067\u5168\u6458\u51fa\u3067\u304d\u3066\u3082\uff0c\u60aa\u6027\u5ea6\u304c\u3042\u308b\u3082\u306e\u3067\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u5fc5\u8981\u306a\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u907a\u4f1d\u5b50\u8a3a\u65ad\u3057\u3066\u3082\u3057\u306a\u304f\u3066\u3082\uff0c\u6cbb\u7642\u65b9\u6cd5\u306f\u5909\u308f\u308a\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #000080;\">\u9ac4\u6db2\u306b\u306e\u3063\u3066<strong>\u64ad\u7a2e\u8ee2\u79fb<\/strong><\/span>\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<h5><span style=\"color: #ff0000;\">\u6ce8\u610f\uff01<\/span><\/h5>\n<h5><span style=\"color: #000080;\">2023\u5e74\uff0c\u907a\u4f1d\u5b50\u8a3a\u65ad\u3067\u8a73\u3057\u304f<\/span><span style=\"color: #000080;\">\u5206\u985e\u3057\u3066\u3082\uff0c\u65b0\u3057\u3044\u6cbb\u7642\u304c\u3042\u308b\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3057\u6cbb\u308b\u898b\u8fbc\u307f\u306f\u5909\u308f\u308a\u307e\u305b\u3093<\/span><\/h5>\n<h4>\u75c7\u72b6<\/h4>\n<ul>\n<li>\u8133\u5ba4\u306e\u4e2d\u306b\u3067\u304d\u308b\u306e\u3067\u9ac4\u6db2\u306e\u6d41\u308c\u304c\u59a8\u3052\u3089\u308c\u3066\uff0c<span style=\"color: #000080;\"><strong>\u6c34\u982d\u75c7<\/strong><\/span>\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u6c34\u305f\u307e\u308a\u306b\u306a\u3063\u3066\u8133\u5ba4\u304c\u3075\u304f\u3089\u3080\u9589\u585e\u6027\u6c34\u982d\u75c7\u3068\u3044\u3044\u307e\u3059<\/li>\n<li>\u6c34\u982d\u75c7\u306b\u306a\u308b\u3068\u982d\u306e\u4e2d\u306e\u5727\uff08\u8133\u5727\uff09\u304c\u3042\u304c\u3063\u3066\uff0c<span style=\"color: #000080;\"><strong>\u982d\u75db\u3084\u5614\u5410<\/strong><\/span>\uff0c<span style=\"color: #000080;\"><strong>\u610f\u8b58\u969c\u5bb3<\/strong><\/span>\u304c\u3067\u307e\u3059<\/li>\n<li>\u30c6\u30f3\u30c8\u4e0b\u306e\u3082\u306e\u3067\u306f<span style=\"color: #000080;\"><strong>\uff0c\u6b69\u884c\u304c\u4e0d\u5b89\u5b9a\uff0c\u9996\u304c\u75db\u3044\uff0c\u98f2\u307f\u8fbc\u307f\u306b\u304f\u3044<\/strong><\/span><\/li>\n<li>\u30c6\u30f3\u30c8\u4e0a\uff0c\u5927\u8133\u5b9f\u8cea\u306e\u4e2d\u306b\u3067\u304d\u308b\u4e0a\u8863\u816b <span style=\"color: #000080;\"><strong>extraventricular ependymoma<\/strong><\/span> \u306f\uff0c<strong><span style=\"color: #000080;\">\u3066\u3093\u304b\u3093\u767a\u4f5c\uff0c\u9ebb\u75fa<\/span><\/strong>\u306a\u3069\u306e\u5c40\u6240\u8133\u75c7\u72b6\u3067\u767a\u75c7\u3057\u307e\u3059<\/li>\n<\/ul>\n<h4>\u8a3a\u65ad<\/h4>\n<ul>\n<li>MRI\u3067\u306f\uff0c\u8133\u5ba4\u5185\u306b\u7a81\u51fa\u3059\u308b\u5883\u754c\u660e\u77ad\u306a\u816b\u760d\u3067\u3059<\/li>\n<li>MRI T1\u5f37\u8abf\u753b\u50cf\u3067\u306f\u4f4e\u4fe1\u53f7\u306b\uff0cT2\u5f37\u8abf\u753b\u50cf\u3067\u306f\u9ad8\u4fe1\u53f7\u306b\u63cf\u51fa\u3055\u308c\uff0c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u3067\u5897\u5f37\u3055\u308c\u307e\u3059<\/li>\n<li>\u816b\u760d\u5185\u90e8\u306e\u4fe1\u53f7\u5f37\u5ea6\u306f\uff0c\u77f3\u7070\u5316\u3084\u56a2\u80de\u5f62\u6210\uff0c\u816b\u760d\u5185\u51fa\u8840\uff0c\u58ca\u6b7b\u306e\u6df7\u5728\u306b\u3088\u308a\u4e0d\u5747\u4e00\u306b\u306a\u308b\u3053\u3068\u306e\u65b9\u304c\u3080\u3057\u308d\u591a\u3044\u3067\u3059<\/li>\n<li>CT\u6240\u898b\u3068\u3057\u3066\uff0c\u77f3\u7070\u5316\u304c\u7d04\u534a\u6570\u306b\u3042\u308a\u307e\u3059<\/li>\n<li>\u5f8c\u982d\u7aa9\uff08\u30c6\u30f3\u30c8\u4e0b\uff09\u306e\u3082\u306e\u306fMRI\u3060\u3051\u3067\u8a3a\u65ad\u3067\u304d\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u30eb\u30b7\u30e5\u30ab\u5b54\u304b\u3089\u5c0f\u8133\u6a4b\uff08\u5ef6\u9ac4\uff09\u89d2\u69fd\u3078\u3068\u4f38\u5c55<\/strong><\/span>\u3059\u308b\u6240\u898b\u306f\u9ac4\u82bd\u816b\u3068\u306e\u5927\u304d\u306a\u9451\u5225\u70b9\u3067\u3059\u3002<\/li>\n<\/ul>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymtsag.jpg\"><img loading=\"lazy\" decoding=\"async\" title=\"ependymtsag\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymtsag-297x300.jpg\" alt=\"\" width=\"297\" height=\"300\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymt.jpg\"><img loading=\"lazy\" decoding=\"async\" title=\"ependymt\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymt-300x282.jpg\" alt=\"\" width=\"300\" height=\"282\" \/><\/a><\/p>\n<p>\u7b2c\uff14\u8133\u5ba4\u5e8a\u306b\u767a\u751f\u3057\u305f\u5178\u578b\u7684\u306a\u4e0a\u8863\u816b EPN-PFA \u306e\u753b\u50cf\u3067\u3059\u3002\u6c34\u982d\u75c7\u306b\u306a\u3063\u3066\uff0c\u982d\u75db\u3068\u5614\u5410\uff0c\u610f\u8b58\u969c\u5bb3\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u5178\u578b\u7684\u306aMRI\u753b\u50cf\u3068\u75c5\u7406\u6240\u898b\u3067\u3059\u3002MRI\u3067\u306f<span style=\"color: #000080;\"><strong>\u7b2c\uff14\u8133\u5ba4\u304b\u3089\u30de\u30b8\u30e3\u30f3\u30c7\u30a3\u30fc\u5b54\u3092\u8d8a\u3048\u3066\u810a\u9ac4\u80cc\u5074<\/strong><\/span>\u307e\u3067\u9577\u304f\u816b\u760d\u304c\u4f38\u3073\u3066\u3044\u307e\u3059\u3002\u816b\u760d\u5185\u90e8\u306b\u5c0f\u3055\u306a\u306e\u3046\u80de\u304c\u8907\u6570\u307f\u3089\u308c\u307e\u3059\u3002\u75c5\u7406\u50cf\u3067\u306f\uff0c\u8840\u7ba1\u5468\u56f2\u306b\u7d30\u80de\u6838\u304c\u306a\u3044\u7121\u6838\u91ce\u304c\u8a8d\u3081\u3089\u308c\u307e\u3059\u3002\u8840\u7ba1\u5468\u56f2\u306b\u4f38\u3073\u305f\u7e4a\u7d30\u306a\u5358\u6975\u6027\u7a81\u8d77\u304c\u96c6\u307e\u3063\u305f\u9818\u57df\u3067\u3059\u3002\u3053\u308c\u306f\uff0c\u8840\u7ba1\u5468\u56f2\u507d\u30ed\u30bc\u30c3\u30c8 perivascular pseudorosette \u3068\u3044\u3046\u4e0a\u8863\u816b\u306b\u7279\u5fb4\u7684\u306a\u75c5\u7406\u6240\u898b\u3067\u3059\u3002<\/p>\n<ul>\n<li>\u30c6\u30f3\u30c8\u4e0a\u306e\u3082\u306e\u306f\uff0c\u4ed6\u306e<span style=\"color: #000080;\"><strong>\u9ad8\u60aa\u6027\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de\u306b\u4f3c\u3066\u3044\u3066<\/strong><\/span>MRI\u3060\u3051\u3067\u306f\u8a3a\u65ad\u304c\u96e3\u3057\u3044\u3067\u3059<\/li>\n<li>\u306a\u305c\u306a\u3089\uff0c\u8133\u5ba4\u58c1\u304b\u3089\u5927\u8133\u6df1\u90e8\u767d\u8cea\u3078\u3068\u6d78\u6f64\u3059\u308b<\/li>\n<li>\u3042\u308b\u3044\u306f\u8133\u5ba4\u3068\u5168\u304f\u96e2\u308c\u305f\u5927\u8133\u5b9f\u8cea\u5185\u306e\u307f\u3067\u306e\u767a\u80b2\u304c\u3042\u308b\u304b\u3089\u3067\u3059<\/li>\n<li>\u307e\u308c\u3067\u3059\u304c\uff0c<span style=\"color: #000080;\"><strong>\u9ac4\u6db2\u306b\u306e\u3063\u3066\u8133\u3084\u810a\u9ac4\u306e\u8868\u9762\u306b\u591a\u767a\u8ee2\u79fb\u3057\u307e\u3059\uff08\u9ac4\u6db2\u64ad\u7a2e\u3068\u3044\u3044\u307e\u3059\uff09<\/strong><\/span><\/li>\n<li>MRI\u8a3a\u65ad\u6642\u306b\u3059\u3067\u306b\u64ad\u7a2e\u3057\u3066\u3044\u308b\u306e\u306f\u6570\uff05\u4ee5\u4e0b\u3067\u3059<\/li>\n<li>\u9ac4\u6db2\u7d30\u80de\u8a3a\u306f\u8a3a\u65ad\u7684\u4fa1\u5024\u304c\u3042\u308a\u307e\u305b\u3093<\/li>\n<\/ul>\n<\/div>\n<div class=\"setumei\">\n<h4>\u5206\u985e\u3068\u907a\u4f1d\u5b50\u8a3a\u65ad<\/h4>\n<ul>\n<li><span style=\"color: #000080;\"><strong>2021\u5e74WHO\u75c5\u7406\u5206\u985e\u3067\u306f\uff0c6\u7a2e\u985e\u306b\u5206\u985e\u3055\u308c\u307e\u3059\uff08\u4e0b\u306e\u65b9\u306b\u66f8\u3044\u3066\u3042\u308a\u307e\u3059\uff09<\/strong><\/span><\/li>\n<li>\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u3068\u907a\u4f1d\u5b50\u8a3a\u65ad\u306e\u7d44\u307f\u5408\u308f\u305b\u3067\u6700\u7d42\u8a3a\u65ad\u3092\u6c7a\u3081\u307e\u3059<\/li>\n<li>\u30c6\u30f3\u30c8\u4e0a\u3067ZFTA\u3082YAP\u3082\u967d\u6027\u3068\u306a\u3089\u306a\u3044\u3082\u306e\u3082\u591a\u3044\u306e\u3067\uff0c\u591a\u304f\u306f\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u3067\u60aa\u6027\u5ea6\u3068\u6cbb\u7642\u65b9\u91dd\u3092\u6c7a\u3081\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u907a\u4f1d\u5b50\u8a3a\u65ad\u3057\u3066\u3082\uff0c\u6cbb\u7642\u6cd5\u306e\u9078\u629e\u80a2\u304c\u5897\u3048\u308b\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/strong><\/span>\uff0c\u6b8b\u5ff5\u306a\u304c\u3089\u6cbb\u308a\u3084\u3059\u3055\u306e\u4e88\u60f3\u304c\u3067\u304d\u308b\u306e\u307f\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u6cbb\u7642\u3092\u8003\u3048\u308b\u3068\u304d\u306b\u306f\uff0c\u4e0a\u8863\u816b \u30b0\u30ec\u30fc\u30c92\uff0c<\/strong><strong>\u4e0a\u8863\u816b\u30b0\u30ec\u30fc\u30c93 \uff08\u304b\u3064\u3066\u306e\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b anaplastic ependymoma\uff09\uff0c\u00a0\u30c6\u30f3\u30c8\u4e0a\u00a0<i>ZFTA<\/i>\u878d\u5408\u967d\u6027\u4e0a\u8863\u816b \u30b0\u30ec\u30fc\u30c9\uff12\u304b\uff13<\/strong><\/span>\u306e\uff13\u7a2e\u985e\u306b\u3057\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>PF-EPN-A\u3068WHO\u5206\u985e\u3055\u308c\u308b\u3068\u8a33\u304c\u308f\u304b\u308a\u307e\u305b\u3093<\/strong><\/span>\u304c\uff0c\u8981\u3059\u308b\u306b\u5e7c\u5150\u306e\u6cbb\u308a\u306b\u304f\u3044\u7b2c\uff14\u8133\u5ba4\u4e0a\u8863\u816b\u3068\u8003\u3048\u3066\u826f\u3044\u3067\u3059\uff0c\u5c0f\u5150\u30c6\u30f3\u30c8\u4e0b \u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u30b0\u30ec\u30fc\u30c9\uff13\u306e\u307b\u3068\u3093\u3069\u304cPF-EPN-A\u306a\u306e\u3067\u3059<\/li>\n<li>\u810a\u9ac4\u306b\u3067\u304d\u308b\u4e0a\u8863\u816b\u3060\u3051\u306f\u4f8b\u5916\u3067\u826f\u6027\u306e\u30b0\u30ec\u30fc\u30c92\u3067\u3059<\/li>\n<\/ul>\n<h4>\u308f\u304b\u308a\u306b\u304f\u3044 ZFTA (C11orf95-RELA) fusion\u3068\u306f<\/h4>\n<ul>\n<li><strong>\u5b50\u3069\u3082<span style=\"color: #000080;\">\u306e\u5927\u8133\u534a\u7403<\/span><\/strong>\u306b\u3067\u304d\u308b\u3082\u306e\u3067\uff0c\u7537\u5150\u306b\u591a\u3044\u3067\u3059<\/li>\n<li>\u5b50\u3069\u3082\u306e<span style=\"color: #000080;\"><strong>\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b\u306e60-70%<\/strong><\/span>\u3092\u5360\u3081\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong><i>ZFTA-RELA<\/i>\u907a\u4f1d\u5b50\u306e\u878d\u5408<\/strong><\/span>\u3067\uff0cNFkB\u7cfb\u304c\u6d3b\u6027\u5316\u3055\u308c\u3066\u816b\u760d\u304c\u767a\u751f\u3057\u307e\u3059<\/li>\n<li>\u691c\u67fb\u65b9\u6cd5\u306fFISH\u3067\u3059<\/li>\n<li>MRI\u753b\u50cf\u3067\u306f\uff0c\u306e\u3046\u80de\u3084\u58ca\u6b7b\u3092\u4f34\u3044\uff0c\u81a0\u82bd\u816b\u3092\u601d\u308f\u305b\u308b\u60aa\u6027\u30b0\u30ea\u30aa\u30fc\u30de\u306e\u50cf\u3067\u3059<\/li>\n<li>\u7d44\u7e54\u50cf\u306f\uff0cEMA\u967d\u6027\uff0c\u975e\u5e38\u306b\u591a\u5f69\u3067\u96d1\u591a\u306a\u6240\u898b\u3092\u793a\u3057\u307e\u3059\uff0c\u8a3a\u65ad\u3057\u3065\u3089\u3044<\/li>\n<li>\u6cbb\u7642\u6cd5\u306f\uff0c\u624b\u8853\u3068\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u307f\u3067\u3059<\/li>\n<li>\u60aa\u6027\u5ea6\u304c\u9ad8\u304f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u3066\u3082\u518d\u767a\uff08\u518d\u71c3\uff09\u304c\u591a\u304f\uff0c\u751f\u547d\u4e88\u5f8c\u304c\u60aa\u3044\u3082\u306e\u3067\u3059<\/li>\n<li>\u3067\u3082WHO \u30b0\u30ec\u30fc\u30c9\u306f2\u304b3\u3067\u3059??<\/li>\n<li>\u7d50\u5c40\uff0c\u624b\u8853\u3067\u3057\u3063\u304b\u308a\u6458\u51fa\u3067\u304d\u305f\u5834\u5408\u306b\u6cbb\u308b\u898b\u8fbc\u307f\u304c\u3042\u308a\u307e\u3059<\/li>\n<li><i>ZFTA<\/i>\u878d\u5408\u306e\u6709\u7121\u306b\u304b\u304b\u308f\u3089\u305a\uff0c\u30b0\u30ec\u30fc\u30c9\u304c\u540c\u3058\u3067\u3042\u308c\u3070\u6cbb\u7642\u9078\u629e\u306f\u540c\u3058\u3067\u3059\uff0c\u3064\u307e\u308a\u53ef\u80fd\u9650\u308a\u624b\u8853\u6458\u51fa\u3057\u3066\u8a31\u5bb9\u3055\u308c\u308b\u3060\u3051\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b<\/li>\n<\/ul>\n<h4>\u308f\u304b\u308a\u306b\u304f\u3044 YAP fusion\u3068\u306f<\/h4>\n<ul>\n<li><i>YAP<\/i>\u907a\u4f1d\u5b50\u306e\u878d\u5408\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u5c0f\u3055\u3044\u5b50\u3069\u3082\u306e\u5927\u8133\u306b\u3067\u304d\u308b\u73cd\u3057\u3044\u30bf\u30a4\u30d7\u3067\u3059\uff0c\u3053\u308c\u306f\u5973\u5150\u306b\u591a\u3044\u3067\u3059<\/li>\n<li>MRI\u3067\u306f\u5883\u754c\u304c\u660e\u77ad\u3067\u304f\u308a\u3093\u3068\u5168\u6458\u51fa\u3057\u3084\u3059\u3044\u816b\u760d\u306b\u898b\u3048\u307e\u3059<\/li>\n<li>\u75c5\u7406\u7d44\u7e54\u3067\u898b\u308b\u3068\uff0c\u7d30\u80de\u5bc6\u5ea6\u3082\u9ad8\u304f\uff0c\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b anaplastic ependymoma \u00a0\u30b0\u30ec\u30fc\u30c93\u3068\u3055\u308c\u308b\u3082\u306e\u304c\u304c\u591a\u3044\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u3057\u304b\u3057\uff0c\u6cbb\u308a\u3084\u3059\u3044\u306e\u3067\u3059\uff0c\u5b9f\u8cea\u30b0\u30ec\u30fc\u30c92\u3067\u3059<\/strong><\/span><\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u306e\u6709\u52b9\u6027\u306f\u77e5\u3089\u308c\u3066\u3044\u306a\u3044\u306e\u3067\uff0c\u6d78\u6f64\u6027\u304c\u4f4e\u304f\u6458\u51fa\u3057\u3084\u3059\u304f\u653e\u5c04\u7dda\u611f\u53d7\u6027\u3082\u9ad8\u3044\u3068\u8003\u3048\u3089\u308c\u307e\u3059<\/li>\n<\/ul>\n<h5>\u6cbb\u7642\u306f<\/h5>\n<ul>\n<li><span style=\"color: #333333;\">\u6cbb\u7642\u306f\uff0c<\/span><strong><span style=\"color: #ff0000;\">\u5b8c\u5168\u6458\u51fa\u3092\u7b2c\u4e00\u76ee\u6a19\u306b\u3057\u307e\u3059<\/span><\/strong><\/li>\n<li><span style=\"color: #333333;\">\u8a31\u5bb9\u3067\u304d\u308b\u7bc4\u56f2\u306e\u5f8c\u907a\u75c7\u3092\u51fa\u3057\u3066\u3082\u6700\u5927\u9650\u6458\u51fa\u3059\u308b\u3068\u3044\u3046\u8003\u3048\u65b9\u3067\u671b\u307f\u307e\u3059<\/span><\/li>\n<li>\u5c0f\u5150\u306e\u5f8c\u982d\u7aa9\u4e0a\u8863\u816b\u3067\u306f\uff0c\u820c\u54bd\u795e\u7d4c\u3084\u8ff7\u8d70\u795e\u7d4c\u3084\u9854\u9762\u795e\u7d4c\u3092\u72a0\u7272\u306b\u3057\u3066\u3082\u5168\u90e8\u53d6\u308c\u308c\u3070\u3068\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #333333;\">\u624b\u8853\u3067\u306f\u7d30\u80de\u3092\u6563\u3089\u3070\u3055\u306a\u3044\uff08\u9ac4\u6db2\u8ee2\u79fb\u3092\u9632\u3050\uff09\u3088\u3046\u306b\u3068\u3066\u3082\u6c17\u3092\u3064\u3051\u307e\u3059<\/span><\/li>\n<li><span style=\"color: #333333;\">\u75c5\u7406\u5b66\u7684\u306b\u5206\u5316\u5ea6\u306e\u9ad8\u3044\u307b\u3093\u3068\u306e\u610f\u5473\u3067\u306e\u826f\u6027\u4e0a\u8863\u816b\u306f\u5c11\u306a\u3044\u306e\u3067\u3059\u304c\uff0c\u3082\u3057\u305d\u308c\u3067\u3042\u308c\u3070\u624b\u8853\u3067\u5168\u6458\u51fa\u3067\u304d\u308c\u3070\u6cbb\u308a\u307e\u3059<\/span><\/li>\n<li><span style=\"color: #333333;\">\u4f8b\u3048\u3070\uff0c\u30c6\u30f3\u30c8\u4e0a\u306e\u30b0\u30ec\u30fc\u30c92\u4e0a\u8863\u816b\uff08\u983b\u5ea6\u306f\u4f4e\u3044\uff09\u306f\u826f\u6027\u3067\uff0c\u624b\u8853\u3060\u3051\u3067\u6cbb\u7652\u3057\u307e\u3059<\/span><\/li>\n<li>\u601d\u6625\u671f\u304b\u3089\u82e5\u5e74\u6210\u4eba\u306b\u767a\u751f\u3059\u308b\u30c6\u30f3\u30c8\u4e0b\u306e\u4e0a\u8863\u816b\u3082\uff0c\u624b\u8853\u6458\u51fa\u3067\u304d\u308c\u3070\u5b8c\u5168\u306b\u6cbb\u308b\u3068\u3044\u3046\u826f\u6027\u816b\u760d\u3067\u3059<\/li>\n<li><span style=\"color: #333333;\">\u4e0a\u8863\u816b\u30b0\u30ec\u30fc\u30c9\uff12\u3067\u5b8c\u5168\u6458\u51fa complete removal \u3067\u304d\u305f\u5834\u5408\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u307e\u305b\u3093\u304c\uff0c\u305d\u306e\u4ed6\u306e\u3082\u306e\u3067\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u307e\u3059<\/span><\/li>\n<li><span style=\"color: #333333;\">\u591a\u304f\u306e\u5834\u5408\u3001<\/span><strong><span style=\"color: #ff0000;\">\u624b\u8853\u5f8c\u306b\u306f\u53d6\u308a\u6b8b\u3057\u305f\u816b\u760d\u90e8\u5206\u306b\u306e\u307f\u653e\u5c04\u7dda\u6cbb\u7642<\/span><span style=\"color: #000080;\">\uff08\u5f37\u5ea6\u5909\u8abf\u653e\u5c04\u7dda\u6cbb\u7642IMRT\uff0c<\/span><\/strong><strong><span style=\"color: #000080;\">\u539f\u4f53\u7167\u5c04 highly conformal radiation therapy\uff09<\/span><\/strong>\u3092\u3057\u307e\u3059<\/li>\n<li>\u304b\u3064\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u5168\u90e8\u306e\u8133\u3068\u810a\u9ac4\u306b\u304b\u3051\u308b\u3079\u304d\u3060\u3068\u8003\u3048\u3089\u308c\u307e\u3057\u305f\u304c\uff0c\u4eca\u306f\uff0c\u816b\u760d\u5c40\u6240\u306b\u9ad8\u3044\u7dda\u91cf\u3092\u3042\u3066\u308b\u3079\u304d\u3067\u3042\u308b\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\uff13\u6b21\u5143\u539f\u4f53\u7167\u5c04\u304c\u3067\u304d\u308b\u65bd\u8a2d\u3067\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u3087\u3046<\/li>\n<li><strong><span style=\"color: #ff0000;\">\u5316\u5b66\u7642\u6cd5\u306b\u306f\u62b5\u6297\u6027\u306e\u816b\u760d<\/span><\/strong><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">\u306a\u306e\u3067<span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/medullo\/\">\u9ac4\u82bd\u816b<\/a><\/span>\u3068\u540c\u3058\u6cbb\u7642\u3092\u8003\u3048\u3066\u306f\u3044\u3051\u307e\u305b\u3093<\/span><\/span><\/li>\n<li>2021\u5e74\u6642\u70b9\u3067\u3082\uff0c\u6709\u52b9\u3067\u304a\u52e7\u3081\u306e\u5316\u5b66\u7642\u6cd5\u306f\u77e5\u3089\u308c\u3066\u3044\u307e\u305b\u3093<\/li>\n<li>\u624b\u8853\u5f8c\u6b8b\u5b58\u816b\u760d\u304c\u3042\u3063\u305f\u5834\u5408\u306b\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u3067\u306f\u306a\u304f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u307e\u305a\u884c\u3063\u305f\u65b9\u304c\u3044\u3044\u3067\u3059<\/li>\n<li>\u810a\u9ac4\u306a\u3069\u306b\u64ad\u7a2e\u3057\u305f\u5834\u5408\u306b\u306f\uff0c\u52a9\u3051\u3089\u308c\u308b\u624b\u6bb5\u306f\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093<\/li>\n<li><strong><span style=\"color: #ff0000;\">\u6cbb\u308b\u304b\u3069\u3046\u304b\u306e\u6c7a\u3081\u624b\u306f\u624b\u8853\u3067\u5b8c\u5168\u306b\u3068\u308c\u305f\u304b\u3069\u3046\u304b<\/span><\/strong>\u3068\u3044\u3046\u3053\u3068\u3067\u3042\u308b\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u4e73\u5e7c\u5150\u306e\u5834\u5408\u306f\u751f\u547d\u4e88\u5f8c\u304c\u4e0d\u826f\u306a\u60aa\u6027\u816b\u760d<\/strong><\/span>\u3068\u3057\u3066\u5bfe\u51e6\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u5c0f\u5150\u306e\u4e0a\u8863\u816b\u3078\u306e\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u7d50\u679c\u304c\u767a\u8868\u3055\u308c\u307e\u3057\u305f\u304c\uff0c\u4eca\u307e\u3067\u306e\u901a\u5e38\u5316\u5b66\u7642\u6cd5\u306e\u6210\u7e3e\u3092\u8d85\u3048\u308b\u3082\u306e\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f<\/li>\n<li>\u9006\u306b\u8a00\u3048\u3070\u305d\u308c\u3060\u3051<strong><span style=\"color: #ff0000;\">\u5316\u5b66\u7642\u6cd5\u304c\u52b9\u304b\u306a\u3044\u816b\u760d<\/span><\/strong>\u3060\u3068\u601d\u308f\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u4e73\u5e7c\u5150\u306e\u6458\u51fa\u3067\u304d\u306a\u3044\u4e0a\u8863\u816b\u306f\uff0c\u7121\u7406\u306a\u6cbb\u7642\u3092\u3057\u306a\u3044\u3067\u7de9\u548c\u30b1\u30a2\u3092\u9078\u3073\u307e\u3059<\/li>\n<\/ul>\n<h4>\u6cbb\u7642\u306e\u6839\u672c\u306f\u624b\u8853\u3067\u3059<\/h4>\n<ul>\n<li><span style=\"color: #000080;\"><strong>\u4e0a\u8863\u816b\u306e\u4e88\u5f8c\uff08\u6cbb\u308b\u304b\u3069\u3046\u304b\uff09\u306f\u624b\u8853\u306e\u7d50\u679c\u306b\u3088\u3063\u3066\u6c7a\u307e\u308a\u307e\u3059<\/strong><\/span>\u304b\u3089\uff0csurgical disease \uff08\u5916\u79d1\u6cbb\u7642\u4f9d\u5b58\u306e\u75c5\u6c17\uff09\u3068\u8a00\u308f\u308c\u307e\u3059<\/li>\n<li>\u624b\u8853\u306f\u7c21\u5358\u3067\u306f\u306a\u3044\u306e\u3067\u7d4c\u9a13\u5024\u306e\u9ad8\u3044\u8133\u5916\u79d1\u533b\u306b\u304a\u9858\u3044\u3059\u308b\u5fc5\u7528\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u4e0a\u8863\u816b\u306f\u30c6\u30f3\u30c8\u4e0a\uff08\u5927\u8133\uff09\u3068\u30c6\u30f3\u30c8\u4e0b\uff08\u8133\u5e79\u90e8\u5468\u56f2\uff09\u3067\u306f\uff0c\u624b\u8853\u65b9\u6cd5\u3068\u8003\u3048\u65b9\u304c\u305c\u3093\u305c\u3093\u9055\u3063\u3066\u304d\u307e\u3059<\/li>\n<li>\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b\u306f\uff0c\u666e\u901a\u306e\u30b0\u30ea\u30aa\u30fc\u30de\u306e\u624b\u8853\u306e\u3088\u3046\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u30c6\u30f3\u30c8\u4e0b \u4e0a\u8863\u816b\u306f\uff0c\u8133\u5e79\u90e8\uff0c\u8133\u795e\u7d4c\uff0c\u8133\u8840\u7ba1\u3068\u306e\u5265\u96e2\u304c\u8981\u70b9\u3068\u306a\u308a\u307e\u3059<\/li>\n<li>\u5168\u6458\u51fa\u3067\u304d\u308c\u3070\u3044\u3044\u306e\u3067\u3059\u304c\uff0c\u73fe\u5b9f\u7684\u306b\u306f\u534a\u6570\u4ee5\u4e0a\u306e\u4f8b\u3067\u5168\u6458\u51fa\u304c\u3067\u304d\u307e\u305b\u3093<\/li>\n<li>1\u56de\u76ee\u306e\u624b\u8853\u3067\u3068\u308a\u304d\u308c\u306a\u304f\u3066\u3082\uff0c2\u5ea6\u76ee\u306e\u624b\u8853\u3067\u6458\u51fa\u3067\u304d\u308b\u3068\u5224\u65ad\u3057\u305f\u5834\u5408\u306b\u306f\uff0c<span style=\"color: #000080;\"><strong>\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u5f8c\u3067\u3042\u3063\u3066\u3082\uff0c\u3082\u3046\u4e00\u5ea6\u958b\u982d\u624b\u8853\u3057\u3066\u5168\u6458\u51fa\u3092\u3081\u3056\u3057\u307e\u3059 (<span style=\"color: #ff0000;\">second look surgery<\/span>)<\/strong><\/span><\/li>\n<li>AIEOP\u00a02016\u5e74\u3067\u306f\uff0c29%\u30672\u56de\u4ee5\u4e0a\u306e\u6458\u51fa\u8853\u304c\u884c\u308f\u308c\u3066\uff0c69%\u3067\u5168\u6458\u51fa\u304c\u5f97\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<\/ul>\n<h5>\u4e0a\u8863\u816b\u304c2023\u5e74\u3067\u3082surgical disease\u3068\u8a00\u308f\u308c\u308b\u6240\u4ee5<\/h5>\n<p>\u3072\u308b\u304c\u3048\u3063\u3066\u8a00\u3048\u3070\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3082\u5316\u5b66\u7642\u6cd5\uff08\u5236\u304c\u3093\u5264\uff09\u3082\u5f53\u3066\u306b\u3067\u304d\u306a\u3044\u306e\u3067\uff0c\u624b\u8853\u3067\u6cbb\u7642\u6210\u7e3e\uff08\u6cbb\u308b\u304b\u3069\u3046\u304b\uff09\u304c\u6c7a\u307e\u3063\u3066\u3057\u307e\u3046\u75c5\u6c17\u3068\u3044\u3046\u610f\u5473\u3067\u3059<\/p>\n<\/div>\n<h4>\u653e\u5c04\u7dda\u6cbb\u7642\uff08\u591a\u304f\u306e\u4f8b\u3067\u7528\u3044\u308b\uff09<\/h4>\n<ul>\n<li>\u4e0a\u8863\u816b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u611f\u53d7\u6027\u304c\u3042\u308b\u795e\u7d4c\u81a0\u816b\u3068\u3057\u3066\u77e5\u3089\u308c\u88dc\u52a9\u7642\u6cd5\u3068\u3057\u3066\u78ba\u7acb\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b\u30b0\u30ec\u30fc\u30c92\uff0c\u30c6\u30f3\u30c8\u4e0b EPN-PFB\u304c\u5b8c\u5168\u6458\u51fa\u3067\u304d\u305f\u6642\u3060\u3051\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u305b\u3093<\/strong><\/span><\/li>\n<li><strong><span style=\"color: #000080;\">50Gy\u4ee5\u4e0a\u306e\u7167\u5c04\u91cf<\/span><\/strong>\u304c\u63a8\u5968\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u4e0a\u8863\u816b\u3078\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u30e9\u30f3\u30c0\u30e0\u5316\u8a66\u9a13\u306e\u5831\u544a\u306f\u306a\u3044\u306e\u3067\uff0c\u7dda\u91cf\u3068\u7167\u5c04\u91ce\u3092\u78ba\u5b9a\u3059\u308b\u305f\u3081\u306e\u6839\u62e0\u3068\u306a\u308b\u30c7\u30fc\u30bf\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u3053\u308c\u4ee5\u4e0a<strong><span style=\"color: #000080;\">\u7dda\u91cf\u3092\u4f4e\u304f\u3059\u308b\u3068\u52b9\u679c\u304c\u671f\u5f85\u3067\u304d\u306a\u3044<\/span><\/strong>\uff0c\u4e88\u5f8c\u304c\u60aa\u5316\u3059\u308b\u3053\u3068\u306f\u8a3c\u660e\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u624b\u8853\u5f8c\u306e\u6b8b\u5b58\u816b\u760d\u306b\u306f\u7d44\u7e54\u5b66\u7684\u60aa\u6027\u5ea6\u3092\u554f\u308f\u305a\uff0c\u816b\u760d\u5c40\u6240\u306b50-59.4Gy\uff081\u65e5\u7dda\u91cf1.8Gy\uff09\u7a0b\u5ea6\u306e\u5206\u5272\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u3046<\/strong><\/span>\u306e\u304c\u4e00\u822c\u7684\u3067\u3059<\/li>\n<li>2004\u5e74\u306b\u5c0f\u5150\u306e\u4e0a\u8863\u816b\u306b\u5bfe\u3059\u308b\u9650\u5c40\u7684\u306a\u5c40\u6240\u539f\u4f53\u7167\u5c04 (conformal radiation therapy) \u306e\u7b2c2\u76f8\u8a66\u9a13\u306e\u6210\u7e3e\u3068\u3057\u3066\uff0c\u7121\u5897\u60aa3\u5e74\u751f\u5b58\u7387\u304c74%\u3067\u3042\u3063\u305f\u3068\u5831\u544a\u3055\u308c\uff0c\u6cbb\u7642\u306e\u65b9\u5411\u6027\u304c\u5909\u5316\u3057\u3066\u6765\u307e\u3057\u305f<\/li>\n<li>\u7167\u5c04\u65b9\u6cd5\u306f\uff0c\u539f\u4f53\u7167\u5c04 (conformal radiation therapy) \u3067\uff0cMRI\u3067\u898b\u3048\u308b\u816b\u760d\u3088\u308a10mm\u3072\u308d\u304f\u30de\u30fc\u30b8\u30f3\u3092\u53d6\u308b PTV\u3067\u7dda\u91cf\u8a08\u753b\u304c\u306a\u3055\u308c\u307e\u3059<\/li>\n<li>2019\u5e74\u6642\u70b9\u3067\u306f\uff0c18\u30f6\u6708\u4ee5\u4e0a\uff0c3\u6b73\u672a\u6e80\u306e\u5b50\u4f9b\u305f\u3061\u306f\u624b\u8853\u5f8c\u3059\u3050\u306b\u9593\u3092\u304a\u304b\u305a\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u305f\u65b9\u304c\u826f\u3044\u3068\u3055\u308c\u307e\u3059<\/li>\n<li>\u4e00\u65b9\uff0c\u64ad\u7a2e\u3092\u4e88\u9632\u3059\u308b\u305f\u3081\u306e\u5168\u8133\u810a\u9ac4\u7167\u5c04\u306e\u6709\u52b9\u6027\u306b\u95a2\u3059\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u7b2c4\u8133\u5ba4\u8fd1\u508d\u306b\u767a\u751f\u3057\u305f\u3082\u306e\u306f\u9ac4\u8154\u5185\u64ad\u7a2e\u3059\u308b\u3053\u3068\u304c\u3042\u308a\uff0c\u9006\u306b\u30c6\u30f3\u30c8\u4e0a\u306e\u4e0a\u8863\u816b\u304c\u64ad\u7a2e\u3059\u308b\u3053\u3068\u306f\u3068\u3066\u3082\u5c11\u306a\u3044\u3067\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u7b2c4\u8133\u5ba4\u306b\u767a\u751f\u3057\u305f\u7d44\u7e54\u5b66\u7684\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u306b\u5bfe\u3059\u308b\u8133\u810a\u9ac4\u7167\u5c04\u306e\u5fc5\u8981\u6027\u306b\u304a\u3044\u3066\u3082\u4e00\u5b9a\u306e\u898b\u89e3\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u529f\u3092\u594f\u305b\u305a\u306b\u518d\u767a\u3059\u308b\u5834\u5408\u306f\uff0c\u816b\u760d\u539f\u767a\u90e8\u4f4d\u306b\u518d\u767a\u3059\u308b\u3053\u3068\u304c\u6700\u3082\u591a\u3044\u3068\u3044\u3048\u307e\u3059<\/li>\n<li>\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u3066\u304b\u3064\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u3066\u308220-40%\u306b\u518d\u767a\u304c\u751f\u3058\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u5c40\u6240\u518d\u767a\u6642\u306e\u6cbb\u7642\u3068\u3057\u3066\u5b9a\u4f4d\u653e\u5c04\u7dda\u5916\u79d1\u6cbb\u7642 SRS<\/strong><\/span> \u304c\u7528\u3044\u3089\u308c\uff0c\u518d\u5ea6\u306e\u5bdb\u89e3\u5c0e\u5165\u306b\u6709\u52b9\u306a\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u4e0a\u8863\u816b\u306f\u6d78\u6f64\u6027\u795e\u7d4c\u81a0\u816b\u3067\u3042\u308b\u306e\u3067\u3053\u306e\u624b\u6cd5 SRS \u306f\u521d\u767a\u6642\u306b\u5358\u72ec\u3067\u306f\u7528\u3044\u3089\u308c\u308b\u3079\u304d\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u521d\u671f\u6cbb\u7642\u306b\u304a\u3044\u3066\u306e\u653e\u5c04\u7dda\u5916\u79d1\u306e\u9069\u5fdc\u306f\uff0c\u5f93\u6765\u306e\u5916\u7167\u5c04\u306b\u52a0\u3048\u3066\u8853\u5f8c\u6b8b\u5b58\u816b\u760d\u90e8\u4f4d\u306b\u8ffd\u52a0\u7167\u5c04\u3068\u3057\u3066\u7528\u3044\u308b\u3053\u3068\u306b\u3042\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093<\/li>\n<li>\u967d\u5b50\u7dda\u6cbb\u7642\u306f\u6b63\u5e38\u8133\u7d44\u7e54\u3078\u306e\u88ab\u66dd\u3092\u4f4e\u4e0b\u3055\u305b\u3066\u77e5\u80fd\u3092\u5b88\u308c\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u52b9\u679c\u3092\u8a3c\u660e\u3055\u308c\u308b\u307e\u3067\u306b\u306f\u81f3\u3063\u3066\u3044\u307e\u305b\u3093<\/li>\n<\/ul>\n<h4>\u5316\u5b66\u7642\u6cd5<\/h4>\n<ul>\n<li>\u660e\u3089\u304b\u306b\u6709\u52b9\u3067\u3042\u308b\u3068\u3044\u3046\u5316\u5b66\u7642\u6cd5\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u5e79\u7d30\u80de\u6551\u63f4\u3068\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u6709\u52b9\u6027\u306f\u8a3c\u660e\u3055\u308c\u3066\u3044\u307e\u305b\u3093<\/li>\n<li>\u30e8\u30fc\u30ed\u30c3\u30d1\u306e2018\u5e74\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\uff0c12\u30f6\u6708\u672a\u6e80\u306e\u5b50\u4f9b\u3060\u3051\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3057\u306a\u3044\u3067\uff0c\u5316\u5b66\u7642\u6cd5\u5358\u72ec\u6cbb\u7642\u3092\u884c\u3046\u3068\u3057\u3066\u3044\u307e\u3059<\/li>\n<li>2014\u5e74\uff0c3\u6b73\u672a\u6e80\u306e\u5b50\u3069\u3082\u306b\u3042\u308b\u7a0b\u5ea6\u306e\u6709\u52b9\u6027\u304c\u3042\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u3068\u3057\u3066\u5831\u544a\u3055\u308c\u305f\u5316\u5b66\u7642\u6cd5\u306f\uff0cPOG9233\u306e\u30b7\u30af\u30ed\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\u3092\u4f75\u7528\u3059\u308b\u30ec\u30b8\u30e1\u30f3\u3067\uff0c\u304b\u306a\u308a\u591a\u304f\u306e\u91cf\u3092\u6295\u4e0e\u3057\u307e\u3059<\/li>\n<li>2016\u5e74\u00a0AIEOP\u3067\u306f\uff0c\u5c0f\u5150\u3067\u624b\u8853\u5f8c\u6b8b\u5b58\u816b\u760d\u304c\u3042\u308b\u304b\u30b0\u30ec\u30fc\u30c93\u306e\u4f8b\u306bVEC (\u30b7\u30af\u30ed\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9)\u304c\u7528\u3044\u3089\u308c\u307e\u3057\u305f\uff0c\u3057\u304b\u3057\u5316\u5b66\u7642\u6cd5\u306e\u6709\u610f\u6027\u306f\u8a3c\u660e\u3055\u308c\u3066\u3044\u307e\u305b\u3093<\/li>\n<li>2020\u5e74 \u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3068\u30e9\u30d1\u30c1\u30cb\u30d6\u306e\u4f75\u7528\u304c\u518d\u767a\u4f8b\u306b\u6709\u52b9\u3067\u3042\u3063\u305f\u3068\u306e\u7b2c2\u76f8\u8a66\u9a13\u5831\u544a\u304c\u3042\u308a\u307e\u3057\u305f<\/li>\n<\/ul>\n<h5>\u4e0a\u8863\u816b\u306e\u5316\u5b66\u7642\u6cd5\u306a\u3069\u3067\u306a\u3084\u3093\u3060\u3089\u57fc\u7389\u533b\u5927\u56fd\u969b\u533b\u7642\u30bb\u30f3\u30bf\u30fc\u306e\u9234\u6728\u667a\u6210\u5148\u751f\u306b\u76f8\u8ac7\u3057\u3066\u304f\u3060\u3055\u3044\uff0c\u8fd4<a href=\"tmsuzuki@saitama-med.ac.jp\">\u4e8b\u3092\u3044\u305f\u3060\u3051\u307e\u3059\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/h5>\n<div class=\"setumei\">\n<h4>\u6cbb\u7642\u5f8c\u306e\u4e88\u5f8c<\/h4>\n<ul>\n<li>\u793e\u4f1a\u5fa9\u5e30\u3092\u6c7a\u3081\u308b\u6c7a\u5b9a\u7684\u306a\u9055\u3044\u306f\uff0c\u624b\u8853\u3067\u5408\u4f75\u75c7\u3092\u3042\u307e\u308a\u51fa\u3055\u306a\u3044\u3067\uff0c\u5168\u6458\u51fa\u3067\u304d\u305f\u304b\u3069\u3046\u304b\u3067\u3059<\/li>\n<li>\u518d\u767a\u306e80%\u304f\u3089\u3044\u306f\u3082\u3068\u3082\u3068\u816b\u760d\u304c\u3042\u3063\u305f\u5834\u6240\u306b\u751f\u3058\u307e\u3059<\/li>\n<li>\u6cbb\u7642\u5f8c\u907a\u75c7\u3092\u8003\u3048\u308b\u3068\uff0c\u5c40\u6240\u7167\u5c04\u3088\u308a\u3082\u624b\u8853\u5408\u4f75\u75c7\u306e\u307b\u3046\u304c\u91cd\u3044\u3067\u3059<\/li>\n<li>\uff13\u6b73\u672a\u6e80\u306e\u5c0f\u5150\u3067\u306e\u6cbb\u7642\u6210\u7e3e\u306f\u7279\u306b\u60aa\u3044\u3067\u3059<\/li>\n<li>\u4e0a\u8863\u816b\u5168\u4f53\u3067\uff0c60\uff05\u304f\u3089\u3044\u306e\u78ba\u7387\u3067\u6cbb\u7652 (\u5b8c\u5168\u306b\u6cbb\u308b) \u304c\u671f\u5f85\u3067\u304d\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>10\u5e74\u751f\u5b58\u5272\u5408\uff08\u751f\u5b58\u7387\uff09\u306f\uff0c\u5c0f\u5150\u306760\uff05\u304f\u3089\u3044\uff0c\u6210\u4eba\u306780\uff05\u304f\u3089\u3044<\/strong><\/span>\u3067\u3059\u3002<\/li>\n<li>\u624b\u8853\u3067\u5168\u6458\u51fa\u3067\u304d\u305f\uff0c\u75c5\u7406\u5b66\u7684\u306a\u60aa\u6027\u5ea6\u304c\u4f4e\u3044\uff0c\u8853\u5f8c\u306e\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u304d\u3061\u3093\u3068\u3057\u305f\u3068\u3044\u3046\u6761\u4ef6\u304c\u3042\u308b\u3068\u6cbb\u308b\u671f\u5f85\u304c\u5927\u304d\u3044\u3067\u3059<\/li>\n<li>\u30b0\u30ec\u30fc\u30c93\u306e\u9577\u671f\u751f\u5b58\u5272\u5408\u306f40%\u3092\u4e0b\u56de\u308a\u307e\u3059<\/li>\n<\/ul>\n<div>\n<h4><span style=\"color: #000080;\">\u521d\u671f\u6cbb\u7642\u306b\u304a\u3051\u308b\u6ce8\u610f<\/span><\/h4>\n<ul>\n<li>\u624b\u8853\u6458\u51fa\u3057\u3066\u304b\u3089\u5316\u5b66\u7642\u6cd5\u3060\u3051\u3057\u3066\uff0c\u7d4c\u904e\u3092\u898b\u3066\uff0c\u518d\u767a\uff08\u518d\u71c3\uff09\u3057\u3066\u304b\u3089\u306e\u76f8\u8ac7\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u305d\u3046\u306a\u308b\u3068\uff0c\u591a\u304f\u306e\u5834\u5408\u306b\u306f\u3082\u3046\u3059\u3067\u306b\u6cbb\u7642\u624b\u6bb5\u304c\u306a\u304f\uff0c\u4e0d\u5e78\u306a\u8ee2\u5e30\u3092\u3068\u3089\u308c\u308b\u60a3\u5150\uff08\u60a3\u8005\u3055\u3093\uff09\u304c\u307b\u3068\u3093\u3069\u3067\u3059<\/li>\n<li>\u3067\u304d\u308b\u9650\u308a\u306e\u6458\u51fa\u3092\u3057\u3066\u304b\u3089\uff0c<span style=\"color: #ff0000;\"><strong>\u53d6\u308a\u304d\u308c\u306a\u3044\u816b\u760d\u306b\u306f<\/strong><strong>\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3068\u307b\u3068\u3093\u3069\u52a9\u304b\u3089\u306a\u3044\u75c5\u6c17<\/strong><\/span>\u3067\u3042\u308b\u3053\u3068\u3092\u77e5\u3063\u3066\u4e0b\u3055\u3044\u3002<\/li>\n<li>\u52b9\u304f\u3053\u3068\u3082\u7a00\u306b\u306f\u3042\u308b\u306e\u3067\u3057\u3087\u3046\u304c\uff0c\u5316\u5b66\u7642\u6cd5\u306e\u6709\u52b9\u6027\u306f\u4f4e\u3044\u306e\u3067\u3059<\/li>\n<\/ul>\n<ul>\n<li>3\u6b73\u672a\u6e80\u306e\u5b50\u3069\u3082\u305f\u3061\u306b\u306f\u5316\u5b66\u7642\u6cd5\u3092\u5148\u884c\u3055\u305b\u308b\u3068\u3044\u3046\u9078\u629e\u80a2\u306f\u6b8b\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u304c\uff0c3\u6b73\u672a\u6e80\u3067\u3082\u5c40\u6240\u7167\u5c04\u3092\u8853\u5f8c\u306b\u884c\u306a\u3046\u3079\u304d\u3067\u3042\u308b\u3068\u3044\u3046\u610f\u898b\u306e\u65b9\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u5e7c\u5150\u3067\u3042\u3063\u3066\u3082\u539f\u4f53\u7167\u5c04\u3042\u308b\u3044\u306fIMRT\u3092\u7528\u3044\u308c\u3070\u77e5\u80fd\u306e\u4f4e\u4e0b\uff08\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\uff09\u306f\u9855\u8457\u3067\u306f\u306a\u3044\u3068\u3044\u3046\u9577\u671f\u89b3\u5bdf\u5831\u544a\u3082\u3042\u308a\u307e\u3059 (Netson KL 2012)<\/li>\n<li>\u30b0\u30ec\u30fc\u30c92\u4e0a\u8863\u816b\u3067\u624b\u8853\u3067\u5b8c\u5168\u306b\u6458\u51fa\u3067\u304d\u305f\u6642\u306f\uff0c\u30c6\u30f3\u30c8\u4e0a\u3067\u3082\u30c6\u30f3\u30c8\u4e0b\u3067\u3082\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u306a\u3044\u3067\u7d4c\u904e\u89b3\u5bdf\u3057\u307e\u3059<\/li>\n<\/ul>\n<h4>\u64ad\u7a2e\uff08\u8133\u810a\u9ac4\u6db2\u8154\u8ee2\u79fb\uff09<\/h4>\n<ul>\n<li>\u3068\u3066\u3082\u53b3\u3057\u3044\u72b6\u614b\u3067\u3059<\/li>\n<li>\u8133\u810a\u9ac4\u7167\u5c0436\u30b0\u30ec\u30a4\u3068MRI\u3067\u307f\u3048\u308b\u816b\u760d\u584a\u306b54-59\u30b0\u30ec\u30a4\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u3044\u307e\u3059<\/li>\n<li>\u6cbb\u305b\u308b\u78ba\u7387\u306f\u304b\u306a\u308a\u4f4e\u3044\u306e\u3067\uff0c\u7de9\u548c\u30b1\u30a2\u3084\u5b9a\u4f4d\u7167\u5c04\u306e\u307f\u3082\u9078\u629e\u80a2\u3067\u3059<\/li>\n<\/ul>\n<\/div>\n<h4>\u518d\u767a\uff08\u518d\u71c3\uff09<\/h4>\n<ul>\n<li>\u624b\u8853\u3067\u816b\u760d\u304c\u5b8c\u5168\u306b\u3068\u308c\u306a\u3044\u3067\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u3066\u3082\u816b\u760d\u304c\u6d88\u5931\u3057\u306a\u3044\u5834\u5408\u306e\u518d\u71c3\uff08\u6b8b\u3063\u305f\u816b\u760d\u304c\u5927\u304d\u304f\u306a\u308b\uff09\u306e\u78ba\u7387\u306f\u9ad8\u3044\u3067\u3059<\/li>\n<li>\u518d\u767a\uff08\u518d\u71c3\uff09\u3057\u305f\u3089\uff0c\u307e\u305a\u624b\u8853\u3067\u6458\u51fa\u3067\u304d\u308b\u304b\u3069\u3046\u304b\u3092\u691c\u8a0e\u3057\u307e\u3059<\/li>\n<li>\u518d\u71c3\u3057\u305f\u3089\uff0c\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\uff08\u3042\u308b\u3044\u306f\u653e\u5c04\u7dda\u5916\u79d1\uff0c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\uff09\u3092\u52a0\u3048\u307e\u3059\u304c\uff0c\u6709\u52b9\u7387\u306f\u9ad8\u304f\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3067\u3082\u6d88\u5931\u3059\u308b\u3053\u3068\u306f\u3081\u3063\u305f\u306b\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u307e\u305f\u8133\u5e79\u90e8\uff08\u5ef6\u9ac4\uff09\u306b\u304f\u3063\u3064\u3044\u3066\u3044\u308b\u3068\u518d\u624b\u8853\u3092\u3057\u3066\u3082\u53d6\u308a\u304d\u308c\u306a\u304f\u3066\uff0c\u307e\u305f\u305d\u306e\u5834\u6240\u304b\u3089\u518d\u767a\u3059\u308b\u3053\u3068\u3092\u7e70\u308a\u8fd4\u3057\u307e\u3059<\/li>\n<li>\u5927\u7dda\u91cf\u518d\u7167\u5c04\u306e\u6cbb\u7642\u6210\u7e3e\u304c\u826f\u3044\u3068\u306e\u5831\u544a\u3082\u3042\u308a\u307e\u3059\u304c\uff0c\u6b63\u3057\u3044\u304b\u3069\u3046\u304b\u306f\u89e3\u308a\u307e\u305b\u3093\u3002<\/li>\n<li>\u3082\u3046\u4e00\u3064\u306f\uff0c\u9ac4\u6db2\u64ad\u7a2e\u3067\u3059<\/li>\n<li>\u5168\u90e8\u306e\u8133\u3068\u810a\u9ac4\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u8133\u810a\u9ac4\u7167\u5c04\u3067\u6d88\u5931\u3042\u308b\u3044\u306f\u9032\u884c\u505c\u6b62\u3059\u308c\u3070\u3044\u3044\u306e\u3067\u3059\u304c\uff0c\u6d88\u3048\u306a\u3044\u3068\u305d\u306e\u5f8c\u306b\u3069\u306e\u3088\u3046\u306a\u5316\u5b66\u7642\u6cd5\u3092\u3057\u3066\u3082\u6cbb\u3089\u306a\u3044\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u518d\u767a\u518d\u71c3\u306e\u6cbb\u7642\u306f\u56f0\u96e3\u3067\u3059\u304b\u3089\uff0c<span style=\"color: #ff0000;\"><strong>\u521d\u56de\u624b\u8853\u3067\u306f\u591a\u5c11\u306e\u7121\u7406\u3092\u3057\u3066\u3067\u3082\u5168\u90e8\u816b\u760d\u3092\u53d6\u308b<\/strong><\/span>\u3068\u3044\u3046\u8003\u3048\u65b9\u3092\u3082\u3064\u3053\u3068\u304c\u5927\u5207\u3067\u3059\uff0c\u305d\u3057\u3066\u816b\u760d\u3092\u53d6\u308a\u6b8b\u305b\u3070\u5e74\u9f62\u306b\u95a2\u308f\u3089\u305a\u306b\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u3059<\/li>\n<li>\u518d\u767a\uff08\u518d\u71c3\uff09\u3042\u308b\u3044\u306f\u8ee2\u79fb\u518d\u767a\u306b\u306f\uff0c\u518d\u7167\u5c04\u3068\u3057\u3066\u5168\u3066\u8133\u810a\u9ac4\u7167\u5c04\u3092\u52a0\u3048\u308b\u3068\u3044\u3046\u610f\u898b\u304c\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<h5 class=\"setumei\"><span style=\"color: #000080;\"><strong>\u4e0a\u8863\u816b\u3000\u5bb6\u65cf\u306e\u4f1a\u304c\u3042\u308a\u307e\u3059\uff08\u30cd\u30c3\u30c8\u3067\u691c\u7d22\u3057\u3066\u304f\u3060\u3055\u3044\uff09<span style=\"font-size: 16.00160026550293px;\">\u00a0<\/span><\/strong><\/span><\/h5>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlbaby.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-thumbnail wp-image-11930\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlbaby-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlbaby-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlbaby-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/p>\n<h5>\u3053\u3053\u304b\u3089\u5148\u306f\u96e3\u3057\u3044\u3067\u3059<\/h5>\n<\/div>\n<hr \/>\n<h4><strong>\u7b2c4\u8133\u5ba4\u4e0a\u8863\u816b\uff08\u60aa\u6027\u306e\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\uff1aEPN-PFA\uff09<\/strong><\/h4>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-10065\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa2-300x282.jpg\" alt=\"\" width=\"300\" height=\"282\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa2-300x282.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa2.jpg 461w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-10066\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa1-300x295.jpg\" alt=\"\" width=\"300\" height=\"295\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa1-300x295.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa1.jpg 461w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u5e7c\u5150\u306e\u5de8\u5927\u306a\u4e0a\u8863\u816b\u3067\u3059\u3002\u5de6\u30eb\u30b7\u30e5\u30ab\u5b54\u304b\u3089\u5ef6\u9ac4\u3092\u53d6\u308a\u56f2\u3080\u69d8\u306b\u5c0f\u8133\u5ef6\u9ac4\u89d2\u69fd\u306b\u9032\u5c55\u3057\u3066\u3044\u307e\u3059\u3002\u6700\u3082\u5178\u578b\u7684\u3067\u6cbb\u7642\u304c\u96e3\u3057\u3044\u30bf\u30a4\u30d7\u3067\u3059\u3002\u3053\u308c\u306fT2\u5f37\u8abf\u753b\u50cf\u3067\u3059\u304c\uff0c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u306a\u3044\u3082\u306e\u3067\u3057\u305f\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa7.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-10067\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa7-300x298.jpg\" alt=\"\" width=\"300\" height=\"298\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa7-300x298.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa7-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa7-550x546.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa7-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa7.jpg 756w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-10068\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa3-300x279.jpg\" alt=\"\" width=\"300\" height=\"279\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa3-300x279.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa3-768x714.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa3-550x512.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa3.jpg 886w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u5de6\u304c\u8853\u524d\uff0c\u53f3\u304c\u8853\u5f8c\u3067\u3059\u3002\u8133\u5e95\u52d5\u8108\u306e\u5468\u56f2\u304c\u6458\u51fa\u3067\u304d\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u5e7c\u5150\u3067\u3059\u304c\u624b\u8853\u5f8c\u306b\u306f\u5c40\u6240\u7167\u5c04\u3092\u3059\u308b\u3057\u304b\u65b9\u6cd5\u304c\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-10069\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa5-300x224.jpg\" alt=\"\" width=\"300\" height=\"224\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa5-300x224.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa5-768x574.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa5-550x411.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa5.jpg 984w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa6.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-10070\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa6-300x224.jpg\" alt=\"\" width=\"300\" height=\"224\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa6-300x224.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa6-768x574.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa6-550x411.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/epnpfa6.jpg 984w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u3067\u306f\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\uff0cMIB-1\u306f40%\u4ee5\u4e0a\u306b\u3082\u9054\u3057\u307e\u3059\u3002<\/p>\n<p>\u3053\u306e\u69d8\u306aEPN-PFA\u306f\uff0c\u8133\u5916\u79d1\u306e\u5148\u751f\u3068\u5c0f\u5150\u79d1\u306e\u5148\u751f\u304c\u6700\u3082\u82e6\u52b4\u3059\u308b\u3082\u306e\u3067\u3059\u304c\uff0c\u4e88\u5f8c\u306f\u6975\u3081\u3066\u4e0d\u826f\u3067\u3059\u3002<\/p>\n<h4><strong style=\"background-color: #f4f9ff;\">\u7b2c4\u8133\u5ba4\u4e0a\u8863\u816b\uff08\u826f\u6027\u3068\u8a00\u3048\u308b\u601d\u6625\u671f\u4f8b\uff1aEPN-PFB\uff09<\/strong><\/h4>\n<div class=\"setumei\">\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdsag.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-5089\" title=\"ependyysgdsag\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdsag-300x281.jpg\" alt=\"\" width=\"300\" height=\"281\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdsag-300x281.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdsag-550x515.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdsag.jpg 653w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysciss.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-5090\" title=\"ependyysciss\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysciss-286x300.jpg\" alt=\"\" width=\"286\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysciss-286x300.jpg 286w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysciss-550x576.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysciss.jpg 600w\" sizes=\"auto, (max-width: 286px) 100vw, 286px\" \/><\/a><\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdsa.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-5091\" title=\"ependyysgdsa\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdsa-290x300.jpg\" alt=\"\" width=\"290\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdsa-290x300.jpg 290w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdsa-550x567.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdsa.jpg 552w\" sizes=\"auto, (max-width: 290px) 100vw, 290px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdax.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-5092\" title=\"ependyysgdax\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdax-288x300.jpg\" alt=\"\" width=\"288\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdax-288x300.jpg 288w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgdax.jpg 424w\" sizes=\"auto, (max-width: 288px) 100vw, 288px\" \/><\/a><\/p>\n<p>\u9752\u5e74\u306b\u767a\u751f\u3057\u305f\u3082\u306e\u3067\u3059\u3002\u304b\u306a\u308a\u5206\u5316\u5ea6\u306e\u9ad8\u3044\u5ef6\u9ac4\u80cc\u5074 ovex \u767a\u751f\u306e\u4e0a\u8863\u816b\u3067\u3059\u3002\u5883\u754c\u304c\u660e\u77ad\u306a\u306e\u3067\u3059\u304c\uff0c\u5b9f\u969b\u306b\u5074\u65b9\uff08\u5ef6\u9ac4\u5c0f\u8133\u811a\u69fd\uff09\u3067\u690e\u9aa8\u52d5\u8108\u3084\u5f8c\u4e0b\u5c0f\u8133\u52d5\u8108\uff0c\u4e0b\u4f4d\u8133\u795e\u7d4c\u306b\u7652\u7740\u3057\u3066\u3044\u308b\u306e\u3067\u5265\u96e2\u306f\u5fc5\u305a\u3057\u3082\u5bb9\u6613\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u3053\u306e\u4f8b\u3067\u306f\u5e78\u3044\u5168\u6458\u51fa\u3067\u304d\u307e\u3057\u305f\u3002<\/p>\n<h5>\u624b\u8853\u30d3\u30c7\u30aa\u306f\u4e0b\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068YouTube\u3067\u307f\u3048\u307e\u3059<br \/>\n<a href=\"https:\/\/www.youtube.com\/watch?v=OrDctZs91Gw&amp;feature=youtube_gdata_player\">part 1<\/a>\u00a0\u00a0<a href=\"https:\/\/www.youtube.com\/watch?v=zXK1lZawynU&amp;feature=youtube_gdata_player\">part 2<\/a><\/h5>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysperivas1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-5078\" title=\"ependyysperivas\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysperivas1-300x223.jpg\" alt=\"\" width=\"300\" height=\"223\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysperivas1-300x223.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysperivas1-550x410.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysperivas1.jpg 886w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyystube.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-5079\" title=\"ependyystube\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyystube-300x223.jpg\" alt=\"\" width=\"300\" height=\"223\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyystube-300x223.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyystube-550x410.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyystube.jpg 886w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u6458\u51fa\u3057\u305f\u6a19\u672c\u306eHE\u67d3\u8272\u3067\u3059\u3002\u5de6\u5074\u3067\u306fperivascular pseudorosette\uff08\u8840\u7ba1\u5468\u56f2\u306e\u7121\u6838\u91ce\uff09\u304c\u307f\u3089\u308c\uff0c\u53f3\u5074\u3067\u306fependymal tube (ependymal canal) \u304c\u8a8d\u3081\u3089\u308c\u307e\u3059\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgfap.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-5080\" title=\"ependyysgfap\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgfap-300x223.jpg\" alt=\"\" width=\"300\" height=\"223\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgfap-300x223.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgfap-550x410.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysgfap.jpg 886w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysmib.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-5081\" title=\"ependyysmib\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysmib-300x249.jpg\" alt=\"\" width=\"300\" height=\"249\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysmib-300x249.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysmib-550x457.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependyysmib.jpg 749w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u5de6\u304cGFAP\u67d3\u8272\u3001\u53f3\u304cMIB-1(Ki-67)\u67d3\u8272\u3067\u3059\u3002 GFAP\u306f\u816b\u760d\u8840\u7ba1\u306e\u5468\u56f2\u306e\u7121\u6838\u91ce\u306b\u5f37\u967d\u6027\u3067\u3059\u3002MIB-1 labelling index \u304c1%\u4ee5\u4e0b\u3067\u3042\u308a\uff0c\u3053\u306e\u4e0a\u8863\u816b\u306e\u5897\u6b96\u80fd\u304c\u6975\u3081\u3066\u4f4e\u3044\u3053\u3068\u3092\u793a\u3057\u3066\u3044\u307e\u3059\u3002\u3053\u306e\u3088\u3046\u306a\u9ad8\u5206\u5316\u578b\u3067\u5897\u6b96\u80fd\u306e\u4f4e\u3044\u4e0a\u8863\u816b\u306f\u810a\u9ac4\u9ac4\u5185\u306b\u306f\u591a\u3044\u306e\u3067\u3059\u304c\uff0c\u8133\u3067\u306f\u73cd\u3057\u3044\u3082\u306e\u3067\u3059\u3002ovex\u4e2d\u5fc3\u4e0a\u8863\u816b\u306b\u307f\u3089\u308c\u307e\u3059\u3002<\/p>\n<\/div>\n<h4><strong>\u30c6\u30f3\u30c8\u4e0a \u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b \u30b0\u30ec\u30fc\u30c93\uff1aEPN-ST-RELA negative<\/strong><\/h4>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-9123\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma4-200x200.jpg\" alt=\"anaplasticependyma4\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma4-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma4-298x300.jpg 298w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma4-550x553.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma4-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma4.jpg 709w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-9124\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma3-200x200.jpg\" alt=\"anaplasticependyma3\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma3-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma3-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma12.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-9125\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma12-200x200.jpg\" alt=\"anaplasticependyma12\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma12-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma12-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-9126\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma1-285x300.jpg\" alt=\"anaplasticependyma1\" width=\"285\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma1-285x300.jpg 285w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma1-550x579.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma1.jpg 709w\" sizes=\"auto, (max-width: 285px) 100vw, 285px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-9127\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma5-289x300.jpg\" alt=\"anaplasticependyma5\" width=\"289\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma5-289x300.jpg 289w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma5-768x797.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma5-550x571.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/anaplasticependyma5.jpg 850w\" sizes=\"auto, (max-width: 289px) 100vw, 289px\" \/><\/a><\/p>\n<p>\u81a0\u82bd\u816b\u3092\u601d\u308f\u305b\u308b\u3088\u3046\u306a\uff0c\u816b\u760d\u5185\u90e8\u306e\u58ca\u6b7b\uff0c\u306e\u3046\u80de\u5f62\u6210\uff0c\u51fa\u8840\u304c\u3042\u308a\u307e\u3059\u3002\u9ad8\u5ea6\u306e\u8840\u7ba1\u5897\u751f\u3068\u52d5\u9759\u8108\u30b7\u30e3\u30f3\u30c8\u304c\u3042\u308a\uff0c\u65e9\u671f\u816b\u760d\u9759\u8108\u63cf\u51fa early venous filling\u304c\u307f\u3089\u308c\u307e\u3059\u300210\u4ee3\u306e\u304a\u305d\u3089\u304f\u53f3\u5074\u8133\u5ba4\u4e09\u89d2\u90e8\u8fba\u308a\u304b\u3089\u767a\u751f\u3057\u305f\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u3067\u3059\u3002\u6fc0\u3057\u3044\u51fa\u8840\u304c\u3042\u308a\u307e\u3057\u305f\u304c\u5168\u6458\u51fa gross total removal \u3057\u307e\u3057\u305f\u3002\u30ea\u30b9\u30af\u3092\u304b\u3048\u308a\u307f\u306a\u3044\u624b\u8853\u3082\u5fc5\u8981\u3067\u3059\u3002\u753b\u50cf\u6240\u898b\u3082\u75c5\u7406\u7d44\u7e54\u50cf\u3082\u8d85\u60aa\u6027\u816b\u760d\u306a\u306e\u3067\u3059\u304c\uff0c\u6cbb\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u30bf\u30a4\u30d7\u3067\u3059\u3002<\/p>\n<h4><strong>\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b \u30b0\u30ec\u30fc\u30c92<\/strong><\/h4>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-11928\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok1-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok1-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-11929\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok2-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok2-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><br \/>\n\u6210\u4eba\u306b\u767a\u751f\u3057\u305f\u3082\u306e\u3067\u3059\u3002\u5883\u754c\u304c\u660e\u77ad\u306a\u816b\u760d\u3067\uff0c\u5468\u56f2\u306b\u3068\u3066\u3082\u5f37\u3044\u8133\u6d6e\u816b\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-11931\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok5-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok5-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok5-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-11932\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok4-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok4-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok4-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-11933\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok3-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok3-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomaok3-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/p>\n<p>\u7d44\u7e54\u50cf\u306f\u30b0\u30ec\u30fc\u30c92\uff0c\u5c0f\u578b\u5186\u5f62\u306e\u5747\u4e00\u306a\u6838\u3092\u3082\u3061\u8840\u7ba1\u5468\u56f2\u306b\u306f\u7121\u6838\u5e2f\u6240\u898b\u304c\u3042\u308a\u307e\u3059\u3002EMA epitherial membrane antigen\u306f\u967d\u6027\u3067\u3059\u3002MIB-1\u67d3\u8272\u7387\u306f\u975e\u5e38\u306b\u9ad8\u304f15%\u304f\u3089\u3044\u304c\u967d\u6027\u3067\uff0c\u518d\u767a\u306e\u53ef\u80fd\u6027\u3092\u4e88\u60f3\u3055\u305b\u308b\u3082\u306e\u3067\u3057\u305f\u3002<br \/>\n\u30b0\u30ec\u30fc\u30c92\u3067\u5168\u6458\u51fa\u3067\u304d\u305f\u3068\u8003\u3048\u305f\u306e\u3067\u3059\u304c\uff0c7\u5e74\u5f8c\uff0c10\u5e74\u5f8c\uff0c12\u5e74\u5f8c\u306b\u5c40\u6240\u518d\u767a\u3057\u3066\uff0c4\u56de\u306e\u958b\u982d\u624b\u8853\u3092\u3057\u307e\u3057\u305f\u3002\u5f8c\u907a\u75c7\u306f\u306a\u304f\u3066\u4eca\u306f\u6cbb\u3063\u3066\u60a3\u8005\u3055\u3093\u306f\u5143\u6c17\u3067\u3044\u307e\u3059\u3002\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b\u30b0\u30ec\u30fc\u30c9\uff12\u306f\uff0c\u305f\u3068\u3048\u518d\u767a\u3057\u3066\u3082\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u907f\u3051\u3089\u308c\u308b\u975e\u6d78\u6f64\u578b\u306e\u4f8b\u3067\u3059\u3002<\/p>\n<h3>\u3053\u3053\u304b\u3089\u4e0b\u306f\u5c02\u9580\u533b\u5411\u3051\u3067\u3055\u3089\u306b\u96e3\u3057\u3044\u3067\u3059<\/h3>\n<h5 align=\"left\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/braintumors\/2021who\/\"><span style=\"color: #000080;\"><strong>2021\u5e74 WHO\u5206\u985e\u3000\u4e0a\u8863\u7cfb\u816b\u760d \u00a0<\/strong><strong>Ependymal tumors<\/strong><\/span><\/a><\/h5>\n<p>\u8133\u5ba4\u58c1\u306e\u4e0a\u8863\u7d30\u80de (ependymal cell)\u304b\u3089\u767a\u751f\u3059\u308b\u4e2d\u67a2\u795e\u7d4c\u539f\u767a\u816b\u760d\u3067\u3042\u308a\uff0c\u4e0a\u8863\u7cfb\u816b\u760d (ependymal tumors) \u306e\u4e2d\u306b\u5206\u985e\u3055\u308c\u307e\u3059\u3002\u5927\u8133\u5185\u90e8\u306e\u3082\u306e\u306f\u4e0a\u8863\u7d30\u80de\u304b\u3089\u767a\u751f\u3059\u308b\u304b\u3069\u3046\u304b\u306f\u3063\u304d\u308a\u3057\u3066\u3044\u307e\u305b\u3093\u30022021\u5206\u985e\u3067\u306f\uff0c\u767a\u751f\u90e8\u4f4d\uff0c\u8abf\u7406\u7d44\u7e54\u8a3a\u65ad\uff0c\u5206\u5b50\u8a3a\u65ad\u3092\u6df7\u5408\u3055\u305b\u3066\u5206\u985e\u3057\u307e\u3059\u3002<\/p>\n<ul>\n<li><strong><span style=\"color: #333399;\">\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b<br \/>\nSupratentoirial ependymoma<span style=\"color: #000080;\"> (\u30b0\u30ec\u30fc\u30c9 2, 3)<\/span><\/span><\/strong><\/li>\n<li><strong><span style=\"color: #000080;\"><span style=\"color: #333399;\">\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b <em>ZFTA<\/em> fusion-positive<br \/>\nSupratentoirial ependymoma, <em>ZFTA<\/em> fusion-positive<\/span><\/span><\/strong><\/li>\n<li><strong><span style=\"color: #333399;\">\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b <em>YAP1<\/em> fusion-positive<br \/>\nSupratentoirial ependymoma, <em>YAP1<\/em> fusion-positive<\/span><\/strong><\/li>\n<li><span style=\"color: #333399;\"><span style=\"caret-color: #333399;\"><b>\u5f8c\u982d\u7aa9 \u4e0a\u8863\u816b<br \/>\nPosterior fossa ependymoma<strong><span style=\"color: #000080;\"> (\u30b0\u30ec\u30fc\u30c9 2, 3)<\/span><\/strong><\/b><\/span><\/span><\/li>\n<li><span style=\"color: #333399;\"><span style=\"caret-color: #333399;\"><b>\u5f8c\u982d\u7aa9 \u4e0a\u8863\u816b PFA\u30b0\u30eb\u30fc\u30d7<br \/>\nPosterior fossa ependymoma, group PFA<\/b><\/span><\/span><\/li>\n<li><span style=\"color: #333399;\"><span style=\"caret-color: #333399;\"><b>\u5f8c\u982d\u7aa9 \u4e0a\u8863\u816b PFB\u30b0\u30eb\u30fc\u30d7<br \/>\nPosterior fossa ependymoma, group PFB<\/b><\/span><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>\u810a\u9ac4\u4e0a\u8863\u816b<\/strong><\/span><br \/>\n<span style=\"color: #000080;\"><strong>\u00a0 \u00a0Spinal ependymoma (\u30b0\u30ec\u30fc\u30c9 2)<\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>\u810a\u9ac4\u4e0a\u8863\u816b<\/strong><\/span><br \/>\n<span style=\"color: #000080;\"><strong>\u00a0 \u00a0Spinal ependymoma, <em>MYCN<\/em>-amplified<\/strong><\/span><\/li>\n<li><strong><span style=\"color: #000080;\"><a style=\"color: #000080;\" title=\"\u7c98\u6db2\u4e73\u982d\u72b6\u4e0a\u8863\u816b\" href=\"\/sawamura\/braintumors\/glioma\/myxopapillary\/\">\u7c98\u6db2\u4e73\u982d\u72b6\u4e0a\u8863\u816b<\/a><br \/>\nMyxopapillary ependymoma (\u30b0\u30ec\u30fc\u30c9 2)<br \/>\n<\/span><\/strong><\/li>\n<li><strong><span style=\"color: #333399;\"><a style=\"color: #333399;\" title=\"\u4e0a\u8863\u4e0b\u816b\" href=\"\/sawamura\/braintumors\/glioma\/subependymoma\/\">\u4e0a\u8863\u4e0b\u816b<\/a><br \/>\nSubependymoma<span style=\"color: #000080;\"> (\u30b0\u30ec\u30fc\u30c9 1)<\/span><\/span><\/strong><\/li>\n<\/ul>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomamahe.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-9149\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomamahe-300x291.jpg\" alt=\"ependymomamahe\" width=\"300\" height=\"291\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomamahe-300x291.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomamahe-550x534.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/ependymomamahe.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\n\u30b0\u30ec\u30fc\u30c9\uff12\u306e\u7d44\u7e54\u50cf\u3067\u3059\u3002\u8840\u7ba1\u5468\u56f2\u306b\u7121\u6838\u91ce\u304c\u3042\u308a\uff0c\u816b\u760d\u306e\u6838\u306f\u8840\u7ba1\u304b\u3089\u96e2\u308c\u3066\u3044\u308b\u30d1\u30bf\u30fc\u30f3\u304c\u7279\u9577\u3067\u3059\u3002perivascular pseudo-rosette\u3068\u3044\u3044\u307e\u3059\u3002<\/p>\n<p>\u3053\u306e\u4e0a\u8863\u7cfb\u816b\u760d\u306b\u306f\u7d44\u7e54\u50cf\u3067\u5206\u985e\u3059\u308b\u3068\uff0c\u4e0a\u8863\u816b (ependymoma) \uff0c\u60aa\u7cbe\u5ea6\u306e\u9ad8\u3044\u30b0\u30ec\u30fc\u30c93 \u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b (anaplastic ependymoma)\uff0c\u8170\u9ac4\u4e0b\u90e8\u3068\u7d42\u7cf8\u306b\u597d\u767a\u3059\u308b\u7c98\u6db2\u4e73\u982d\u72b6\u4e0a\u8863\u816b(myxopapillary ependymoma)\uff0c\u904e\u8aa4\u816b\u3068\u3057\u3066\u306e\u6027\u683c\u3092\u6709\u3059\u308b\u4e0a\u8863\u4e0b\u816b(subependymoma)\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n<p>\u4e0a\u8863\u816b\u306f\u30b0\u30ec\u30fc\u30c9 2\u3068\u3055\u308c\u307e\u3059\u304c\uff0c\u661f\u7d30\u80de\u816bIDH\u5909\u7570\u578b\u30b0\u30ec\u30fc\u30c9 2 (astrocytoma IDH mutant grade 2) \u3068\u540c\u69d8\u306b\uff0c\u816b\u760d\u6b7b\u3059\u308b\u3053\u3068\u304c\u5c11\u306a\u304b\u3089\u305a\u3042\u308a\uff0c\u5b9f\u969b\u306b\u306f\u30b0\u30ec\u30fc\u30c93 \u7a0b\u5ea6\u306e\u4e88\u5f8c\u306b\u5339\u6575\u3057\u307e\u3059\u3002\u9006\u306b\u810a\u9ac4\u4e0a\u8863\u816b\u306f\u5168\u6458\u51fa\u3067\u304d\u308c\u3070\u5b8c\u6cbb\u3057\u3066\u30b0\u30ec\u30fc\u30c91\u306b\u8fd1\u3044\u4e88\u5f8c\u306b\u306a\u308a\u307e\u3059\u3002\u767a\u751f\u3059\u308b\u90e8\u4f4d\uff08\u810a\u9ac4\uff0c\u5c0f\u8133\uff0f\u5f8c\u982d\u7aa9\uff0c\u5927\u8133\uff09\u3067\u751f\u7269\u5b66\u7684\u306b\u306f\u9055\u3063\u305f\u907a\u4f1d\u5b50\u306e\u7570\u5e38\u3067\u767a\u751f\u3057\u3066\uff0c\u4e88\u5f8c\u3082\u304b\u306a\u308a\u7570\u306a\u308a\u307e\u3059 (Matthew 2014)\u3002\u795e\u7d4c\u7dda\u7dad\u816b\u75c7\uff12\u578b\u3067\u306f\u810a\u9ac4\u9ac4\u5185\u306b\u591a\u767a\u6027\u306e\u4e0a\u8863\u816b\u3092\u307f\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u3053\u308c\u306f\u96e3\u6cbb\u6027\u3067\u3059\u3002<\/p>\n<p>2020\u5e74\u307e\u3067\u306f\uff0c\u30b0\u30ec\u30fc\u30c9\uff12\u306e\u4e0a\u8863\u816b\u306fvariant\u3068\u3057\u3066\uff0c<strong><span style=\"color: #000080;\">papillary ependymoma, clear-cell ependymoma, tanycytic ependymoma<\/span><\/strong><span style=\"color: #333333;\">\u00a0\u3068\u3044\u308f\u308c\u308b\u3082\u306e\u304c\u3042\u308a\u307e\u3057\u305f\u3002<\/span>\u307e\u305f\uff0c\u5c0f\u5150\u306b\u767a\u751f\u3059\u308b\u80ce\u5150\u6027\u816b\u760d\u3068\u3057\u3066\u306e<span style=\"color: #000080;\"><strong>\u4e0a\u8863\u82bd\u7d30\u80de\u816b(ependymoblastoma)<\/strong><\/span>\u306f\u80ce\u5150\u6027\u816b\u760d\u3068\u3057\u3066\u6271\u308f\u308c\u308b\u306e\u3067\u3053\u306e\u816b\u760d\u7fa4\u306b\u5165\u308a\u307e\u305b\u3093\u3002<\/p>\n<h4>\u5206\u5b50\u7279\u6027\u5206\u985e<\/h4>\n<h5><strong><span style=\"text-decoration: underline;\">Infratentorial tumors<\/span><br \/>\n<span style=\"color: #ff0000;\">Posterior fossa group A<\/span><\/strong>, CpG island methylator phenotype (CIMP)-positive ependymoma, termed EPN-PFA<br \/>\n<strong><span style=\"color: #ff0000;\">Posterior fossa group B<\/span><\/strong>, CIMP-negative ependymoma, termed EPN-PFB<\/h5>\n<div class=\"pdq-content-list\">\n<h5><span style=\"text-decoration: underline;\"><strong>Supratentorial tumors<\/strong><\/span><br \/>\n<strong><span style=\"color: #000080;\"><span style=\"color: #333399;\"><em>ZFTA<\/em> fusion-positive<\/span><\/span><\/strong><br \/>\n<strong><span style=\"color: #333399;\"><em>YAP1<\/em> fusion-positive<\/span><\/strong><\/h5>\n<\/div>\n<div class=\"pdq-content-list\">\n<p><span style=\"color: #333333;\"><span style=\"color: #000080;\"><strong>EPN-PFA<br \/>\n<\/strong><\/span>\u5f8c\u982d\u7aa9\u4e0a\u8863\u816bA EPN-PFA\u306f\u4e2d\u592e\u50243\u6b73\u304f\u3089\u3044\u306e\u5e7c\u5150\u306b\u767a\u751f\u3057\u307e\u3059\u3002\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u306e\u307b\u3068\u3093\u3069\u304cPFA\u3067\u3059\u3002DNA CpG island methylation profile status\u3068gene expression\u3067Group B\u3068\u533a\u5225\u3055\u308c\u307e\u3059\u3002\u5c0f\u5150\u306e\u4e0a\u8863\u816b\u3068\u3057\u3066\u6700\u3082\u983b\u5ea6\u304c\u9ad8\u3044\u3082\u306e\u3067\u3059\u3002\u3053\u308c\u304c\u4e0a\u8863\u816b\u5168\u4f53\u306e\u5e73\u5747\u5e74\u9f62\u3092\u4e0b\u3052\u3066\u3044\u307e\u3059\u30021q gain\u304c\u3042\u308b\u3068\u4e88\u5f8c\u304c\u60aa\u3044\u3053\u3068\u304c\u77e5\u3089\u308c\uff0c\u7121\u3044\u3082\u306e\u30675\u5e74EFS 81%\uff0cgain\u304c\u3042\u308b\u306835%\u307e\u3067\u4f4e\u4e0b\u3057\u307e\u3059\u3002\u3002\u6cbb\u7642\u62b5\u6297\u6027\u30675\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f70%\u304f\u3089\u3044\u3067\u3059\u3002\u3053\u308c\u306f\u751f\u7269\u5b66\u7684\u7279\u6027\u3068\u3044\u3046\u3088\u308a\uff0c\u4e73\u5e7c\u5150\u306e\u5f8c\u982d\u7aa9\u306e\u5ef6\u9ac4\u5468\u56f2\u306b\u767a\u751f\u3059\u308b\u305f\u3081\u306b\uff0c\u624b\u8853\u6458\u51fa\u304c\u56f0\u96e3\u306a\u3053\u3068\u306b\u56e0\u3057\u307e\u3059\u3002<\/span><\/p>\n<p><span style=\"color: #333333;\"><span style=\"color: #000080;\"><strong>EPN-PFB<\/strong><br \/>\n<span style=\"color: #333333;\">\u57fa\u672c\u7684\u306b\u30b0\u30ec\u30fc\u30c92\u306e\u75c5\u7406\u50cf\u3068\u81e8\u5e8a\u6027\u683c\u3092\u793a\u3057\u307e\u3059\u3002\u601d\u6625\u671f\u304b\u3089\u82e5\u5e74\u6210\u4eba\uff08\u5e74\u9f62\u4e2d\u592e\u502430\u6b73\uff09\u306b\u767a\u751f\u3057\u307e\u3059\u304c\uff0c\u983b\u5ea6\u306f\u4f4e\u3044\u3082\u306e\u3067\u3059\u30025\u5e74\u7121\u5897\u60aa\u751f\u5b58\u671f\u959373%\uff0c5\u5e74\u5168\u751f\u5b58\u671f\u9593\u306f\u307b\u307c100%\u3068\u826f\u6027\u816b\u760d\u306e\u6027\u683c\u3092\u793a\u3057\u307e\u3059\u3002<\/span><br \/>\n<\/span><\/span><\/p>\n<p id=\"_sm_CDR0000779396_1917\" tabindex=\"-1\"><strong><span style=\"color: #000080;\"><span style=\"color: #333399;\"><em>ZFTA<\/em> fusion-positive<\/span><\/span><\/strong>\uff1a\u5c0f\u5150\uff08\u5e74\u9f62\u4e2d\u592e\u50248\u6b73\uff09\u306e\u5927\u8133\u4e0a\u8863\u816b\u306e70%\u304f\u3089\u3044\u3067\u3059\u3002\u5897\u5927\u901f\u5ea6\u304c\u901f\u304f(MIB-1 &gt;10%) \u4e88\u5f8c\u304c\u60aa\u304f\u6cbb\u308a\u306b\u304f\u3044\u3082\u306e\u3067\u3059\u30025\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f29%\uff0c\u5168\u751f\u5b58\u5272\u5408\u306f75%\u3067\u3059\u30024\u5206\u306e1\u306fgain of chromosome 1q\u304c\u3042\u308a\u3055\u3089\u306b\u4e88\u5f8c\u4e0d\u826f\u3067\u3059\u3002\u9006\u306b\uff0cclear cell ependymoma\u306f\u3053\u306e\u4e2d\u306b\u3042\u3063\u3066\u3082\u5c11\u3057\u4e88\u5f8c\u304c\u826f\u3044\u3082\u306e\u3068\u3057\u3066\u77e5\u3089\u308c\u307e\u3059\u3002<\/p>\n<p tabindex=\"-1\"><strong><span style=\"color: #333399;\"><em>YAP1<\/em> fusion-positive<\/span><\/strong>\uff1a\u4e73\u5e7c\u5150\u306b\u767a\u751f\u3059\u308b\u30bf\u30a4\u30d7\u3067\u4e88\u5f8c\u304c\u826f\u597d\u3060\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u307e\u308c\u306a\u3082\u306e\u3067\u3059\u3002<\/p>\n<h5 tabindex=\"-1\">\u6ce8\u610f\uff01 \u5206\u5b50\u5206\u985e\u304c\u5fc5\u305a\u3057\u3082\u7d76\u5bfe\u7684\u306b\u6b63\u3057\u3044\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b\u306f\u5168\u6458\u51fa\u3067\u304d\u308c\u3070\u4e88\u5f8c\u304c\u826f\u3044\u3068\u3044\u3046\u539f\u5247\u306f\u5909\u308f\u308a\u307e\u305b\u3093\u3002\u307e\u305f\u30b0\u30ec\u30fc\u30c92\u306f\uff0c\u8133\u795e\u7d4c\u7d44\u7e54\u6d78\u6f64\u304c\u307b\u3068\u3093\u3069\u306a\u3044\u306e\u3067\u6458\u51fa\u3057\u3084\u3059\u3044\u3068\u3044\u3046\u5927\u539f\u5247\u3082\u6b8b\u308a\u307e\u3059\u3002<\/h5>\n<p>&nbsp;<\/p>\n<\/div>\n<div class=\"setumei\">\n<h5>\u6587\u732e\u60c5\u5831<\/h5>\n<\/div>\n<h4 class=\"heading-title\"><strong>\u521d\u767a\u4e0a\u8863\u816b\u306e\u7dad\u6301\u5316\u5b66\u7642\u6cd5\u306f\u7121\u52b9<\/strong><\/h4>\n<p>Smith AA: Phase 3 randomized trial of post-irradiation chemotherapy in patients with newly diagnosed ependymoma, a report from the Children&#8217;s Oncology Group. Neuro Oncol. 2025<br \/>\n2019\u5e74\u306b\u767a\u8868\u3055\u308c\u305f\u5317\u7c73COG ACNS0121\u8a66\u9a13\u306b\u7d9a\u3044\u3066\u884c\u308f\u308c\u305f ACNS0831\u8a66\u9a13\u306e\u5831\u544a\u3067\u3059\u3002<br \/>\n\u521d\u767a\u306e\u982d\u84cb\u5185\u4e0a\u8863\u816b\u60a3\u8005 449\u4eba \u3092\u5bfe\u8c61\u306b\u3001\u5e73\u57475.2\u5e74 \u306e\u8ffd\u8de1\u8abf\u67fb\u304c\u884c\u308f\u308c\u307e\u3057\u305f\u3002ACNS0121\u306e\u30b3\u30f3\u30bb\u30d7\u30c8\u3092\u7d99\u627f\u3057\u305f\u5c64\u5225\u5316\u304c\u884c\u308f\u308c\u3001\u6cbb\u7642\u306e\u6700\u5f8c\u306b\u7dad\u6301\u5316\u5b66\u7642\u6cd5\u3092\u8ffd\u52a0\u3057\u3001\u305d\u306e\u52b9\u679c\u304c\u691c\u8a0e\u3055\u308c\u307e\u3057\u305f\u3002\u5168\u6458\u30fb\u6e96\u5168\u6458\u4f8b\u3067\u306f\u3001\u653e\u5c04\u7dda\u6cbb\u7642\uff08RT\uff09\u5358\u72ec\u7fa4\u306e5\u5e74\u7121\u30a4\u30d9\u30f3\u30c8\u751f\u5b58\u7387\uff08EFS\uff09\u306f 63.7%\u3001RT\uff0b\u7dad\u6301\u5316\u5b66\u7642\u6cd5\u7fa4\u306f 69.2% \u3067\u3057\u305f\u304c\u3001\u7d71\u8a08\u5b66\u7684\u306a\u6709\u610f\u5dee\u306f\u8a8d\u3081\u3089\u308c\u307e\u305b\u3093\u3067\u3057\u305f\u3002<br \/>\n\u4e00\u65b9\u3001\u521d\u56de\u624b\u8853\u3067\u816b\u760d\u306e\u6b8b\u5b58\u304c\u3042\u308a\u3001\u305d\u306e\u5f8c\u306e\u5316\u5b66\u7642\u6cd5\u3084\u518d\u624b\u8853\u306b\u3088\u3063\u3066\u5168\u6458\u306b\u81f3\u3063\u305f\u7fa4\u3067\u306f\u3001\u7dad\u6301\u5316\u5b66\u7642\u6cd5\u3092\u8ffd\u52a0\u3057\u305f\u7fa4\uff0841.7%\uff09\u3088\u308a\u3082\u3001RT\u306e\u307f\u306e\u7fa4\uff0867.5%\uff09\u306e\u65b9\u304c\u826f\u597d\u306a\u6210\u7e3e\u3067\u3057\u305f\u3002\u4ee5\u4e0a\u306e\u7d50\u679c\u304b\u3089\u3001\u4e0a\u8863\u816b\u306e\u6cbb\u7642\u306b\u304a\u3044\u3066\u7dad\u6301\u5316\u5b66\u7642\u6cd5\u3092\u8ffd\u52a0\u3057\u3066\u3082\u3001\u660e\u78ba\u306a\u5229\u76ca\u306f\u306a\u3044\u3068\u7d50\u8ad6\u3065\u3051\u3089\u308c\u307e\u3057\u305f\u3002<br \/>\n\u3053\u308c\u307e\u3067\u69d8\u3005\u306a\u5f62\u3067\u5316\u5b66\u7642\u6cd5\u306e\u6709\u7528\u6027\u304c\u691c\u8a0e\u3055\u308c\u3066\u304d\u307e\u3057\u305f\u304c\u3001\u73fe\u6642\u70b9\u3067\u306f\u751f\u5b58\u7387\u3092\u6539\u5584\u3059\u308b\u52b9\u679c\u306f\u9650\u5b9a\u7684\u3068\u8003\u3048\u3089\u308c\u307e\u3059\u3002<\/p>\n<h4 class=\"heading-title\"><strong>SIOP\u30c8\u30e9\u30a4\u30a2\u30eb\u306e\u6700\u7d42\u5831\u544a<\/strong><\/h4>\n<p>Ritzmann TA: SIOP Ependymoma I: Final results, long-term follow-up, and molecular analysis of the trial cohort\u2014A BIOMECA Consortium Study. Neuro Oncol, 2022<br \/>\n3\u6b73\u304b\u308921\u6b73\u306e\u8ee2\u79fb\u306e\u306a\u3044\u4e0a\u8863\u816b74\u4f8b\u3092\u5bfe\u8c61\u306b\u3057\u3066\uff0c\u30b9\u30c6\u30fc\u30b8\u306b\u5fdc\u3058\u305f\u6cbb\u7642\u306e\u7d50\u679c\u3067\u3059\u3002\u5168\u6458\u51fa\u3067\u304d\u305f\u5834\u5408\u306b\u306f\u8853\u5f8c\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u307f\uff0c\u90e8\u5206\u6458\u51fa subtotal resection\u306e\u5834\u5408\u306fVEC (VCR, VP-16, CP) \u5316\u5b66\u7642\u6cd5\u3092\u5148\u884c\u3055\u305b\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u306a\u3055\u308c\u307e\u3057\u305f\u3002<br \/>\n74\u4f8b\u4e2d33\u4f8b(44.6%)\u3067\u5168\u6458\u51fa\u304c\u3067\u304d\u307e\u3057\u305f\uff08\u3053\u306e\u6570\u5b57\u306f\u5c11\u3057\u4f4e\u3044\uff1f\uff09\u3002\u5168\u6458\u51fa\u4f8b\u3067\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u306e\u6709\u610f\u306a\u5ef6\u9577\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u30b0\u30ec\u30fc\u30c93\u306e\u7d44\u7e54\u50cf\uff0c1q gain, H3K27me3 loss, hTERT expression\u306a\u3069\u304c\u3042\u308b\u3068\u751f\u5b58\u671f\u9593\u304c\u77ed\u3044\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>VEC\u5316\u5b66\u7642\u6cd5\u306b\u306f\u3063\u304d\u308a\u3057\u305f\u52b9\u679c\u306f\u8a8d\u3081\u3089\u308c\u3066\u3044\u307e\u305b\u3093<\/strong><\/span>\u3002\u5168\u4f53\u306e10\u5e74\u751f\u5b58\u5272\u5408\u306f60.5%\u3067\u3057\u305f\u3002<\/p>\n<h4><b>\u518d\u767a\u4e0a\u8863\u816b\u3078\u306e\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3068\u30e9\u30d1\u30c1\u30cb\u30d6\u306e\u52b9\u679c\u304c\u3042\u308a\u305d\u3046<\/b><\/h4>\n<p class=\"heading-title\"><span class=\"authors-list-item \">Gilbert MR:\u00a0<\/span>A Phase II Study of Dose-Dense Temozolomide and Lapatinib for Recurrent Low-Grade and Anaplastic Supratentorial, Infratentorial, and Spinal Cord Ependymoma. Neuro Oncol 2020<br \/>\n\u4e0a\u8863\u816b\u306b\u6709\u52b9\u306a\u5316\u5b66\u7642\u6cd5\u306f\u77e5\u3089\u308c\u3066\u3044\u307e\u305b\u3093\u3002\u518d\u767a\u4e0a\u8863\u816b50\u4f8b\u306b\u5bfe\u3057\u3066\u7b2c2\u76f8\u8a66\u9a13\u304c\u884c\u308f\u308c\u307e\u3057\u305f\u3002unmethylated MGMT promoter status\u306b\u5bfe\u3057\u3066\u591a\u91cf\u306e\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\uff0cErbB2 (HER2)\/ErbB1 (EGFR)\u306e\u767a\u73fe\u306b\u5bfe\u3057\u3066\u963b\u5bb3\u5264\u3067\u3042\u308b\u30e9\u30d1\u30c1\u30cb\u30d6\u3092\u4f75\u7528\u3059\u308b\u3082\u306e\u3067\u3059\u3002\u5e74\u9f62\u4e2d\u592e\u502445\u6b73\uff0c\u534a\u6570\u304c\u810a\u9ac4\u4e0a\u8863\u816b\u3067\uff0c\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u4f8b\u306f16\u4f8b\u3067\u3059\u3002\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024 PFS\u306f7.8\u30f6\u6708\u3067\u3057\u305f\u3002CR\u306f2\u4f8b\uff0cPR\u306f6\u4f8b\u3067\u3059\u3002\u591a\u304f\u306e\u4f8b\u3067\u75c7\u72b6\u306e\u6539\u5584\u304c\u8a8d\u3081\u3089\u308c\u305f\u305d\u3046\u3067\u3059\u3002\u7d50\u8ad6\u3068\u3057\u3066\u82e5\u5e72\u306e\u6709\u52b9\u6027\u304c\u3042\u308b\u3068\u3044\u3046\u3082\u306e\u3067\u3059\u3002<\/p>\n<h4><strong>\u539f\u4f53\u7167\u5c04 CRT \u306f\u3059\u3079\u3066\u306e\u4e0a\u8863\u816b\u3078\u306e\u57fa\u672c\u7684\u6cbb\u7642\u6cd5\u3067\u3042\u308b<\/strong><\/h4>\n<p><span class=\"highlight\">Merchant TE: Conformal<\/span> <span class=\"highlight\">Radiation<\/span> <span class=\"highlight\">Therapy<\/span> for <span class=\"highlight\">Pediatric<\/span> <span class=\"highlight\">Ependymoma<\/span>, <span class=\"highlight\">Chemotherapy<\/span> for <span class=\"highlight\">Incompletely<\/span><span class=\"highlight\">Resected<\/span> <span class=\"highlight\">Ependymoma<\/span>, and <span class=\"highlight\">Observation<\/span> for <span class=\"highlight\">Completely<\/span> <span class=\"highlight\">Resected<\/span>, <span class=\"highlight\">Supratentorial<\/span><span class=\"highlight\">Ependymoma<\/span>. <span role=\"menubar\">J Clin Oncol.<\/span> 2019<br \/>\n\u5317\u7c73\u306eCOG ACN0121\u8a66\u9a13\u306e\u5831\u544a\u3067\u3059\u3002\u6cbb\u7642\u767b\u9332\u306f2007\u307e\u3067\u3067\uff0c5\u5e74\u4ee5\u4e0a\u8ffd\u8de1\u3055\u308c\u307e\u3057\u305f\u3002\u521d\u767a\u4e0a\u8863\u816b356\u4eba\uff081\u6b73\u304b\u308921\u6b73\uff09\u304c\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u30c6\u30f3\u30c8\u4e0a \u4e0a\u8863\u816b\u3060\u3051\u306f\u5168\u6458\u51fa\u3067\u304d\u308c\u3070\uff0c\u6cbb\u7642\u3092\u52a0\u3048\u308b\u3053\u3068\u306a\u304f\u7d4c\u904e\u89b3\u5bdf\u3055\u308c\u307e\u3057\u305f\u3002\u90e8\u5206\u5168\u6458 subtotal resecsion \u306b\u7d42\u308f\u3063\u305f\u3082\u306e\u306f\uff0c\u5316\u5b66\u7642\u6cd5\uff0c\u518d\u624b\u8853\uff0c\u539f\u4f53\u7167\u5c04 CRT \u304c\u52a0\u3048\u3089\u308c\u307e\u3057\u305f\u3002\u307b\u307c\u5168\u6458\u51fa near total \/ gross total \u3067\u304d\u305f\u4f8b\u3067\u306f\uff0c\u624b\u8853\u5f8c\u3059\u3050\u306b\u9593\u3092\u304a\u304b\u305a immediate \u306b10mm\u306e\u30de\u30fc\u30b8\u30f3\u3092CTV\u3068\u3057\u305f\u539f\u4f53\u7167\u5c04\u304c\u884c\u308f\u308c\u3066\u3044\u307e\u3059\u300218\u30f6\u6708\u3088\u308a\u5e7c\u3044\u4e73\u5e7c\u5150\uff0c\u5168\u6458\u51fa\u3067\u304d\u305f\u4f8b\u3067\u306f54\u30b0\u30ec\u30a4\u304c\u7528\u3044\u3089\u308c\uff0c\u4ed6\u306e\u4f8b\u3067\u306f59.4\u30b0\u30ec\u30a4\u3068\u3044\u3046\u7dda\u91cf\u304c\u7528\u3044\u3089\u308c\u307e\u3057\u305f\u3002<br \/>\n5\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408 EFS \u306f\uff0c\u30c6\u30f3\u30c8\u4e0a\u30b0\u30ec\u30fc\u30c92\u306e\u5168\u6458\u4f8b\u30676.4%\uff0c\u90e8\u5206\u6458\u51fa\u4f8b\u306737.2%\uff0c\u307b\u307c\u5168\u6458\u51fa\u4f8b\u306b\u76f4\u5f8c\u306eCRT\u306768.5%\u3067\u3057\u305f\u30025\u5e74ETF\u306f\uff0c\u30b0\u30ec\u30fc\u30c9\uff13\u3067\u4f4e\u304b\u3063\u305f\u306e\u3067\u3059\u304c\uff0c\u5e74\u9f62\uff0c\u90e8\u4f4d\uff0cRELA\u878d\u5408\u306e\u6709\u7121\uff0c\u5f8c\u982d\u7aa9A\u3068B\u306e\u9593\u306b\u306f\u6709\u610f\u306a\u5dee\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002EFS\u306f1p gain\u306e\u3042\u3063\u305f\u3082\u306e\u3067\u4f4e\u3044\u3068\u3044\u3046\u7d50\u679c\u3067\u3059\u3002<br \/>\n\u7d50\u8ad6\u3068\u3057\u3066\uff0c\u90e8\u5206\u6458\u51fa\u4f8b\u3067\u306f\u4e88\u5f8c\u304c\u4e0d\u826f\u3068\u3044\u3048\u308b\u3088\u3046\u3067\u3059\u3002\u4e00\u65b9\u3067\uff0c3\u6b73\u672a\u6e80\u3067\u3042\u3063\u3066\u3082\u624b\u8853\u5f8c\u3059\u3050\u306b\u653e\u5c04\u7dda\u6cbb\u7642 CRT\u3092\u53d7\u3051\u305f\u5b50\u4f9b\u305f\u3061\u306f\uff0c\u5e74\u9577\u5150\u3068\u540c\u3058\u7a0b\u5ea6\u306eEFS\u304c\u5f97\u3089\u308c\u308b\u3068\u3057\u3066\u3044\u307e\u3059\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u3069\u306e\u3088\u3046\u306a\u30bf\u30a4\u30d7\u3067\u3042\u3063\u3066\u3082\u8853\u5f8c\u306b\u306f\u4e3b\u305f\u308b\u6cbb\u7642\u624b\u6bb5\u3067\u3042\u308a\uff0c\u624b\u8853\u5f8c\u306b\u306f\u9593\u3092\u7f6e\u304b\u306a\u3044\u3067\u539f\u4f53\u7167\u5c04 (immediate CRT) \u3092\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b\u3068\u8ff0\u3079\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4 class=\"cit\">\u4e0a\u8863\u816b\u306e\u518d\u767a\u6642\u306b\u306f\uff0c\u5c40\u6240\u518d\u767a\u3067\u3082\u8133\u810a\u9ac4\u7167\u5c04\u3092\u3059\u308b<\/h4>\n<p><span class=\"highlight\">Tsang DS, et al.: Craniospinal irradiation<\/span> as <span class=\"highlight\">part<\/span> of <span class=\"highlight\">re-irradiation<\/span> for <span class=\"highlight\">children<\/span> with <span class=\"highlight\">recurrent<\/span> <span class=\"highlight\">intracranial<\/span><span class=\"highlight\">ependymoma<\/span>.\u00a0<span role=\"menubar\">Neuro Oncol.<\/span> 2019<br \/>\n\u30c8\u30ed\u30f3\u30c8\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u30022012\u5e74\u304b\u3089\u306f\uff0c\u518d\u767a\u4e0a\u8863\u816b\u306b\u5bfe\u3057\u3066\u9ac4\u6db2\u64ad\u7a2e\u30fb\u8ee2\u79fb\u306e\u6709\u7121\u3092\u554f\u308f\u305a\u306b\u8133\u810a\u9ac4\u7167\u5c04\u304c\u6cbb\u7642\u65b9\u91dd\u3067\u3057\u305f\u3002\u8ee2\u79fb\u518d\u767a\u304c\u306a\u304b\u3063\u305f22\u4eba\u306e\u3046\u3061\u3067\uff0c\u816b\u760d\u9032\u884c\u304c5\u5e74\u9593\u6291\u3048\u3089\u308c\u305f FFP freedom from progression\u00a0\u306e\u306f\uff0c\u8133\u810a\u9ac4\u7167\u5c04\u3092\u53d7\u3051\u305f\u60a3\u8005\u3055\u3093\u306783%\uff0c\u5c40\u6240\u306e\u307f\u306e\u518d\u7167\u5c04\u3067\u306f15%\u3060\u3063\u305f\u305d\u3046\u3067\u3059\u3002\u89b3\u5bdf\u671f\u9593\u4e2d\u592e\u5024 5,5\u5e74\u3067\u653e\u5c04\u7dda\u8133\u58ca\u6b7b\u306f1\u4f8b\u3082\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u3057\u304b\u3057\uff0c\u307b\u3068\u3093\u3069\u306e\u751f\u5b58\u8005\u304c\u88dc\u52a9\u3092\u53d7\u3051\u306a\u3044\u3068\u901a\u5b66\u3067\u304d\u3066\u3044\u307e\u305b\u3093\u3002\u3053\u308c\u3089\u518d\u767a\u4f8b\u306e\u5206\u5b50\u8a3a\u65ad\u3067\u306f\uff0c\u5168\u3066\u3067RELA\u878d\u5408\u304c\u3042\u308b\u304b\u5f8c\u982d\u7aa9\u30b0\u30eb\u30fc\u30d7A\u3067\u3057\u305f\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u518d\u767a\u3057\u3066\u304f\u308b\u3082\u306e\u306f\u9ac4\u6db2\u64ad\u7a2e\u3059\u308b\u50be\u5411\u304c\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3057\u3087\u3046\u304b\u3002\u5c40\u6240\u518d\u767a\u3067\u3082\u8133\u810a\u9ac4\u7167\u5c04\u3092\u518d\u7167\u5c04\u3068\u3057\u3066\u7528\u3044\u308b\u3053\u3068\u306f\uff0c\u518d\u767a\u4e0a\u8863\u816b\u306e\u64ad\u7a2e\u8ee2\u79fb\u304c\u9ad8\u7387\u3067\u3042\u308b\u3068\u3044\u3046\u7406\u8ad6\u304c\u306a\u3044\u3068\u6210\u308a\u7acb\u3061\u307e\u305b\u3093\u3002<\/p>\n<h4 class=\"cit\">\u810a\u9ac4 \u4e0a\u8863\u816b spinal ependymoma<\/h4>\n<p><span class=\"highlight\">Wostrack M: Spinal<\/span> <span class=\"highlight\">ependymoma<\/span> in <span class=\"highlight\">adults<\/span>: a <span class=\"highlight\">multicenter<\/span> <span class=\"highlight\">investigation<\/span> of <span class=\"highlight\">surgical<\/span> <span class=\"highlight\">outcome<\/span> and <span class=\"highlight\">progression-free survival<\/span>.\u00a0<span role=\"menubar\">J\u00a0Neurosurg Spine.<\/span> 2018<br \/>\n\u4f55\u3082\u65b0\u3057\u3044\u3053\u3068\u306f\u306a\u3044\u306e\u3067\u3059\u304c\uff0c2006\u5e74\u304b\u30892013\u5e74\u306b\u6cbb\u7642\u3055\u308c\u305f\u591a\u6570\u4f8b\u5831\u544a\uff08158\u4f8b\uff09\u3067\u3059\u300280%\u306e\u60a3\u8005\u3055\u3093\u3067\u5168\u6458\u51fa gross total resection \u304c\u53ef\u80fd\u3067\u3057\u305f\u300237%\u306e\u60a3\u8005\u3055\u3093\u3067\uff0c\u624b\u8853\u5f8c\u306e\u795e\u7d4c\u75c7\u72b6\u306e\u5897\u60aa\u304c\u3042\u308a\u307e\u3057\u305f\u304c\uff0c\u591a\u304f\u3067\u6539\u5584\u3092\u898b\u3066\u3044\u307e\u3059\u300276\uff05\u306e\u60a3\u8005\u3055\u3093\u3067\u624b\u8853\u524d\u3068\u540c\u3058\u72b6\u614b\u3067\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\uff0c2%\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\u56de\u5fa9\u3057\u306a\u3044\u91cd\u3044\u75c7\u72b6\u304c\u6b8b\u308a\u307e\u3057\u305f\u3002\u9ad8\u9f62\u8005\u306e\u624b\u8853\u6210\u7e3e\u306f\u60aa\u3044\u50be\u5411\u306b\u3042\u308a\u307e\u3057\u305f\u30025\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408 PFS\u306f80%\u3067\uff0c\u5168\u6458\u51fa\u3067\u304d\u305f\u60a3\u8005\u3055\u3093\u3068Ki-67 index (MIB-1\u67d3\u8272\u7387\uff09\u304c\u4f4e\u304b\u3063\u305f\u60a3\u8005\u3055\u3093\u3067\u518d\u767a\u304c\u5c11\u306a\u3044\u305d\u3046\u3067\u3059\uff08\u5f53\u305f\u308a\u524d\u3067\u3059\u304c\uff09\u300215\u4eba\u304c\u624b\u8853\u5f8c\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u307e\u3059\u304c\u52b9\u679c\u306f\u4e0d\u660e\u3067\u3059\u3002<\/p>\n<div class=\"setumei\">\n<h4>\u624b\u8853\u3067\u5168\u6458\u3057\u3066\u308210\u5e74\u751f\u5b58\u306f60%\u304f\u3089\u3044<\/h4>\n<p class=\"ArticleTitle\" lang=\"en\">Marinoff AE, et al.: Rethinking childhood ependymoma: a retrospective, multi-center analysis reveals poor long-term overall survival. J Neuro-Oncol 2017<br \/>\n\u30c0\u30ca\u30fb\u30d5\u30a1\u30fc\u30d0\u30fc\u3053\u3069\u3082\u75c5\u9662\u306e\u4f8b\u3092\u4e2d\u5fc3\u306b\u3057\u3066450\u4f8b\u306e\u30b0\u30ec\u30fc\u30c92\u30683\u306e\u4e0a\u8863\u816b\u306e\u9577\u671f\u751f\u5b58\u5272\u5408\u304c\u89e3\u6790\u3055\u308c\u307e\u3057\u305f\u3002\u624b\u8853\u3067\u5168\u6458\u51fa\u3059\u308b\u3068\u6cbb\u308b\u3068\u3044\u3046\u671f\u5f85\u306f\u5927\u304d\u3044\u306e\u3067\u3059\u304c\uff0c\u5168\u6458\u51fa\u3057\u3066\u308210\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u540836%\uff0c\u5168\u751f\u5b58\u5272\u5408\u306f61%\u3068\u306e\u7d50\u679c\u3067\u3057\u305f\u3002\u5168\u6458\u3057\u3066\u30822\/3\u306f\u518d\u767a\u3057\u3066\uff0c4\u5272\u306e\u5b50\u306f\u547d\u3092\u4ea1\u304f\u3059\u3068\u3044\u3046\u3082\u306e\u3067\u3059\u3002\u3067\u3082\u5168\u6458\u51fa\u3067\u304d\u306a\u3044\u3068\u3082\u3063\u3068\u751f\u5b58\u5272\u5408\u306f\u4f4e\u304f\u306a\u308a\u307e\u3059\u3002<\/p>\n<\/div>\n<h4>\u967d\u5b50\u7dda\u3068\u653e\u5c04\u7dda\u306e\u6cbb\u7642\u6210\u7e3e\u306b\u5dee\u304c\u306a\u3044<\/h4>\n<p>Sato M, et al.: Progression-free survival of children with localized ependymoma treated with intensity-modulated radiation therapy or proton-beam radiation therapy. Cancer 2017<br \/>\n79\u4eba\u306e\u4e0a\u8863\u816b\u306e\u5b50\u4f9b\u306e\u6cbb\u7642\u6210\u7e3e\u304c\u691c\u8a0e\u3055\u308c\u307e\u3057\u305f\u3002<span style=\"color: #000080;\"><strong>\u967d\u5b50\u7dda\u6cbb\u7642 PRT\u3068\u653e\u5c04\u7dda\u6cbb\u7642 IMRT\u306e\u6cbb\u7642\u6210\u7e3e survical outcome \u306b\u5dee\u304c\u306a\u3044<\/strong><\/span>\u3068\u3044\u3046\u5831\u544a\u3067\u3059\u3002\u5c11\u306a\u304f\u3068\u3082\u967d\u5b50\u7dda\u306fIMRT\u306b\u52a3\u3089\u306a\u3044\u3068\u89e3\u91c8\u3067\u304d\u307e\u3059\u30023\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f\uff0c\u967d\u5b50\u7dda\u306782%\uff0c\u653e\u5c04\u7dda IMRT\u306760%\u3068\u967d\u5b50\u7dda\u306e\u307b\u3046\u304c\u512a\u3063\u3066\u3044\u308b\u30c7\u30fc\u30bf\u3067\u3059\u304c\uff0c\u967d\u5b50\u7dda\u6cbb\u7642\u7fa4\u3067GTR\u306e\u6bd4\u7387\u304c\u9ad8\u304f\uff0c\u305d\u308c\u3088\u308a\u3082\u3084\u306f\u308a\u624b\u8853\u304c\u6210\u529f\u3057\u305f\u304b\u3069\u3046\u304b\u304c\u751f\u5b58\u306e\u6c7a\u3081\u624b\u306b\u306a\u3063\u305f\u305d\u3046\u3067\u3059\u3002\u4e88\u5f8c\u56e0\u5b50\u306f\u5168\u6458\u51fa GTR gross total removal \u304b\u5426\u304b\u3060\u3051\u3060\u3068\u306e\u7d50\u8ad6\u3067\u3057\u305f\u3002<\/p>\n<h4>\u5c0f\u5150\u4e0a\u8863\u816b\u3078\u306e\u5927\u898f\u6a21\u524d\u5411\u304d\u8a66\u9a13\u306e\u7d50\u679c<\/h4>\n<p>Massimino M, et al.:\u00a0Final results of the second prospective AIEOP protocol for pediatric intracranial\u00a0ependymoma. Neuro Oncol\u00a02016<br \/>\n\u30a4\u30bf\u30ea\u30a2\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u30022002-2014\u5e74\u307e\u3067\u306b\uff0c\u5e74\u9f62\u4e2d\u592e\u50245\u6b73\uff0c160\u4eba\u306e\u5c0f\u5150\u304c\u767b\u9332\u3055\u308c\u3066\u884c\u308f\u308c\u305f\u524d\u5411\u304d\u8a66\u9a13\u3067\u3059\u3002110\u4f8b (69%) \u3067\u5168\u6458\u51fa\u3067\u304d\u307e\u3057\u305f\u300284\u4f8b (53%)\u304c\u30b0\u30ec\u30fc\u30c93\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u3067\u3057\u305f\u3002\u00a02\u56de\u4ee5\u4e0a\u306e\u816b\u760d\u6458\u51fa\u8853\u304c46\u4f8b (29%)\u3067\u884c\u308f\u308c\u307e\u3057\u305f\u3002\u30b0\u30ec\u30fc\u30c93\u3068\u624b\u8853\u5f8c\u6b8b\u5b58\u816b\u760d\u304c\u3042\u3063\u305f\u7fa4\u3067\u306fVEC\u5316\u5b66\u7642\u6cd5\u304c\u884c\u308f\u308c\u3066\u3044\u307e\u3059\u30025\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408 PFS \u306f58%\uff0c\u5168\u751f\u5b58\u5272\u5408 OS \u306f69%\u3067\u3057\u305f\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u7d50\u8ad6\u3067\uff0c59.4Gy\u306e\u901a\u5e38\u306e\u6cbb\u7642\u304c\u884c\u308f\u308c\u305f\u5f8c\u306b\u3055\u3089\u306b\u6b8b\u3063\u305f\u816b\u760d\u306b\uff0c8Gy\/2fr\u306e\u8ffd\u52a0\u7167\u5c04\u3092\u884c\u3063\u305f\u3082\u306e\u3067PFS 58%, OS 69%\u3068\u4e88\u5f8c\u6539\u5584\u306b\u5bc4\u4e0e\u3057\u305f\u3068\u3042\u308a\u307e\u3059\u300270Gy\u4ee5\u4e0a\u306b\u76f8\u5f53\u3059\u308b\u3082\u306e\u3059\u3054\u3044\u7dda\u91cf\u3067\u3059\u3002\u8133\u5e79\u90e8\u3084\u8133\u795e\u7d4c\u306b\u3053\u306eboost\u304c\u3042\u305f\u308c\u3070\u8133\u5e79\u90e8\u58ca\u6b7b\u306b\u306a\u308a\u307e\u3059\u3002VEC\u5316\u5b66\u7642\u6cd5\u306e\u6709\u610f\u6027\u306f\u8a3c\u660e\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n<h5>VEC regimen<\/h5>\n<p>VCR (1.5mg\/m2, day1)<br \/>\nCPA (1g\/m2 infused in 1 h for 3 doses, 3 h apart, day 1)<br \/>\nVP-16 (100mg\/m2 infused in 2 h, days 1, 2, and 3)<\/p>\n<h4>\u6210\u4eba\u306e\u30c6\u30f3\u30c8\u4e0a\uff08\u5927\u8133\uff09\u4e0a\u8863\u816b<\/h4>\n<p>Hollon T, et al.: Supratentorial hemispheric ependymomas: an analysis of 109 adults for survival and prognostic factors. J Neurosurg: 2016<br \/>\n109\u4f8b\u306e\u6210\u4eba\u306e\u30c6\u30f3\u30c8\u4e0a\u306b\u3067\u304d\u305f\u4e0a\u8863\u816b\u306e\u6cbb\u7642\u6210\u7e3e\u3067\u3059\u3002\u30b0\u30ec\u30fc\u30c93\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u304c62%\u3067\uff0c10\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f42%\uff0c\u5168\u751f\u5b58\u5272\u5408\u306f58%\u3067\u3057\u305f\u3002\u30b0\u30ec\u30fc\u30c93\u306b\u9650\u308c\u307010\u5e74\u751f\u5b58\u306f48%\u3067\u3059\u304c\uff0c\u5168\u6458\u51fa\u3067\u304d\u3066\u3044\u306a\u3044\u30680%\u8fd1\u304f\u306b\u306a\u308a\u307e\u3059\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u6709\u7121\u306f\u4e88\u5f8c\u306b\u95a2\u9023\u304c\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u3053\u308c\u306f\u7c73\u56fd\u8133\u5916\u79d1\u5b66\u4f1a\u306e\u6a5f\u95a2\u8a8c\u306b\u66f8\u304b\u308c\u305f\u3082\u306e\u3067\u3059\u304c\uff0c\u5168\u6458\u51fa total removal\u3067\u304d\u308c\u3070\u751f\u5b58\u5272\u5408\u304c\u9ad8\u3044\u3068\u3044\u3046\u4eca\u307e\u3067\u306e\u5e38\u8b58\u304c\u8ffd\u8a8d\u3055\u308c\u307e\u3057\u305f\u3002\u5916\u79d1\u6cbb\u7642\u4f9d\u5b58\u3067\u3042\u308a\uff0c4\u5272\u306f\u6b7b\u4ea1\u3057\u307e\u3059\u304b\u3089\uff0cradical resection\u304c\u63a8\u5968\u3055\u308c\u307e\u3059\u3002<\/p>\n<h4>\u967d\u5b50\u7dda\u6cbb\u7642\u5f8c\u306eMRI\u753b\u50cf\u306e\u5909\u5316<\/h4>\n<p>Gunther JR, et al.: Imaging Changes in Pediatric Intracranial Ependymoma Patients Treated With Proton Beam Radiation Therapy Compared to Intensity Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 93:54-63, 2016<br \/>\nMD\u30a2\u30f3\u30c0\u30fc\u30bd\u30f3\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u3002\u967d\u5b50\u7dda\u6cbb\u7642\u306737\u4eba\u306e\u4e0a\u8863\u816b\u306e\u5b50\u4f9b\uff08\u4e2d\u592e\u50244.4\u6b73\uff09\u304c\uff0cIMRT (photon)\u306735\u4eba\u306e\u5b50\u4f9b\u304c\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002\u967d\u5b50\u7dda\u6cbb\u7642\u3092\u884c\u3063\u305f\u3046\u3061\u306e16\u4eba(43%)\u3067\u7d044\u30f6\u6708\u5f8c\u306bMRI\u3067\u5909\u5316\u304c\u898b\u3089\u308c\u307e\u3057\u305f\u3002\u3053\u306e\u6240\u898b\u306f6\u30f6\u6708\u307b\u3069\u3067\u53ce\u307e\u3063\u3066\u3044\u307e\u3059\u30024\u4eba\u306e\u5b50\u4f9b\u304c\u30b9\u30c6\u30ed\u30a4\u30c9\u3084\u30a2\u30d0\u30b9\u30c1\u30f3\u3067\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u304c\uff0c3\u4eba\u3067\u5f8c\u907a\u75c7 neurological deficits\u304c\u6b8b\u308a\uff0c1\u4f8b\u304c\u653e\u5c04\u7dda\u58ca\u6b7b\u3067\u6b7b\u4ea1\u3057\u307e\u3057\u305f\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u967d\u5b50\u7dda\u6cbb\u7642\u306f\u6b63\u5e38\u7d44\u7e54\u3092\u907f\u3051\u3066\u6cbb\u7642\u3067\u304d\u308b\u3068\u3044\u3046\u671f\u5f85\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u9006\u306b\uff0c\u7167\u5c04\u91ce\u306b\u542b\u307e\u308c\u308b\u8133\u5e79\u90e8\u306e\u91cd\u7be4\u306a\u653e\u5c04\u7dda\u969c\u5bb3\u304c\u9ad8\u304f\u306a\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002\u967d\u5b50\u7dda\u306e\u52b9\u679c\u306f\u307e\u3060\u8a3c\u660e\u3055\u308c\u3066\u3044\u306a\u3044\u306e\u3067\u904e\u5ea6\u306a\u671f\u5f85\u306f\u3067\u304d\u307e\u305b\u3093\u3057\uff0c\u8133\u5e79\u90e8\u306e\u9ad8\u7dda\u91cf\u88ab\u66dd\u3092\u907f\u3051\u308b\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3057\u3087\u3046\u3002<\/p>\n<h4>\u6210\u4eba\u306e\u4e0a\u8863\u816b\u306e\u81e8\u5e8a\u7d4c\u904e<\/h4>\n<p>Vera-Bolanos E: Clinical course and progression-free survival of adult intracranial and spinal ependymoma patients.\u00a0Neuro Oncol 2015<br \/>\n\u6210\u4eba\u4e0a\u8863\u816b282\u4eba\u306e\u89e3\u6790\u7d50\u679c\u3067\u3059\u3002\u7537\u5973\u540c\u6570\u304f\u3089\u3044\u5e73\u5747\u5e74\u9f62\u306f43\u6b73\u3002\u307b\u3068\u3093\u306978%\u304c\u30b0\u30ec\u30fc\u30c92\u3067\u3057\u305f\u3002\u30c6\u30f3\u30c8\u4e0a 19%\uff0c\u30c6\u30f3\u30c8\u4e0b 35%\uff0c\u810a\u9ac4 46%\u3067\u3059\u3002\u816b\u760d\u518d\u767a\u306f26%\u306b\u3042\u308a\uff0c\u7121\u5897\u60aa\u671f\u9593\u306f14\u5e74\u3067\u3057\u305f\u3002\u3053\u306e\u8ad6\u6587\u306f\u6570\u3068\u3057\u3066\u306f\u591a\u3044\u306e\u3067\u3059\u304c\uff0c\u8133\u3068\u810a\u9ac4\u306e\u4e0a\u8863\u816b\u3092\u3054\u3061\u3083\u6df7\u305c\u306b\u3057\u3066\u3044\u308b\u306e\u3067\u7d50\u679c\u306b\u610f\u5473\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u810a\u9ac4\u4e0a\u8863\u816b\u306f\u5727\u5012\u7684\u306b\u4e88\u5f8c\u304c\u826f\u3044\u306e\u3067\u3059\u3002<\/p>\n<h4>\u4e0a\u8863\u816b\u306e\u5206\u5b50\u5206\u985e<\/h4>\n<p>Pajtler KW, et al.: Molecular Classification of Ependymal Tumors across All CNS Compartments, Histopathological Grades, and Age Groups. Cancer Cell. 27, 2015<br \/>\n\u56f0\u3063\u305f\u3053\u3068\u306b\uff0c\u4e0a\u8863\u4e0b\u816b SE \u3082\u4e00\u7dd2\u304f\u305f\u306e\u8ad6\u6587\u3067\u3059\u3002SE\u3092\u9664\u3051\u3070\uff0c<strong><span style=\"color: #000080;\">\u30c6\u30f3\u30c8\u4e0a\u3067YAP1 (PF-YAP1)<\/span><\/strong><span style=\"color: #000080;\">\u3068<\/span><strong><span style=\"color: #000080;\">RELA (PF-RELA)<\/span><\/strong>\u306e\u878d\u5408\u304c\u3042\u308b\u3082\u306e\uff0c<span style=\"color: #000080;\"><strong>\u30c6\u30f3\u30c8\u4e0b\u3067balanced genome (ST-A)<\/strong>\u3068<strong>chromosomal instability (ST-B)<\/strong><\/span>\u304c\u3042\u308b\u3082\u306e\uff14\u7a2e\u985e\u306b\u5206\u985e\u3067\u304d\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002392\u4f8b\u306e\u8133\u4e0a\u8863\u816b\u306e\u3046\u3061\uff0c<strong><span style=\"color: #000080;\">PF-A 240\u4f8b\uff08\u5c0f\u3055\u306a\u5b50\u3069\u3082\u4e2d\u592e\u50243\u6b73\uff09<\/span><\/strong>\uff0cPF-B 51\u4f8b\uff08\u601d\u6625\u671f\u304b\u3089\u82e5\u5e74\u6210\u4eba\u4e2d\u592e\u502430\u6b73\uff09\uff0cST-YAP 13\u4f8b\uff08\u4e2d\u592e\u50241.4\u6b73\uff09\uff0c<strong><span style=\"color: #000080;\">ST-RELA\u304c88\u4f8b\uff08\u4e2d\u592e\u50248\u6b73\uff0c\u6210\u4eba\u4f8b23%\uff09<\/span><\/strong>\u3067\u3057\u305f\u3002\u5927\u8133\u306f\u307b\u3068\u3093\u3069\u304cRELA\u878d\u5408\u304c\u3042\u308b\u30bf\u30a4\u30d7\u3067\u3059\u300210\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f\uff0c\u305d\u308c\u305e\u308c PF-A 56%, PF-B 88%, ST-YAP1 100%, ST-RELA 49%\u3067\uff0c<strong><span style=\"color: #ff0000;\">PF-A\u3068ST-RELA\u306e\u4e88\u5f8c\u304c\u6975\u3081\u3066\u60aa\u3044<\/span><\/strong>\u3067\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u78ba\u304b\u306b\u5206\u5b50\u8a3a\u65ad\u3067\u5206\u985e\u3057\u305f\u65b9\u304c\u4e3b\u89b3\u7684\u306a\u75c5\u7406\u8a3a\u65ad\u3088\u308a\u3088\u3044\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u3067\u3082\u3053\u3053\u3067\u5224\u660e\u3057\u305f\u3053\u3068\u306f\uff0c\u4e73\u5e7c\u5150\u306e\u5f8c\u982d\u7aa9\u4e0a\u8863\u816b\u306e\u4e88\u5f8c\u304c\u60aa\u3044\uff0c\u5c0f\u5150\u3068\u82e5\u5e74\u6210\u4eba\u306e\u8133\u5185\u4e0a\u8863\u816b\u306e\u4e88\u5f8c\u304c\u60aa\u3044\u3068\u3044\u3046\uff0c\u4eca\u307e\u3067\u77e5\u3089\u308c\u3066\u3044\u305f\u3053\u3068\u306e\u713c\u304d\u76f4\u3057\u306e\u30c7\u30fc\u30bf\u306b\u4ed6\u306a\u308a\u307e\u305b\u3093\uff1f\uff1f\u305d\u3082\u305d\u3082\u30c6\u30f3\u30c8\u4e0a\u306e\u30b0\u30ec\u30fc\u30c92\u306e\u4e0a\u8863\u816b\u306f\u5916\u79d1\u6458\u51fa\u3057\u3084\u3059\u3044\u3082\u306e\u3067\u3059\uff0c\u3067\u3059\u304b\u3089\u5b8c\u5168\u6458\u51fa\u3067\u304d\u308b\u30c1\u30e3\u30f3\u30b9\u304c\u591a\u3044\u306e\u3067\u4e88\u5f8c\u304c\u3088\u3044\u3068\u3044\u3046\u306e\u306f\u5206\u5b50\u907a\u4f1d\u5b66\u7684\u306a\u5dee\u7570\u3067\u306f\u306a\u304f\u3066\uff0c\u5916\u79d1\u6cbb\u7642\u5b66\u7684\u306a\u89b3\u70b9\u304b\u3089\u306e\u7d50\u679c\u3067\u3042\u308b\u3053\u3068\u3082\u5fd8\u308c\u3066\u306f\u306a\u308a\u307e\u305b\u3093\u3002<\/p>\n<div class=\"setumei\">\n<h4>3\u6b73\u672a\u6e80\u306e\u5c0f\u5150\u306b\u5316\u5b66\u7642\u6cd5\u306e\u307f\u3067\u6cbb\u7642\u3059\u308b<\/h4>\n<p align=\"left\">Strother DR, et al.: Benefit from prolonged dose-intensive chemotherapy for infants with malignant brain tumors is restricted to patients with ependymoma: a report of the Pediatric Oncology Group randomized controlled trial 9233\/34. Neuro Oncol 16: 457-65, 2014<br \/>\n\uff13\u6b73\u672a\u6e80\u3067\uff0c\u9ac4\u82bd\u816b\uff0c\u4e0a\u8863\u816b\uff0cPNET\u306a\u3069328\u4eba\u306e\u60aa\u6027\u8133\u816b\u760d\u304c\u767b\u9332\u3055\u308c\u305fPOG 9233\u306e\u7d50\u679c\u3067\u3059\u3002\u5168\u4f53\u7684\u306a\u7d50\u8ad6\u3068\u3057\u3066\u306f\uff0c\u6295\u4e0e\u91cf\u3092\u5897\u3084\u3057\u305f\u5316\u5b66\u7642\u6cd5 dose-intensive chemotherapy\u306e\u5229\u70b9\u306f\u5426\u5b9a\u3055\u308c\u307e\u3057\u305f\u3002\u3057\u304b\u3057\uff0c\u4e0a\u8863\u816b\u306e\u60a3\u5150\u3060\u3051\u3067\u306f\uff0c<span style=\"color: #ff0000;\"><strong>\u591a\u91cf\u5316\u5b66\u7642\u6cd5\u7fa4\u306f\u901a\u5e38\u91cf\u5316\u5b66\u7642\u6cd5\u7fa4\u3088\u308a2\u5e74\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593 EFS \u304c\u6539\u5584<\/strong><\/span>\u3055\u308c\u307e\u3057\u305f\u00a0(42.1% vs 19.6%)\u00a0\u3002\u3057\u304b\u3057\uff0c<strong><span style=\"color: #000080;\">\u5168\u751f\u5b58\u5272\u5408 OS \u306b\u6709\u610f\u5dee\u306f\u51fa\u3066\u3044\u307e\u305b\u3093\u3002\u7d0440%\u306e\u4e0a\u8863\u816b\u306e\u5e7c\u5150\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u306a\u304f\u3057\u3066\u6cbb\u7652\u3092\u5f97\u305f\u3068\u8a18\u8f09<\/span><\/strong>\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u5168\u6458\u51fa\u3067\u304d\u305f\u4f8b\u304c\u307b\u3068\u3093\u3069\u3067\u3059\u3002<br \/>\n\u3053\u306e\u8a66\u9a13\u3067\u4f7f\u7528\u3055\u308c\u305f\u5316\u5b66\u7642\u6cd5\u5264\u306f\uff0c\u30b7\u30af\u30ed\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30d3\u30f3\u30af\u30ea\u30b9\u30c1\u30f3\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\u3067\uff0c\u901a\u5e38\u6295\u4e0e\u91cf\u306e1.8\u500d\u306e\u5f37\u5ea6\u3067\u6295\u4e0e\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u5316\u5b66\u7642\u6cd5\u306f\u624b\u8853\u5f8c28\u65e5\u4ee5\u5185\u306b\u958b\u59cb\u3055\u308c\uff0c72\u9031\u9593\u7d99\u7d9a\u3055\u308c\u307e\u3057\u305f\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u7d42\u4e86\u6642\u306b\u816b\u760d\u304c\u6b8b\u3063\u3066\u3044\u305f\u60a3\u5150\u3068\u5316\u5b66\u7642\u6cd5\u7d42\u4e86\u5f8c\uff16\u30f6\u6708\u4ee5\u5185\u306b\u518d\u71c3\u3057\u305f\u60a3\u5150\u306b\u884c\u308f\u308c\u307e\u3057\u305f\u3002<strong><span style=\"color: #000080;\">\u5316\u5b66\u7642\u6cd5\u6b7b<\/span><\/strong>\u304c\uff0c\u591a\u91cf\u306e\u5316\u5b66\u7642\u6cd5\u5264\u3092\u4f7f\u7528\u3057\u305f166\u4eba\u4e2d\u306e10\u4eba (6%) \u306b\u751f\u3058\u307e\u3057\u305f\u3002\u6ce8\u610f\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u306e\u306f\uff0c<span style=\"color: #000080;\"><strong>\u3053\u306e\u7814\u7a76\u3067\u3082\uff0c\u5316\u5b66\u7642\u6cd5\u3088\u308a\u3082\u300c\u624b\u8853\u3067\u6458\u51fa\u3067\u304d\u305f\u304b\u3069\u3046\u304b\u300d\u306e\u65b9\u304c\u751f\u5b58\u5272\u5408\u306b\u5927\u304d\u306a\u5f71\u97ff\u304c\u3042\u3063\u305f<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n<h4>\u30c6\u30f3\u30c8\u4e0a\u4f4e\u60aa\u6027\u5ea6\u3067\u3042\u308c\u3070\u6cbb\u308a\u3084\u3059\u3044<\/h4>\n<p align=\"left\">Ghia AJ, et al.: Supratentorial gross-totally resected non-anaplastic ependymoma: population based patterns of care and outcomes analysis. J Neurooncol. 2013 [Epub]<br \/>\nMD\u30a2\u30f3\u30c0\u30fc\u30bd\u30f3\u30bb\u30f3\u30bf\u30fc\u304c\u7c73\u56fdNCI\u306e\u30c7\u30fc\u30bf\u89e3\u6790\u3092\u3057\u307e\u3057\u305f\u3002\u5bfe\u8c61\u306f<span style=\"color: #000080;\"><strong>\u30b0\u30ec\u30fc\u30c92\u306e\u30c6\u30f3\u30c8\u4e0a\u306e\u4e0a\u8863\u816b\u3067\u624b\u8853\u3067\u5168\u6458\u51fa<\/strong><\/span>\u3092\u53d7\u3051\u305f\u60a3\u8005\u3055\u309392\u4eba\u3067\u3059\u3002\u5e74\u9f62\u4e2d\u592e\u5024\u306f17.5\u6b73\u3002<span style=\"color: #000080;\"><strong>10\u5e74\u5168\u751f\u5b58\u5272\u5408 (cause-specific survival)\u306f78%<\/strong><\/span>\u3067\u3057\u305f\u3002<span style=\"color: #000080;\"><strong>\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u8853\u5f8c\u306b\u52a0\u3048\u3066\u3082\u52a0\u3048\u306a\u304f\u3066\u3082\u540c\u3058\u7d50\u679c<\/strong><\/span>\u3067\u3042\u3063\u305f\u305d\u3046\u3067\u3059\u3002\u30c6\u30f3\u30c8\u4e0a\u306e\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u3067\u306f\u306a\u3044low-risk ependymoma\u3068\u3044\u3046\u306e\u306f\uff0c\u3068\u3066\u3082\u983b\u5ea6\u304c\u4f4e\u304f\u3081\u3063\u305f\u306b\u3042\u308a\u307e\u305b\u3093\u3002extraventricular ependymoma\u3068\u547c\u3070\u308c\u308b\u5927\u8133\u306e\u4e0a\u8863\u816b\u306f\uff0c\u307b\u3068\u3093\u3069\u304c\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u306a\u306e\u3067\u75c5\u7406\u8a3a\u65ad\u3092\u614e\u91cd\u306b\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002<\/p>\n<p align=\"left\">Aizer AA, et al.: Natural history and role of radiation in patients with supratentorial and infratentorial WHO grade II ependymomas: results from a population-based study. J Neurooncol 2013 [Epub]<br \/>\nMGH\u304b\u3089\u306e\u7d71\u8a08\u5831\u544a\u3067\u3059\u3002\u30c6\u30f3\u30c8\u4e0a63\u4f8b\uff0c\u30c6\u30f3\u30c8\u4e0b49\u4f8b\u306e\u30b0\u30ec\u30fc\u30c92\u306e\u4e0a\u8863\u816b\u306e\u4e88\u5f8c\u304c\u691c\u8a0e\u3055\u308c\u307e\u3057\u305f\u3002\u5168\u6458\u51fa\u3067\u304d\u305f\u4f8b\u3067\u306f5\u5e74\u3067\u306e\u4e0a\u8863\u816b\u306b\u3088\u308b\u6b7b\u4ea1\u5272\u5408\u306f\uff0c\u30c6\u30f3\u30c8\u4e0a\u30673.3%\uff0c\u30c6\u30f3\u30c8\u4e0b\u30678.7%\u3067\u3057\u305f\u3002<strong><span style=\"color: #000080;\">\u5168\u6458\u51fa\u3067\u304d\u305f\u4f8b\u3067\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u304f\u3066\u3082\u6b7b\u4ea1\u5272\u5408\u306f\u5909\u308f\u3089\u305a<\/span><\/strong>\uff0c\u5168\u6458\u51fa\u3067\u304d\u305f\u5834\u5408\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3067\u7d4c\u904e\u89b3\u5bdf\u3059\u308b\u3079\u304d\u3060\u3068\u3057\u3066\u3044\u307e\u3059\u3002\u7279\u306b<span style=\"color: #000080;\"><strong>\u30c6\u30f3\u30c8\u4e0a\u30b0\u30ec\u30fc\u30c92\u4e0a\u8863\u816b\u306e\u4e88\u5f8c\u306f\u826f\u3044<\/strong><\/span>\u3068\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4>\u5c0f\u5150\u306e\u4e0a\u8863\u7cfb\u816b\u760d\u3067\u306f\u5168\u6458\u51fa\u3067\u304d\u305f\u3082\u306e\u306b\u751f\u5b58\u7387\u304c\u9ad8\u3044<\/h4>\n<p align=\"left\">Cage TA, et al.: A systematic review of treatment outcomes in pediatric patients with intracranial ependymomas. J Neurosurg Pediatr 11:673-681, 2013<br \/>\n\u3044\u307e\u3055\u3089\u306a\u304c\u3089\u3068\u3044\u3046\u7dcf\u8ad6\u7684\u8ad6\u6587\u3067\u3059\u304c\u300218\u6b73\u4ee5\u4e0b\u306e\u4e0a\u8863\u7cfb\u816b\u760d182\u4f8b\u3067\uff0c\u30b0\u30ec\u30fc\u30c92\u306e\u3082\u306e\u3067\u306f\uff0c\u5168\u6458\u51fa\u3067\u304d\u305f\u4f8b\u306e\u751f\u5b58\u5272\u5408\u304c\u6700\u3082\u9ad8\u3044\u3068\u3044\u3046\u7d50\u8ad6\u3067\u3059\u3002\u30b0\u30ec\u30fc\u30c9\uff13\uff08\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\uff09\u3067\u306f\uff0c\u5168\u6458\u51fa gross-total resection\u304c\u90e8\u5206\u6458\u51fa subtotal resection\u3088\u308a\u3082\u6975\u308f\u305a\u304b\u306b\u751f\u5b58\u5272\u5408\u304c\u9ad8\u304b\u3063\u305f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u5168\u6458\u51fa\u306b\u3057\u3066\u3082\u90e8\u5206\u6458\u51fa\u306b\u3057\u3066\u3082\uff0c\u8853\u5f8c\u306e\u653e\u5c04\u7dda\u6cbb\u7642 external beam radiaion therapy \u3092\u52a0\u3048\u305f\u65b9\u304c\u4e88\u5f8c\u304c\u826f\u3044\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u30c6\u30f3\u30c8\u4e0b\u306e\u65b9\u304c\u30c6\u30f3\u30c8\u4e0a\u3088\u308a\u5168\u751f\u5b58\u5272\u5408\u304c\u9ad8\u3044\u305d\u3046\u3067\u3059\u30022013\u5e74\u306e\u6642\u70b9\u3067\uff0c\u7a4d\u6975\u7684\u624b\u8853\u6458\u51fa\u306e\u610f\u7fa9\u304c\u78ba\u8a8d\u3055\u308c\u3066\u3044\u308b\u3068\u3044\u3046\u3053\u3068\u306f\uff0c\u624b\u8853\u306e\u52b9\u679c\u3092\u4e0a\u56de\u308b\u5316\u5b66\u7642\u6cd5\u3084\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u767a\u5c55\u304c\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u306e\u88cf\u8fd4\u3057\u3067\u3082\u3042\u308a\u307e\u3059\u3002<\/p>\n<h4>\u30a2\u30d0\u30b9\u30c1\u30f3\u3068\u30a4\u30ea\u30ce\u30c6\u30ab\u30f3\u306f\u6709\u52b9\u3067\u306f\u306a\u3044<\/h4>\n<p align=\"left\">Gururangan S, et al.: Lack of efficacy of bevacizumab + irinotecan in cases of pediatric recurrent ependymoma&#8211;a Pediatric Brain Tumor Consortium study Neuro Oncol 14(:1404-1412, 2012<br \/>\n13\u4f8b\u306e\u518d\u767a\u4e0a\u8863\u816b\u306b\u8a66\u3055\u308c\u307e\u3057\u305f\u304c\u6709\u52b9\u6027\u306f\u8a8d\u3081\u3089\u308c\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n<h4>\u518d\u767a\u4e0a\u8863\u816b\u306b\u306f\u5927\u304d\u306a\u7dda\u91cf\u306e\u653e\u5c04\u7dda\u6cbb\u7642\uff08\u518d\u7167\u5c04\uff09\u304c\u5fc5\u8981<\/h4>\n<p>Bouffet E, et al.: Survival benefit for pediatric patients with recurrent ependymoma treated with reirradiation. Int J Radiat Oncol Biol Phys 83: 1541-1548, 2012<br \/>\n\u82f1\u8a9e\u306e\u8ad6\u6587\u3067\u306f\uff0c\u4e0a\u8863\u816b\u304c\u518d\u767a\u3057\u305f\u6642\u306e\u7d50\u679c\u306fdismal\uff08\u9670\u9b31\uff09\u3068\u3057\u3070\u3057\u3070\u8868\u73fe\u3055\u308c\u307e\u3059\u3002\u30c8\u30ed\u30f3\u30c8\u306e\u5b50\u3069\u3082\u75c5\u9662\u3067\u306e1986\u5e74\u304b\u30892010\u5e74\u306e\u7d4c\u9a13\u304c\u5831\u544a\u3055\u308c\u307e\u3057\u305f\u300224\u5e74\u9593\u306b113\u4f8b\u306e\u4e0a\u8863\u816b\u306e\u60a3\u8005\u3055\u3093\u304c\u6cbb\u7642\u3055\u308c\uff0c47\u4eba (42%) \u3067\u518d\u767a\u3057\u307e\u3057\u305f\u3002\u624b\u8853\u6458\u51fa\u3042\u308b\u3044\u306f\u624b\u8853\u3057\u306a\u3044\u3067\uff0c29\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u5316\u5b66\u7642\u6cd5\u3067\u6cbb\u7642\u3055\u308c\uff0c18\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c<strong><span style=\"color: #000080;\">54\u30b0\u30ec\u30a4\u4ee5\u4e0a\u306e\u518d\u7167\u5c04<\/span>\u00a0<\/strong>full-dose (\u2265 54 Gy focal and\/or craniospinal) reirradiation\u3067\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u30023\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f\uff0c<strong><span style=\"color: #000080;\">\u5316\u5b66\u7642\u6cd5\u30677%<\/span>\u00a0<\/strong>(\u00b16%)\uff0c<span style=\"color: #000080;\"><strong>\u518d\u7167\u5c04\u306781%<\/strong><\/span>\u00a0(\u00b112%)\u3067\u3057\u305f\u30023.7\u5e74\u306e\u7d4c\u904e\u89b3\u5bdf\u3067\uff0c\u518d\u7167\u5c04\u3092\u53d7\u3051\u305f18\u4eba\u306e\u3046\u3061\uff0c2\u4eba\u3067\u5185\u5206\u6ccc\u969c\u5bb3\u304c\u3067\u3066\uff0c1\u4eba\u3067\u5b66\u7fd2\u306b\u7279\u5225\u306a\u652f\u63f4\u304c\u5fc5\u8981\u3068\u306a\u308a\u307e\u3057\u305f\u3002\u610f\u5916\u306a\u4e8b\u306b\uff0c\u518d\u7167\u5c04\u3092\u53d7\u3051\u305f\u60a3\u8005\u3055\u3093\u306e\u518d\u3005\u767a\u307e\u3067\u306e\u7121\u5897\u60aa\u671f\u9593\u306f\uff0c\u521d\u767a\u6642\uff08\u4e00\u56de\u76ee\u306e\u7167\u5c04\uff09\u306e\u7121\u5897\u60aa\u671f\u9593\u3088\u308a\u9577\u304b\u3063\u305f\u3068\u306e\u4e8b\u3067\u3059\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0c\u4e0a\u8863\u816b\u306e\u518d\u767a\u306b\u518d\u7167\u5c04\u306f\u6709\u52b9\u306a\u6cbb\u7642\u6cd5\u3067\u3042\u308b\u304c\uff0c\u8a8d\u77e5\u6a5f\u80fd\u306e\u4f4e\u4e0b\u304c\u751f\u3058\u308b\u3067\u3042\u308d\u3046\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<p>\u300c\u89e3\u8aac\u300d\u4e0a\u8863\u816b\u304c\u518d\u767a\u3057\u305f\u6642\u306b\u3082<span style=\"color: #000080;\"><strong>\u3084\u306f\u308a\u6709\u52b9\u306a\u306e\u306f\u653e\u5c04\u7dda\u6cbb\u7642<\/strong><\/span>\u3067\u3059\u3002\u5316\u5b66\u7642\u6cd5\u3067\u9811\u5f35\u3063\u3066\u30823\u5e74\u4ee5\u5185\u306b9\u5272\u4ee5\u4e0a\u306e\u60a3\u8005\u3055\u3093\u304c\u816b\u760d\u6b7b\u3057\u307e\u3059\u3002\u3057\u304b\u3057\uff0c2\u5ea6\u76ee\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u3068\uff18\u5272\u3092\u8d85\u3048\u308b\u60a3\u8005\u3055\u3093\u304c3\u5e74\u4ee5\u4e0a\u751f\u5b58\u3067\u304d\u307e\u3059\u3002\u3053\u306e\u5dee\u306f\u5927\u304d\u3044\u3068\u8a00\u3048\uff0c\u521d\u56de\u6cbb\u7642\u3068\u540c\u3058\u3088\u3046\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3068\u751f\u304d\u5ef6\u3073\u3089\u308c\u306a\u3044\u3053\u3068\u3092\u793a\u3057\u3066\u3044\u307e\u3059\u3002<br \/>\n<strong><span style=\"color: #000080;\">\u5927\u304d\u306a\u6050\u308c\u306f\uff0c2\u5ea6\u76ee\u306e\u7167\u5c04\u306b\u521d\u56de\u7dda\u91cf\u3068\u540c\u3058\u304f\u3089\u3044\u306e54\u30b0\u30ec\u30a4\u3092\u7528\u3044\u3066\u3044\u308b\u3068\u3044\u3046\u4e8b\u3067\u3059<\/span>\u3002<\/strong>\u3044\u304f\u3089\u671f\u9593\u304c\u958b\u3044\u3066\u3044\u308b\u3068\u306f\u3044\u3048\uff0c\u4e0a\u8863\u816b\u306f\u5c40\u6240\u518d\u767a\u304c\u591a\u3044\u306e\u3067\uff0c\u52a0\u7b97\u7dcf\u7dda\u91cf cummulative dose\u306f100\u30b0\u30ec\u30a4\u3068\u3044\u3046\u3059\u3054\u3044\u7dda\u91cf\u306b\u306a\u308a\u307e\u3059\u3002\u3053\u306e\u8ffd\u52a0\u7167\u5c04\u3067\uff0c\u6570\u5e74\u5f8c\u306b\u8133\u5e79\u58ca\u6b7b\u3068\u3044\u3046\u53b3\u3057\u3044\u4e8b\u614b\u306b\u306a\u3089\u306a\u3044\u306e\u304b\u3069\u3046\u304b\u306f\u660e\u3089\u304b\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<h4>\u5f8c\u982d\u7aa9\u4e0a\u8863\u816b\u306e\u8853\u5f8c\u5f8c\u907a\u75c7<\/h4>\n<p>Brannon Morris E, et al.: Evolution of neurological impairment in pediatric intratentorial ependymoma patients. J Neurooncol 2009, Epub<br \/>\n\u5c0f\u8133\u304b\u8133\u5e79\u90e8\u304b\u3089\u767a\u751f\u3057\u305f\u4e0a\u8863\u816b\u3067\u624b\u8853\u3092\u53d7\u3051\u305f96\u4eba\u306e\u5b50\u4f9b\u305f\u3061\u306e\u5f8c\u907a\u75c7\u306b\u95a2\u3057\u3066\u8ad6\u3058\u305f\u3082\u306e\u3067\u3059\u3002\u8853\u5f8c\u306e\u75c7\u72b6\u306f\uff0c\u56db\u80a2\u5931\u8abf\uff08\u624b\u8db3\u306e\u30d0\u30e9\u30f3\u30b9\u304c\u60aa\u3044\uff09\uff0c\u5916\u8ee2\u795e\u7d4c\u9ebb\u75fa\u3068\u9854\u9762\u795e\u7d4c\u9ebb\u75fa\uff0c\u534a\u8eab\u9ebb\u75fa\uff0c\u56a5\u4e0b\u969c\u5bb3\uff08\u98f2\u307f\u8fbc\u307f\u3065\u3089\u3044\uff09\uff0c\u4f53\u5e79\u5931\u8abf\u3067\u3059\u3002\u6b69\u884c\u969c\u5bb3\u3068\u56a5\u4e0b\u969c\u5bb3\u304c\u91cd\u3044\u3053\u3068\u304c\u591a\u3044\u305d\u3046\u3067\u3059\u3002\u3057\u304b\u3057\u5e78\u3044\u306b\u3082\u307b\u3068\u3093\u3069\u306e\u4f8b\u3067\u3053\u308c\u3089\u306e\u75c7\u72b6\u306f\u6539\u5584\u3057\u3066\uff0c\u9577\u671f\u751f\u5b58\u8005\u306b\u304a\u3044\u3066\u306f\uff0c\u65e5\u5e38\u751f\u6d3b\u306e\u5927\u304d\u306a\u969c\u5bb3\u306b\u306a\u3063\u3066\u3044\u306a\u304b\u3063\u305f\u3068\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002\u3067\u3082\u305d\u3046\u3067\u3057\u3087\u3046\u304b\uff1f\u4e00\u6982\u306b\u306f\u4fe1\u3058\u3089\u308c\u307e\u305b\u3093\u3002\u8074\u529b\u969c\u5bb3\u306f\u6539\u5584\u3057\u306a\u3044\u3088\u3046\u3067\u3059\u3002<\/p>\n<h4><span style=\"color: #000080;\"><span class=\"style1\">\u539f\u4f53\u7167\u5c04 conformal radiation \u306e\u6cbb\u7642\u6210\u7e3e<\/span><\/span><\/h4>\n<p>Merchant TE, et al: Conformal radiotherapy after surgery for paediatric ependymoma: a prospective study. J Lancet Oncol 10: 258-266, 2009<br \/>\n\u5bfe\u8c61\u306f\u7167\u5c04\u6642\u5e74\u9f62\u4e2d\u592e\u5024\u30672.9\u6b73(0.9-22.9\u6b73)\u306e\u8ee2\u79fb\uff08\u64ad\u7a2e\uff09\u306e\u306a\u3044\u4e0a\u8863\u816b\u3067\u3059\u30021997\u5e74\u304b\u30892007\u5e74\u306b\u539f\u4f53\u7167\u5c04(conformal radiation therapy)\u3092\u53d7\u3051\u305f153\u4eba\u306e\u7d50\u679c\u3067\u3059\u300285\u4eba\u306f\u9000\u5f62\u6210\u6027\u4e0a\u8863\u816b\u3067\uff0c122\u4f8b\u304c\u5f8c\u982d\u7aa9\u306e\u4e0a\u8863\u816b\uff08\u5c0f\u8133\u8133\u5e79\u90e8\uff09\uff0c35\u4f8b\u304c\u3059\u3067\u306b\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u3066\u3044\u307e\u3057\u305f\u3002 \u624b\u8853\u3067\u5168\u6458\u51fa\u3055\u308c\u305f\u306e\u306f125\u4eba(82%)\uff0c17\u4f8b\u304c\u307b\u307c\u5168\u6458\u51fa(near total)\uff0c\u90e8\u5206\u6458\u51fa(subtotal resection)\u304c11\u4f8b\u3067\u3059\u3002 \u816b\u760d\u306e\u5468\u308a10mm\u3092\u56f2\u3080\u5e83\u3055\u3067\uff0c131\u4eba\u306b\u306f59.4\u30b0\u30ec\u30a4\uff0c22\u4eba\u306b\u306f54\u30b0\u30ec\u30a4\u304c\u7167\u5c04\u3055\u308c\u307e\u3057\u305f\u3002<br \/>\n\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u50245.3\u5e74\u3067\uff0c23\u4eba(15%)\u304c\u6b7b\u4ea1\u3057\u3066\uff0c\u816b\u760d\u304c\u5897\u5927\u3057\u305f\u306e\u304c36\u4eba(24%)\u3067\u3059\u3002\u816b\u760d\u304c\u7167\u5c04\u3092\u53d7\u3051\u305f\u539f\u767a\u90e8\u4f4d\u3067\u5897\u5927\u3057\u305f\u306e\u304c14\u4f8b\uff0c\u8ee2\u79fb\u3092\u751f\u3058\u305f\u306e\u304c15\u4f8b(10%)\uff0c\u4e21\u65b9\u304c7\u4f8b\u3067\u3059\u3002\u3067\u3059\u304b\u3089<strong><span style=\"color: #ff0000;\">\u8ee2\u79fb\u306f22\u4f8b(14%)<\/span><\/strong>\u306b\u751f\u3058\u305f\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002<span style=\"color: #ff0000;\"><strong>\u6cbb\u7642\u5f8c\uff17\u5e74\u3067\u306e\u5c40\u6240\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u7387\u304c87%\uff0c\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u304c69%\uff0c\u5168\u751f\u5b58\u5272\u5408\u304c81%<\/strong><\/span>\u3067\u3057\u305f\u3002\u5c40\u6240\u3068\u8ee2\u79fb\u306e\u5236\u5fa1\u306f16%\u306811.5%\u3067\u3067\u304d\u306a\u304b\u3063\u305f\u3068\u8a18\u3055\u308c\u3066\u3044\u307e\u3059\u3002107\u4eba\u306e\u60a3\u5150\u3067\u306f\u8853\u5f8c\u65e9\u671f\u306b\u5316\u5b66\u7642\u6cd5\u306a\u3057\u3067\u6cbb\u7642\u304c\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u305d\u306e\u7fa4\u3067\u306f\u6cbb\u7642\u5f8c\uff17\u5e74\u3067\u306e\u5c40\u6240\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u7387\u304c89%\uff0c\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u304c77%\uff0c\u5168\u751f\u5b58\u5272\u5408\u304c85%\u3067\u3057\u305f\u3002\u5c40\u6240\u3068\u8ee2\u79fb\u306e\u5236\u5fa1\u306f12.6%\u30688.6%\u3067\u3067\u304d\u307e\u305b\u3093\u3067\u3057\u305f\u30022\u6b21\u764c\u3068\u3057\u3066\u306e\u60aa\u6027\u8133\u816b\u760d\u306e\u767a\u751f\u304c2.3%\uff0c\u8133\u58ca\u6b7b\u304c1.6%\u306b\u751f\u3058\u3066\u3044\u307e\u3059\u3002<span style=\"color: #000080;\"><strong>\u4e88\u5f8c\u4e0d\u826f\u56e0\u5b50\u306f\uff0c\u60aa\u6027\u5ea6grade\uff0c\u624b\u8853\u6458\u51fa\u5272\u5408\uff0c\u4f4e\u5e74\u9f62<\/strong><\/span>\u3067\u3059\u3002\u7d50\u8ad6\u3068\u3057\u3066\u5168\u6458\u51fa\u3059\u308b\u3053\u3068\u8853\u5f8c\u65e9\u671f\u306e\u9ad8\u7dda\u91cf\u7167\u5c04\u304c\u306a\u3055\u308c\u308b\u3079\u304d\u3067\u3042\u308b\u3068\u8a18\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<p>\u300c\u89e3\u8aac\u300d\u4e0b\u306e\u65b9\u306b\u66f8\u3044\u3066\u3042\u308b\u8ad6\u6587\u306e\u8003\u3048\u65b9\u304c\u78ba\u8a8d\u3055\u308c\u3066\u3044\u308b\u3082\u306e\u3067\u3059\u3002\u5c40\u6240\u539f\u4f53\u7167\u5c04\u3068\u3044\u3046\u65b9\u6cd5\u3067\u4e0a\u8863\u816b\u306e\u3042\u308b\u90e8\u5206\u3060\u3051\u306b\u5927\u304d\u306a\u7dda\u91cf\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\uff13\u6b73\u672a\u6e80\u306e\u5b50\u4f9b\u305f\u3061\u306b\u3082\u5316\u5b66\u7642\u6cd5\u3092\u3057\u306a\u3044\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3067\u304d\u3066\u3044\u307e\u3059\u3002\u7e70\u308a\u8fd4\u3057\u307e\u3059\u304c\uff0c\u6ce8\u610f\u3057\u3066\u8aad\u307e\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u70b9\u306f\uff0c<strong><span style=\"color: #000080;\">153\u4f8b\u306e\u3046\u3061125\u4f8b\u307e\u3067\u3082\u304c\u5168\u6458\u51fa(gross total removal)\u306b\u6210\u529f\u3057\u3066\u3044\u308b<\/span><\/strong>\u3053\u3068\u3067\uff0c\u65e5\u672c\u306e\u73fe\u5b9f\u3067\u306f\u3061\u3087\u3063\u3068\u8003\u3048\u3089\u308c\u307e\u305b\u3093\u3002\u539f\u4f53\u7167\u5c04\u304c\u52b9\u304f\u304b\u3089\u3068\u3044\u3063\u3066\u624b\u8853\u306b\u624b\u3092\u629c\u3051\u3070\u6b7b\u4ea1\u7387\u306f\u9ad8\u304f\u306a\u3063\u3066\u3057\u307e\u3044\u307e\u3059\u3002\u307e\u305f\u4f4e\u5e74\u9f62\u3060\u304b\u3089\u3068\u3044\u3063\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u9045\u3089\u305b\u3066\u4e2d\u9014\u534a\u7aef\u306b\u5316\u5b66\u7642\u6cd5\u3092\u3059\u308c\u3070\u751f\u5b58\u5272\u5408\u306f\u4f4e\u304f\u306a\u308a\u307e\u3059\u3002<\/p>\n<h4>\u5c0f\u8133\u6a4b\u89d2\u90e8\u306e\u4e0a\u8863\u816b\u304c\u307b\u3068\u3093\u3069\u306e\u4f8b\u3067\u5168\u6458\u51fa\u3067\u304d\u308b\uff1f?<\/h4>\n<p>Sanford RA, et al.: Advances in surgical techniques for resection of childhood cerebellopontine angle ependymomas are key to survival. Childs Nerv Syst 25: 1229-1240, 2009<br \/>\n\u307b\u3093\u3068\u304b\u306a\uff1f\u3068\u3044\u3046\u8ad6\u6587\u3067\u3059\u300245\u4eba\u306e\u5c0f\u5150\u306e\u5c0f\u8133\u6a4b\u89d2\u90e8\u4e0a\u8863\u816b\u306e\u624b\u8853\u3067\u8457\u8005\u3089\u306e\u624b\u6cd5\u3092\u4f7f\u3048\u3070\uff0c\u5168\u6458\u51faGTR\u304c43\u4eba (95.6%) \uff0c\u307b\u307c\u5168\u6458\u51fanear-total resection\u304c2\u4eba (4.4%)\u3067\u53ef\u80fd\u3067\u3042\u3063\u305f\u3068\u8a18\u8f09\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<p>\u3067\u3082\u3053\u308c\u306f\u73fe\u5b9f\u7684\u306b\u306f\uff0c\u7121\u7406\u3067\u3059\u3002\u307e\u305f\u305d\u306e\u624b\u8853\u306e\u7d50\u679c\u306e\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u304c53.8%\u3067\u3042\u3063\u305f\u3068\u3044\u3046\u306e\u306f\uff0c\u6210\u7e3e\u304c\u3042\u307e\u308a\u306b\u3082\u60aa\u3059\u304e\u307e\u3059\u3002\u5c0f\u8133\u6a4b\u89d2\u90e8\u306e\u4e0a\u8863\u816b\u306f\u30eb\u30b7\u30e5\u30ab\u5b54\u304b\u3089\u5c0f\u8133\u6a4b\u89d2\u69fd\u3068\u5c0f\u8133\u5ef6\u9ac4\u89d2\u69fd\uff0c\u524d\u6a4b\u69fd\u306b\u4f38\u5c55\u3057\u3066\uff0c\u5916\u8ee2\u795e\u7d4c\uff0c\u9854\u9762\u795e\u7d4c\uff0c\u8074\u795e\u7d4c\uff0c\u820c\u54bd\u795e\u7d4c\uff0c\u8ff7\u8d70\u795e\u7d4c\uff0c\u526f\u795e\u7d4c\u3092\u5305\u307f\u8fbc\u307f\u7652\u7740\u3057\uff0c\u3055\u3089\u306b\u690e\u9aa8\u52d5\u8108\u3068\u5f8c\u4e0b\u5c0f\u8133\u52d5\u8108\u3068\u305d\u306e\u5206\u679d\uff08\u8133\u5e79\u90e8\u3078\u306e\u7a7f\u901a\u679d\uff09\u306b\u7652\u7740\u3057\u307e\u3059\u3002\u30b0\u30ec\u30fc\u30c92\u306e\u4e0a\u8863\u816b\u3067\uff0c\u3053\u308c\u3089\u306e\u795e\u7d4c\u8840\u7ba1\u69cb\u9020\u3092\u5727\u8feb\u3059\u308b\u306e\u307f\u306e\u3082\u306e\u3067\u3042\u308c\u3070\u5265\u96e2\u306f\u3067\u304d\u308b\u306e\u3067\u3059\u304c\uff0c\u591a\u304f\u306e\u5834\u5408\u306f\u5265\u96e2\u306f\u56f0\u96e3\u3068\u8a00\u308f\u3056\u308b\u3092\u5f97\u307e\u305b\u3093\u3002\u3067\u3059\u304b\u3089\uff0c\u751f\u547d\u4e88\u5f8c\u306e\u60aa\u3055\u3092\u8003\u616e\u306b\u5165\u308c\u3066\uff0c\u8133\u795e\u7d4c\u9ebb\u75fa\u3084\u8133\u5e79\u90e8\u5c0f\u8133\u6897\u585e\u306e\u30ea\u30b9\u30af\u3092\u4fb5\u3057\u3066\u3067\u3082\u6458\u51fa\u3059\u308b\u3068\u3044\u3046\u8003\u3048\u306e\u3082\u3068\u306b\u7a4d\u6975\u7684\u6458\u51fa\u3092\u884c\u3044\u307e\u3059\u3002\u305d\u308c\u3067\u3082\u5168\u6458\u51fa\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u306a\u3044\u4f8b\u306f\u591a\u304f\uff0c<span style=\"color: #000080;\"><strong>\u5168\u6458\u51fa\u3092\u76ee\u6307\u3059\u3053\u3068\u306f\u6975\u3081\u3066\u30ea\u30b9\u30af\u306e\u9ad8\u3044\u624b\u8853<\/strong><\/span>\u3068\u306a\u308a\u307e\u3059\u3002<\/p>\n<h4>\u4e0a\u8863\u816b\u306b<span style=\"color: #000080;\">\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306f\u6709\u52b9\u3067\u306a\u3044<\/span><\/h4>\n<p>Chamberlain MC, Johnston SK: Temozolomide for recurrent intracranial supratentorial platinum-refractory ependymomma. Cancer 115: 4775-4782, 2009<br \/>\n\u30c6\u30f3\u30c8\u4e0a\u518d\u767a\u4e0a\u8863\u816b\uff08\u30b0\u30ec\u30fc\u30c92\uff09\u306e28\u624d\u304b\u308968\u624d\u306e\u60a3\u8005\u3055\u309325\u4eba\u306b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u304c\u6295\u4e0e\u3055\u308c\u307e\u3057\u305f\u3002\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u304b\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u304c\u3059\u3067\u306b\u4f7f\u7528\u3055\u308c\u3066\u3044\u3066\u518d\u767a\u3057\u305f\u60a3\u8005\u3055\u3093\u305f\u3061\u3067\u3059\u3002\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306f4\u9031\u9593\u306b5\u65e5\u9593\u3060\u3051\u670d\u7528\u3059\u308b\u3068\u3044\u3046\u6295\u3088\u6cd5\u3067\u3059\u30021\u4f8b(4%)\u306e\u307f\u3067\u816b\u760d\u304c\u7e2e\u5c0f(PR)\u3057\u307e\u3057\u305f\u3002\u518d\u71c3\u307e\u3067\u306e\u671f\u9593\u306e\u4e2d\u592e\u5024\u306f2\u30f6\u6708\uff081\u304b\u30897\u30f6\u6708\uff09\u3067\uff0c6\u30f6\u6708\u306812\u30f6\u6708\u306e\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f2%\u30680%\u3067\u3059\u3002\u751f\u5b58\u671f\u9593\u3082\u6570\u30f6\u6708\u3068\u3068\u3066\u3082\u77ed\u3044\u3082\u306e\u3067\u3057\u305f\u3002\u3053\u306e\u6295\u4e0e\u65b9\u6cd5\u3067\u306f\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306f\u6210\u4eba\u306e\u518d\u767a\u30c6\u30f3\u30c8\u4e0a\u4e0a\u8863\u816b\u306b\u52b9\u679c\u306f\u306a\u3044\u3068\u7d50\u8ad6\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u300c\u89e3\u8aac\u300d\u6210\u4eba\u306e\u518d\u767a\u30c6\u30f3\u30c8\u4e0a\u4e0a\u8863\u816b\u3067\u304b\u3064\u30d7\u30e9\u30c1\u30ca\u88fd\u5264\u62b5\u6297\u6027\u3068\u3044\u3046\u6761\u4ef6\u3067\u3059\u304c\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u304c\u5358\u5264\u3067\u306f\u4e0a\u8863\u816b\u306b\u52b9\u679c\u304c\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u304c\u304b\u306a\u308a\u306f\u3063\u304d\u308a\u89e3\u308b\u8ad6\u6587\u3067\u3059\u3002<\/p>\n<h4><span style=\"color: #000080;\"><span class=\"style1\">\u539f\u4f53\u7167\u5c04\u306e\u5f8c\u306e\u5b66\u7fd2\u80fd\u529b<\/span><\/span><\/h4>\n<p>Conklin HM, et al: Predicting in academic abilities after conformal radiaiton therapy for localized ependymoma. J Clin Oncol 26: 3965-3970, 2008<br \/>\n\u64ad\u7a2e\uff08\u8ee2\u79fb\uff09\u304c\u306a\u3044\u4e0a\u8863\u816b\u3092\u5bfe\u8c61\u3068\u3057\u3066\u3044\u307e\u3059\u3002\u539f\u4f53\u7167\u5c04(conformal radiation therapy)\u3068\u3044\u3046\u7cbe\u5ea6\u306e\u9ad8\u3044\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u816b\u760d\u306e\u3042\u308b\u5834\u6240\u3060\u3051\u306b\u5c40\u6240\u7167\u5c04\u3059\u308b\u306e\u3067\u5468\u56f2\u306e\u8133\u306b\u88ab\u66dd\u91cf\u304c\u5c11\u306a\u3044\u65b9\u6cd5\u3067\u3059\u300287\u4eba\u306e\u5b50\u4f9b\u305f\u3061\u304c\uff0c54\u304b\u308959.4\u30b0\u30ec\u30a4\u3068\u3044\u3046\u7dda\u91cf\u306810mm\u306e\u30de\u30fc\u30b8\u30f3\u3092\u3068\u308b\u3053\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u8853\u5f8c\u306b\u53d7\u3051\u307e\u3057\u305f\u3002\u82f1\u8a9e\u306a\u306e\u3067\u6b63\u78ba\u306b\u306f\u65e5\u672c\u8a9e\u306b\u8a33\u305b\u307e\u305b\u3093\u304c\uff0c\u8aad\u3080\u80fd\u529breading scores\u3068\u3044\u3046\u306e\u304c\u4f4e\u4e0b\u3057\u307e\u3057\u305f\u3002\u3057\u304b\u3057\uff0c\u8a08\u7b97math\u3068\u304b\u66f8\u304fspelling performance\u3068\u3044\u3046\u691c\u67fb\u3067\u306f\u4f4e\u4e0b\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002 \u30c6\u30f3\u30c8\u4e0b\uff08\u7b2c\uff14\u8133\u5ba4\uff09\u306e\u60a3\u5150\u3088\u308a\u30c6\u30f3\u30c8\u4e0a\uff08\u5074\u8133\u5ba4\uff0c\u7b2c\uff13\u8133\u5ba4\uff09\u306e\u816b\u760d\u306e\u307b\u3046\u304c\uff0c\u307e\u305f\u591a\u6570\u56de\u306e\u624b\u8853\u3092\u53d7\u3051\u305f\u5b50\u4f9b\u3067reading performance\u306e\u4f4e\u4e0b\u304c\u9855\u8457\u3060\u3068\u306e\u3053\u3068\u3067\u3059\u3002 \u4ed6\u306ereading score\u306e\u4f4e\u4e0b\u306e\u56e0\u5b50\u3068\u3057\u3066\uff0c\u7537\u5150\uff0c\u75c7\u72b6\u306e\u9577\u304f\u7d9a\u3044\u305f\u5b50\uff0c\u653e\u5c04\u7dda\u524d\u306e\u5316\u5b66\u7642\u6cd5\uff0c\u30db\u30eb\u30e2\u30f3\u5206\u6ccc\u4e0d\u5168\uff0c\u6c34\u982d\u75c7\uff0c\uff15\u6b73\u672a\u6e80\u306e\u5e74\u9f62\u306a\u3069\u304c\u3042\u3052\u3089\u308c\u307e\u3059\u3002<br \/>\n\u7d50\u8ad6\u3068\u3057\u3066\uff0c\u539f\u4f53\u7167\u5c04\u3092\u4f7f\u3048\u3070\u5f93\u6765\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3088\u308a\u3082\u6cbb\u7642\u5f8c\u306e\u8a8d\u77e5\u6a5f\u80fd\u306e\u4f4e\u4e0b\u304c\u8efd\u304f\u3059\u3080\u3053\u3068\u3002\u8aad\u3080\u3068\u3044\u3046\u80fd\u529b\u306f\u4ed6\u306e\u77e5\u7684\u80fd\u529b\u3088\u308a\u653e\u5c04\u7dda\u306b\u3088\u3063\u3066\u4f4e\u4e0b\u304c\u751f\u3058\u3084\u3059\u3044\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n<h4>3\u6b73\u672a\u6e80\u306e\u5c0f\u5150\u306b\u5316\u5b66\u7642\u6cd5\u306e\u307f\u3067\u6cbb\u7642\u3059\u308b<\/h4>\n<p>Grundy RG, et al.: Primary postoperative chemotherapy without radiotherapy for intracranial ependymoma in children: the UKCCSG\/SIOP prospective study. Lancet Oncol 8:696-705, 2007<br \/>\n\u30e8\u30fc\u30ed\u30c3\u30d1\u306eUKCCSG\u304b\u3089\u306e\u5831\u544a\u3067\u3059\u30021992\u5e74\u304b\u30892003\u5e74\u306b3\u6b73\u672a\u6e8089\u4eba\u306e\u4e0a\u8863\u816b\u306e\u5b50\u3069\u3082\u305f\u3061\u304c\u5316\u5b66\u7642\u6cd5\u306e\u307f\u3067\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u8a3a\u65ad\u6642\u306b\u64ad\u7a2e\u304c\u3042\u3063\u305f\u306e\u306f9\u4eba(10%)\u3067\u3059\u3002\u64ad\u7a2e\u306e\u306a\u304b\u3063\u305f80\u4eba\u306e\u5b50\u3069\u3082\u306e\u3046\u306150\u4eba\u3067\u816b\u760d\u304c\u5897\u5927\u3057\u307e\u3057\u305f\u3002\u5c40\u6240\u306e\u518d\u767a\uff08\u518d\u71c3\uff09\u304c80\uff05\u3067\u3057\u305f\u300234\u4eba\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u306a\u308a\u307e\u3057\u305f\u30025\u5e74\u7d4c\u3063\u305f\u6642\u70b9\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u305a\u306b\u6e08\u3093\u3060\u5b50\u3069\u3082\u306f42\uff05\u3067\uff0c5\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f63\uff05\u3067\u3057\u305f\u3002\u7d50\u679c\u7684\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u305f\u5e74\u9f62\u306e\u4e2d\u592e\u5024\u306f3.6\u6b73\u3067\u3059\u3002\u5316\u5b66\u7642\u6cd5\u306f\u4e00\u5b9a\u3057\u3066\u3044\u307e\u305b\u3093\u3067\u3057\u305f\u304c\uff0c\u3088\u308a\u591a\u304f\u306e\u91cf\u306e\u5316\u5b66\u7642\u6cd5 (the highest relative dose intensity of chemotherapy) \u3092\u53d7\u3051\u305f\u60a3\u5150\u3067\u751f\u5b58\u5272\u5408\u304c\u9ad8\u304b\u3063\u305f\u305d\u3046\u3067\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u3053\u306e\u5316\u5b66\u7642\u6cd5\u306e\u65b9\u91dd\u3067\uff0c<span style=\"color: #000080;\"><strong>\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u907f\u3051\u308b\u3042\u308b\u3044\u306f\u305d\u306e\u6642\u671f\u3092\u9001\u3089\u305b\u308b\u3053\u3068\u304c\u3067\u304d\u308b\u3068\u7d50\u8ad6<\/strong><\/span>\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u518d\u71c3\u307e\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u5f85\u3064\u306e\u3067\u3059\u304c\uff0c\u305d\u3046\u306a\u308b\u3068\u816b\u760d\u306f\u5897\u5927\u3057\u3066\u3044\u308b\u306f\u305a\u3067\u3059\u3002\u4e0a\u8863\u816b\u306f\u5c11\u3057\u3067\u3082\u591a\u304f\u306e\u816b\u760d\u3092\u6458\u51fa\u3067\u304d\u305f\u65b9\u304c\u751f\u547d\u4e88\u5f8c\u304c\u826f\u3044\u816b\u760d\u3068\u3057\u3066\u77e5\u3089\u308c\u3066\u3044\u307e\u3059\u3002\u304b\u306a\u308a\u5927\u304d\u306a\u5371\u967a\u3092\u304a\u304b\u3057\u3066\u53ef\u80fd\u306a\u9650\u308a\u306e\u816b\u760d\u3092\u6458\u51fa\u3057\u3066\uff0c\u6b8b\u5b58\u816b\u760d\u304c\u5927\u304d\u304f\u306a\u3063\u3066\u3057\u307e\u3063\u3066\u304b\u3089\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u304c\uff0c\u672c\u5f53\u306b\u6b63\u3057\u3044\u304b\u3069\u3046\u304b\uff0c\u66f4\u306b\u691c\u8a3c\u304c\u5fc5\u8981\u306a\u3082\u306e\u3067\u3059\u3002<\/p>\n<h4>\u5f8c\u982d\u7aa9\u4e0a\u8863\u816b\u306f\u5168\u6458\u51fa\u3067\u304d\u3066\u3082\u8853\u5f8c\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u5fc5\u7528<\/h4>\n<p align=\"left\">Rogers L, et al.: Is gross-total resection sufficient treatment for posterior fossa ependymomas? J Neurosurg 102: 629-636, 2005<br \/>\nBarrow\u304b\u3089\u306e\u5358\u65bd\u8a2d\u5831\u544a\u3067\uff0c1983-2002\u5e74\u307e\u3067\u306e\u30c7\u30fc\u30bf\u89e3\u6790\u3067\u3059\u300255\u4eba\u306e\u3046\u306132\u4eba (71%)\u306e\u60a3\u8005\u3055\u3093\u3067\u5168\u6458\u51fa (gross-total removal) \u304c\u53ef\u80fd\u3067\u3057\u305f\u3002\u305d\u306e\u3046\u306113\u4eba\u304c\u8853\u5f8c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u8853\u5f8c10\u5e74\u306e\u6642\u70b9\u3067\u306e\u5c40\u6240\u816b\u760d\u5236\u5fa1\u5272\u5408\u306f\uff0c\u5168\u6458\u51fa\uff0f\u653e\u5c04\u7dda\u3067100%\uff0c\u5168\u6458\u51fa\u306e\u307f\u306750%\u3067\u3057\u305f (p=0.018)\u3002\u8a31\u5bb9\u3067\u304d\u308b\u624b\u8853\u5f8c\u907a\u75c7\u306e\u7bc4\u56f2\u5185\u3067\u5168\u6458\u51fa\u3092\u3081\u3056\u3057\u3066\uff0c\u305d\u308c\u304c\u9054\u6210\u3067\u304d\u3066\u3082\u624b\u8853\u5f8c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u308b\u3088\u3046\u306b\u63a8\u5968\u3059\u308b\u3068\u7d50\u8ad6\u3055\u308c\u3066\u3044\u307e\u3059\u3002<br \/>\n\u5168\u822c\u7684\u306b\u306f\u6b63\u3057\u3044\u7d50\u8ad6\u306a\u306e\u3067\u3057\u3087\u3046\u3057\uff0c\u4e16\u754c\u6a19\u6e96\u7684\u306a\u8003\u3048\u3067\u3082\u3042\u308a\u307e\u3059\u3002\u3057\u304b\u3057\uff0c\u5206\u5316\u5ea6\u306e\u9ad8\u3044\u30b0\u30ec\u30fc\u30c92\u306e\u4e0a\u8863\u816b\u3067\uff0c\u5b8c\u5168\u6458\u51fa\uff08complete removal)\u3067\u304d\u305f\u5834\u5408\u306b\u306f\u8853\u5f8c\u7167\u5c04\u3092\u3059\u308b\u3079\u304d\u3067\u306f\u306a\u3044\u306e\u3067\u3057\u3087\u3046\u3002<\/p>\n<h4><span style=\"color: #ff0000;\"><strong><span class=\"style1\">\u4e0a\u8863\u816b\u306b\u8133\u810a\u9ac4\u7167\u5c04\u3092\u7528\u3044\u306a\u3044<\/span><\/strong><\/span><\/h4>\n<p>Merchant TE, Mulhern RK, Krasin MJ, et al.: Preliminary results from a phase II trial of conformal radiation therapy and evaluation of radiation-related CNS effects for pediatric patients with localized ependymoma. J Clin Oncol 22: 3156-3162, 2004<br \/>\nJ Clin Oncol\u3068\u3044\u3046\u6709\u540d\u306a\u96d1\u8a8c\u306b\uff0c88\u4f8b\u306e\u5c0f\u5150\u60a3\u8005\u306e\u6cbb\u7642\u6210\u7e3e\u304c\u767a\u8868\u3055\u308c\u307e\u3057\u305f\u3002\u64ad\u7a2e\uff08\u8ee2\u79fb\uff09\u304c\u306a\u3044\u4e0a\u8863\u816b\u3092\u5bfe\u8c61\u3068\u3057\u3066\u3044\u307e\u3059\u3002\u539f\u4f53\u7167\u5c04(conformal radiation therapy)\u3068\u3044\u3046\u7cbe\u5ea6\u306e\u9ad8\u3044\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u816b\u760d\u306e\u3042\u308b\u5834\u6240\u3060\u3051\u306b\u5c40\u6240\u7167\u5c04\u3092\u3057\u305f\u5834\u5408\u306e\u6cbb\u7642\u6210\u7e3e\u3067\u3059\u3002\u7279\u306b\u6ce8\u76ee\u3059\u308b\u70b9\u306f\uff0c\u8133\u810a\u9ac4\u7167\u5c04\u3092\u4f7f\u3063\u3066\u3044\u306a\u3044\u306e\u3067\u5b50\u4f9b\u305f\u3061\u306e\u5927\u8133\u306b\u653e\u5c04\u7dda\u304c\u5f53\u305f\u3089\u306a\u3044\u6cbb\u7642\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u60a3\u5150\u306e\u5e74\u9f62\u4e2d\u592e\u5024\u306f2.8\u6b73\u3067\u3059\u304b\u3089\uff0c\u534a\u6570\u4ee5\u4e0a\u304c\uff13\u6b73\u672a\u6e80\u3067\u3059\u300273\u4eba\u306b\u306f59.4\u30b0\u30ec\u30a4\u304c\u7167\u5c04\u3055\u308c\uff0c1.5\u6b73\u672a\u6e80\u3067\u624b\u8853\u3067\u5168\u6458\u51fa\u3067\u304d\u305f15\u75c7\u4f8b\u306b\u306f\u5c11\u3057\u5c11\u306a\u304454\u30b0\u30ec\u30a4\u3068\u3044\u3046\u7dda\u91cf\u304c\u7167\u5c04\u3055\u308c\u307e\u3057\u305f\u3002\u4e0a\u8863\u816b\u306e\u3042\u3063\u305f\u5834\u6240\u3088\u308a10mm\u304f\u3089\u3044\u5e83\u3044\u9818\u57df\uff08\u7167\u5c04\u91ce\uff09\u306b\u539f\u4f53\u7167\u5c04\u304c\u3055\u308c\u3066\u307e\u3057\u305f\u3002<br \/>\n\uff13\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\uff08\uff13\u5e74\u9593\u518d\u767a\u306a\u3057\uff09\u306f75%\u3068\u3044\u3046\u3059\u3070\u3089\u3057\u3044\u6210\u7e3e\u3067\u3059\u3002\u518d\u767a\uff08\u518d\u71c3\uff09\u3057\u305f20\u4f8b\u3067\u306f\uff0c\u5c40\u6240\u518d\u767a\u304c8\u4f8b\uff0c\u64ad\u7a2e\u304c8\u4f8b\uff0c\u5c40\u6240\u3068\u64ad\u7a2e\u306e\u4e21\u65b9\u304c\uff14\u4f8b\u306b\u751f\u3058\u305f\u3068\u3042\u308a\u307e\u3059\u3002\u3053\u306e\u6cbb\u7642\u6cd5\u3067\u3059\u3068\uff13\u5e74\u306e\u6642\u70b9\u3067\u5c40\u6240\u518d\u767a\u3059\u308b\u78ba\u7387\u306f15%\u304f\u3089\u3044\u3067\u3059\u30022\u5e74\u4ee5\u4e0a\u305f\u3063\u3066\u304b\u3089\u691c\u67fb\u306e\u884c\u306a\u308f\u308c\u305f\u751f\u5b58\u4f8b\u3067\u306f\uff0c\u8a8d\u77e5\u6a5f\u80fd\uff08\u77e5\u80fd\uff09\u306e\u4f4e\u4e0b\u306f\u306a\u304f\u6b63\u5e38\u7bc4\u56f2\u5185\u3067\u3042\u3063\u305f\u3068\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0c\u6cbb\u7642\u6210\u7e3e\u304c\u826f\u304f\u3066\u306a\u304a\u77e5\u80fd\u306e\u4f4e\u4e0b\u304c\u307f\u3089\u308c\u306a\u3044\u6cbb\u7642\u6cd5\u3067\u3042\u308b\u3068\u66f8\u304b\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n<p>\u300c\u89e3\u8aac\u300d\u4e0a\u8863\u816b\u306b\u306f\u5168\u8133\u810a\u9ac4\u7167\u5c04\u3092\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u3068\u8003\u3048\u308b\u533b\u5e2b\u304c\u591a\u304f\u3044\u307e\u3057\u305f\u3002\u305d\u3046\u3059\u308b\u3068\u5927\u8133\u3092\u5b88\u308b\u305f\u3081\u306b\uff0c\uff13\u6b73\u672a\u6e80\u306e\u5b50\u4f9b\u305f\u3061\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3067\u304d\u306a\u3044\u306e\u3067\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3067\u3082\u3057\u3066\u307f\u3088\u3046\u3068\u3044\u3046\u8003\u3048\u3082\u6d6e\u304b\u3073\u304c\u3061\u3067\u3059\u3002\u3067\u3082\u5b9f\u969b\u306b\u306f\u4e0a\u8863\u816b\u304c\u64ad\u7a2e\u3059\u308b\u983b\u5ea6\u306f\u9ac4\u82bd\u816b\u307b\u3069\u306f\u9ad8\u304f\u306a\u3044\u306e\u3067\u3059\u3002\u305d\u3053\u306b\u6ce8\u76ee\u3057\u3066\uff0c\u5c40\u6240\u539f\u4f53\u7167\u5c04\u3068\u3044\u3046\u65b9\u6cd5\u3067\u4e0a\u8863\u816b\u306e\u3042\u308b\u8133\u5ba4\u306e\u90e8\u5206\u3060\u3051\u306b\u5927\u304d\u306a\u7dda\u91cf\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u305f\u3068\u3044\u3046\u306e\u304c\u3053\u306e\u7814\u7a76\u3067\u3059\u300268\u4f8b\u3067\u306f\u30c6\u30f3\u30c8\u4e0b\u306b\u767a\u751f\u3057\u3066\u3044\u307e\u3059\u304b\u3089\uff0c\u7d50\u679c\u7684\u306b\u5927\u8133\u306b\u306f\u653e\u5c04\u7dda\u3092\u3042\u3066\u306a\u3044\u3067\u6e08\u3093\u3067\u3044\u307e\u3059\u3002\u3067\u3059\u304b\u3089\uff0c\uff13\u6b73\u672a\u6e80\u306e\u5b50\u4f9b\u305f\u3061\u306b\u3082\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3067\u304d\u3066\u3044\u308b\u306e\u3067\u3059\u3002<br \/>\n\u6ce8\u610f\u3057\u3066\u8aad\u307e\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u70b9\u306f\uff0c88\u4f8b\u306e\u3046\u306174\u4f8b\u307e\u3067\u3082\u304c\u5168\u6458\u51fa(gross total removal)\u306b\u6210\u529f\u3057\u3066\u3044\u308b\u3053\u3068\u3067\u3059\u3002\u524d\u306e\u3068\u3053\u308d\u306b\u3082\u66f8\u304d\u307e\u3057\u305f\u304c\uff0c\u5168\u6458\u51fa\u3067\u304d\u305f\u75c7\u4f8b\u306e\u4e88\u5f8c\u306f\u305d\u3082\u305d\u3082\u826f\u304f\uff0c\u5168\u6458\u51fa\u3057\u306a\u3044\u3068\u3053\u306e\u6210\u7e3e\u306f\u671f\u5f85\u3067\u304d\u306a\u3044\u306e\u3067\u3059\u3002\u5f93\u3063\u3066\uff0c\u624b\u8853\u3067\u5168\u6458\u51fa\u3067\u304d\u3066\u3044\u306a\u3044\u4f8b\u306b\u3053\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308c\u3070\u518d\u767a\u306e\u78ba\u7387\u306f\u9ad8\u304f\u306a\u308b\u3068\u4e88\u60f3\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3057\uff0c\u539f\u4f53\u7167\u5c04\u304c\u52b9\u304f\u304b\u3089\u3068\u3044\u3063\u3066\u624b\u8853\u306b\u624b\u3092\u629c\u3051\u3070\u6b7b\u4ea1\u7387\u306f\u9ad8\u304f\u306a\u3063\u3066\u3057\u307e\u3046\u3053\u3068\u3092\u5fd8\u308c\u3066\u306f\u3044\u3051\u307e\u305b\u3093\u3002<\/p>\n<hr \/>\n<h3 align=\"left\"><span style=\"color: #000080;\">\u810a\u9ac4\u4e0a\u8863\u816b spinal ependymoma<\/span><\/h3>\n<ul>\n<li>\u75c5\u7406\u7d44\u7e54\u5b66\u7684\u306b\u3082\u5206\u5b50\u75c5\u7406\u5b66\u7684\u306b\u3082\u8133\u306b\u767a\u751f\u3059\u308b\u3082\u306e\u3068\u306f\u7570\u306a\u308a\uff0c<span style=\"color: #000080;\"><strong>\u30b0\u30ec\u30fc\u30c91\u3068\u3055\u308c\u308b\u3079\u304d\u816b\u760d<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u810a\u9ac4\u4e0a\u8863\u816b\u306f\u5c0f\u5150\u3067\u306f\u306a\u304f\u3066\u6210\u4eba\u306b\u767a\u751f\u3057\u307e\u3059<\/li>\n<li>\u624b\u8db3\u306e\u3057\u3073\u308c\uff0c\u624b\u8db3\u3068\u4f53\u5e79\u306e\u75db\u307f\uff0c\u624b\u8db3\u306e\u9ebb\u75fa\u306a\u3069\u3067\u767a\u75c7\u3057\u307e\u3059<\/li>\n<li>\u56a2\u80de\u3092\u4f5c\u3063\u305f\u308a\u816b\u760d\u5185\u51fa\u8840\u3057\u305f\u308a\u3057\u307e\u3059<\/li>\n<li>MRI\u3067\u307f\u308b\u3068\u810a\u9ac4\u306e\u771f\u3093\u4e2d\u306b\u3042\u308b\u306e\u304c\u7279\u5fb4\u3067\u3059<\/li>\n<li>\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u9020\u5f71\u5264\u3067\u5897\u5f37\u3055\u308c\u3066\u767d\u304f\u5199\u308a\u307e\u3059<\/li>\n<li>WHO\u306f\u5b9a\u7fa9\u3057\u3066\u3044\u307e\u305b\u3093\u304c\uff0c\u30b0\u30ec\u30fc\u30c91\u306e\u816b\u760d\u3067\u3059<\/li>\n<li>\u810a\u9ac4\u5185\u90e8\u306b\u3067\u304d\u308b\u30b0\u30ea\u30aa\u30fc\u30de\uff08\u9ac4\u5185\u816b\u760d\uff09\u306e\u534a\u6570\u4ee5\u4e0a\u3092\u5360\u3081\u307e\u3059<\/li>\n<li>\u6cbb\u7642\u306f\u690e\u5f13\u5207\u9664\u3068\u810a\u9ac4\u80cc\u9762\u6b63\u4e2d\u5207\u958b\u306b\u3088\u308b\u5168\u6458\u51fa\u3067\u3059<\/li>\n<li>cleavage plane\u304c\u3042\u308a\uff0c\u810a\u9ac4\u6b63\u5e38\u7d44\u7e54\u3068\u5265\u96e2\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059<\/li>\n<li>\u624b\u8853\u3067\u6458\u51fa\u3067\u304d\u308c\u3070\u6cbb\u3063\u3066\u3057\u307e\u3046\u816b\u760d\u3067\u3059<\/li>\n<li>\u3067\u3082\u624b\u8853\u306f\u96e3\u3057\u304f\u3066\u57f7\u5200\u533b\u306b\u3088\u3063\u3066\u624b\u8853\u6210\u7e3e\u304c\u968f\u5206\u9055\u3044\u307e\u3059\u304b\u3089\uff0c\u624b\u8853\u3057\u3066\u3044\u305f\u3060\u304f\u5148\u751f\u3092\u9078\u3093\u3067\u4e0b\u3055\u3044<\/li>\n<li>\u795e\u7d4c\u7dda\u7dad\u816b\u75c72\u578b NF-2\u306e\u60a3\u8005\u3055\u3093\u306e\u810a\u9ac4\u306b\u306f\u591a\u767a\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<h5>\u304a\u307e\u3051\u306e\u77e5\u8b58<\/h5>\n<\/div>\n<h4 class=\"setumei\">\u30c6\u30f3\u30c8\u4e0a\u306e\u4e0a\u8863\u816b\u306e\u767a\u751f\u539f\u56e0<\/h4>\n<p class=\"setumei\"><span style=\"color: #333333; font-size: 16px;\">Parker M, et al.: C11orf95-RELA fusions drive oncogenic NF-\u03baB signalling in ependymoma. Nature 506: 451-455, 2014<br \/>\n<\/span><span style=\"color: #000080;\"><strong>\u4e0a\u8863\u816b\u306f\uff0c\u5c0f\u8133\uff0f\u5f8c\u982d\u7aa9\uff0c\u5927\u8133\uff0c\u810a\u9ac4\u3067\u539f\u56e0\u907a\u4f1d\u5b50\u304c\u7570\u306a\u308a\u307e\u3059\u3002<\/strong><\/span>\u4e0a\u8863\u816b\u767a\u751f\u306e\u5206\u5b50\u907a\u4f1d\u5b66\u6cbb\u9a13\u306f\u4e4f\u3057\u3044\u3067\u3059\u30022014\u5e74\u306b\u30c6\u30f3\u30c8\u4e0a\u306e\u4e0a\u8863\u816b\u306e3\u5206\u306e2\u3067\uff0concogenic fusions between RELA (the principal effector of canonical NF-\u03baB signalling) and an uncharacterized gene, C11orf95\u304c\u307f\u3089\u308c\u308b\u3053\u3068\u304c\u5831\u544a\u3055\u308c\u307e\u3057\u305f\u3002C11orf95-RELA fusion proteins\u306f\uff0c\u30de\u30a6\u30b9\u306e\u795e\u7d4c\u5e79\u7d30\u80de\u3092\u4e0a\u8863\u816b\u7d30\u80de\u3078\u3068\u5909\u7570\u3055\u305b\u307e\u3059\u3002\u3067\u3059\u304b\u3089\uff0c<span style=\"color: #ff0000;\"><strong>RELA\u878d\u5408\u86cb\u767d<\/strong><\/span>\u3092\u30bf\u30fc\u30b2\u30c3\u30c8\u3068\u3057\u305f\u6cbb\u7642\u304c\u958b\u767a\u3067\u304d\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u3068\u8ff0\u3079\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4 class=\"setumei\">\u30c6\u30f3\u30c8\u4e0b\u4e0a\u8863\u816b\u306fepigenetic mechanism\u3067\u767a\u751f\u3059\u308b<\/h4>\n<p class=\"setumei\">Mack SC, et al.: Epigenetic alterations define lethal CIMP-positive ependymomas of infancy. Nature 506: 445-450, 2014<br \/>\n\u30c6\u30f3\u30c8\u4e0b\u4e0a\u8863\u816b infratentorial ependymoma\u306f\uff0c\u300c\u5e7c\u5150\u306eaggressive\u306a\u3082\u306e\u300d\u3068\u300c\u5e74\u9577\u5150\uff0f\u82e5\u5e74\u6210\u4eba\u306e\u3082\u306e\u300d\u3067\u306f\uff0c\u5206\u5b50\u907a\u4f1d\u5b66\u7684\u306b\u306f\u305d\u308c\u305e\u308c\u4e9c\u578b\u3067\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u30c6\u30f3\u30c8\u4e0b<strong><span style=\"color: #ff0000;\">\u4e0a\u8863\u816b\u306fepigenetic mechanism\u3067\u767a\u751f\u3059\u308b<\/span><\/strong>\u3068\u3044\u3046\u7d50\u8ad6\u3067\u3059\u3002Epigenetic modifiers are the first rational therapeutic candidates for this deadly malignancy, which is epigenetically deregulated but genetically bland.<\/p>\n<div class=\"setumei\">\n<h4>\u6587\u732e<\/h4>\n<ul>\n<li>Aizer AA, et al.: Natural history and role of radiation in patients with supratentorial and infratentorial WHO grade II ependymomas: results from a population-based study. J Neurooncol 2013 [Epub]<\/li>\n<li>Bouffet E, et al.: Survival benefit for pediatric patients with recurrent ependymoma treated with reirradiation. Int J Radiat Oncol Biol Phys 83: 1541-1548, 2012<\/li>\n<li>Cage TA, et al.: A systematic review of treatment outcomes in pediatric patients with intracranial ependymomas. J Neurosurg Pediatr 11:673-681, 2013<\/li>\n<li>Figarella-Branger D, Civatte M, Bouvier-Labit C, et al.: Prognostic factors in intracranial ependymomas in children. J Neurosurg 93:605-613, 2000<\/li>\n<li>Ghia AJ, et al.: Supratentorial gross-totally resected non-anaplastic ependymoma: population based patterns of care and outcomes analysis. J Neurooncol. 2013 [Epub]<\/li>\n<li>Grill J, Le Deley MC, Gambarelli D, et al.: French Society of Pediatric Oncology: Postoperative chemotherapy without irradiation for ependymoma in children under 5 years of age: a multicenter trial of the French Society of Pediatric Oncology.\u3000 J Clin Oncol 19:1288-96, 2001<\/li>\n<li>Grundy RG, et al.: Primary postoperative chemotherapy without radiotherapy for intracranial ependymoma in children: the UKCCSG\/SIOP prospective study. Lancet Oncol 8:696-705, 2007<\/li>\n<li>Gururangan S, et al.: Lack of efficacy of bevacizumab + irinotecan in cases of pediatric recurrent ependymoma&#8211;a Pediatric Brain Tumor Consortium study Neuro Oncol 14(:1404-1412, 2012<\/li>\n<li>Gunther JR, et al.: Imaging Changes in Pediatric Intracranial Ependymoma Patients Treated With Proton Beam Radiation Therapy Compared to Intensity Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 93:54-63, 2016<\/li>\n<li>Hollon T, et al.: Supratentorial hemispheric ependymomas: an analysis of 109 adults for survival and prognostic factors. J Neurosurg: 2016<\/li>\n<li>Horn B, Heideman R, Geyer R, et al.: A multi-institutional retrospective study of intracranial ependymoma in children: Identification of risk factors. J Ped Hematol Oncol 21:203-211, 1999<\/li>\n<li>Hukin J, Epstein F, Lefton D, et al.: Treatment of intracranial ependymoma by surgery alone. Pediatric Neurosurgery 29:40-45, 1998<\/li>\n<li>Mack SC, et al.: Epigenetic alterations define lethal CIMP-positive ependymomas of infancy. Nature 506: 445-450, 2014<\/li>\n<li>McGuire CS, et al.: Incidence patterns for ependymoma: a surveillance, epidemiology, and end results sutdy. J Neurosurg (Epub) 2008<\/li>\n<li>Mansur DB, Drzymala RE, Rich KM, et al: The efficacy of stereotactic radiosurgery in the management of intracranial ependymoma. J Neurooncol 66: 187-190, 2004<\/li>\n<li>Marinoff AE, et al.: Rethinking childhood ependymoma: a retrospective, multi-center analysis reveals poor long-term overall survival. J Neuro-Oncol 2017<\/li>\n<li>Massimino M, et al.:\u00a0Final results of the second prospective AIEOP protocol for pediatric intracranial\u00a0ependymoma. Neuro Oncol\u00a02016<\/li>\n<li>Massimino M, et al.: Second-look surgery for ependymoma: the Italian experience. J Neurosurg Pediatr 8: 246-250, 2011<\/li>\n<li>Merchant TE, Mulhern RK, Krasin MJ, et al.: Preliminary results from a phase II trial of conformal radiation therapy and evaluation of radiation-related CNS effects for pediatric patients with localized ependymoma. J Clin Oncol 22: 3156-3162, 2004<\/li>\n<li>Netson KL, et al.: A 5-year investigation of children&#8217;s adaptive functioning following conformal radiation therapy for localized ependymoma. 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Int J Rad Oncol 46: 287-295, 2000<\/li>\n<li><span class=\"highlight\">Wostrack M: Spinal<\/span> <span class=\"highlight\">ependymoma<\/span> in <span class=\"highlight\">adults<\/span>: a <span class=\"highlight\">multicenter<\/span> <span class=\"highlight\">investigation<\/span> of <span class=\"highlight\">surgical<\/span> <span class=\"highlight\">outcome<\/span> and <span class=\"highlight\">progression-free survival<\/span>.\u00a0<span role=\"menubar\">J\u00a0Neurosurg Spine.<\/span> 2018<\/li>\n<\/ul>\n<div><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owltwin.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-5131\" title=\"owltwin\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owltwin-550x396.jpg\" alt=\"\" width=\"550\" height=\"396\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owltwin-550x396.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owltwin-300x216.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owltwin.jpg 1181w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/a><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>\u5b50\u3069\u3082\u3068\u82e5\u3044\u6210\u4eba\u306b\u591a\u3044\u8133\u816b\u760d\u3067\u3059 \u3067\u304d\u305f\u5834\u6240\u304c\u6cbb\u7642\u3068\u4e88\u5f8c\u306b\u5f71\u97ff\u3057\u307e\u3059 \u624b\u8853\u3067\u53d6\u308a\u5207\u308c\u305f\u6642\u306b\u6cbb\u308b\u816b\u760d\u3067\u3059 \u5ef6\u9ac4\u306e\u5468\u308a\u306e\u3082\u306e\u306f\u53d6\u308a\u5207\u308c\u306a\u3044\u3053\u3068\u304c\u3042\u308a\u307e\u3059 \u3067\u304d\u308b\u5834\u6240\u3067\u6cbb\u308b\u898b\u8fbc\u307f\u304c\u9055\u3044\u307e\u3059\uff1a\u3000\u30c6\u30f3\u30c8\u306e\u4e0a\u3068\u4e0b\u3067\u307e\u305a\u533a\u5225\u3059\u308b \u5927\u8133 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[],"class_list":["post-171","post","type-post","status-publish","format-standard","hentry","category-pediattumor"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/171","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/comments?post=171"}],"version-history":[{"count":226,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/171\/revisions"}],"predecessor-version":[{"id":23903,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/171\/revisions\/23903"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/media?parent=171"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/categories?post=171"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/tags?post=171"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}