{"id":173,"date":"2012-04-19T02:16:57","date_gmt":"2012-04-18T17:16:57","guid":{"rendered":"\/sawamura\/wp\/?p=173"},"modified":"2025-08-12T09:53:50","modified_gmt":"2025-08-12T00:53:50","slug":"germ","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/germcelltumors\/germ\/","title":{"rendered":"\u80da\u7d30\u80de\u816b\u760d germ cell tumors"},"content":{"rendered":"<ul>\n<li><span style=\"color: #ff0000;\"><strong>\u982d\u84cb\u5185\u539f\u767a\uff08\u8133\uff09\u80da\u7d30\u80de\u816b\u760d\u306e\u75c5\u7406\u306f\u3059\u3054\u304f\u8907\u96d1<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u6cbb\u7642\u306f\u3053\u306e\u75c5\u6c17\u306b\u3068\u3063\u3066\u3082\u8a73\u3057\u3044\u5c02\u9580\u5bb6\u306b\u3057\u304b\u3067\u304d\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #000080;\"><strong>\u5e73\u5747\u5e74\u9f62\u306f15\u6b73<\/strong><\/span>\u304f\u3089\u3044\u3067\u5b50\u4f9b\u306b\u591a\u3044\u816b\u760d\u3067\u3059<\/li>\n<li>90%\u304c20\u6b73\u672a\u6e80\u306b\u767a\u751f\u3057\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u4e0b\u5782\u4f53\uff0c\u8996\u5e8a\u4e0b\u90e8\uff0c\u677e\u679c\u4f53<\/strong><\/span>\u3068\u3044\u3046\u5834\u6240\u306b\u3067\u304d\u307e\u3059<\/li>\n<li><a href=\"\/sawamura\/pediattumor\/germcelltumors\/germinoma\/\"><strong><span style=\"color: #000080;\"><span style=\"color: #ff0000;\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\uff17\u5272<\/span><\/span><\/strong><\/a><span style=\"color: #000080;\"><span style=\"color: #000000;\">\u304f\u3089\u3044<\/span><\/span>\u3067\u6700\u3082\u591a\u3044\u3067\u3059<\/li>\n<li>\u3064\u3044\u3067\uff0c<strong><span style=\"color: #000080;\"><a title=\"\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d mixed germ cell tumor\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/germcelltumors\/mixedgermcelltumor\/\">\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d<\/a>\uff0c<\/span><\/strong><span style=\"color: #ff0000;\"><strong><a style=\"color: #ff0000;\" href=\"\/sawamura\/pediattumor\/germcelltumors\/teratoma\/\">\u6210\u719f\u5947\u5f62\u816b\u3068\u672a\u719f\u5947\u5f62\u816b<\/a><\/strong><\/span>\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/teratoma\/\">\u6210\u719f\u5947\u5f62\u816b<\/a><\/span>\u4ee5\u5916\u306f\u60aa\u6027\u816b\u760d\u3067\u3059<\/strong><\/span><\/li>\n<li>\u8a3a\u65ad\u306fMRI\u3067\u307b\u3068\u3093\u3069\u308f\u304b\u308a\u307e\u3059<\/li>\n<li>\u8840\u6db2\u306e\u4e2d\u306e<span style=\"color: #000080;\"><strong><span style=\"color: #ff0000;\">AFP<\/span><\/strong><span style=\"color: #000000;\">\u3068<span style=\"color: #ff0000;\"><strong>HCG<\/strong><\/span><\/span>\u3068\u3044\u3046<strong>\u816b\u760d\u30de\u30fc\u30ab\u30fc<\/strong><\/span>\u3067\u60aa\u6027\u5ea6\u304c\u5206\u304b\u308a\u307e\u3059<\/li>\n<li>\u624b\u8853\u306f\uff0c\u4e88\u60f3\u3055\u308c\u308b\u75c5\u7406\u7d44\u7e54\u578b\u306b\u3088\u3063\u3066\u5168\u304f\u9055\u3046\u8a08\u753b\u306b\u306a\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u60aa\u6027\u5ea6\u304c\u9ad8\u3044\u30bf\u30a4\u30d7\u3067\u306f\u9ac4\u6db2\u306b\u306e\u3063\u3066\u810a\u9ac4\u306b\u64ad\u7a2e\uff08\u8ee2\u79fb\uff09<\/strong><\/span>\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u3092\u7528\u3044\u308b\u306e\u3067\uff0c\u57fa\u672c\u7684\u306b\u5c0f\u5150\u79d1\u75c5\u68df\u3067\u6cbb\u7642\u3059\u308b\u75be\u60a3\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>AFP<span style=\"color: #000080;\">\u3084<\/span>HCG<\/strong><\/span><span style=\"color: #000080;\"><strong>\u304c\u3068\u3066\u3082\u9ad8\u3044\u5024\u3067\u60aa\u6027\u5ea6\u304c\u9ad8\u3044\u816b\u760d\u306f\uff0c\u307e\u305a\u653e\u5c04\u7dda\u3068\u5316\u5b66\u7642\u6cd5\u3092\u3057\u3066\u304b\u3089\u6b8b\u3063\u305f\u816b\u760d\u3092\u624b\u8853\u3067\u53d6\u308a\u9664\u304d\u307e\u3059<\/strong><\/span>\uff08\u751f\u5869\u535a\u58eb\u306e\u8003\u3048\uff09<\/li>\n<li>\u65e5\u672c\u3067\u306e<strong><span style=\"color: #ff0000;\"><span style=\"color: #000080;\">\u5316\u5b66\u7642\u6cd5\uff08\u5236\u304c\u3093\u5264\uff09\u306f\uff0cCARE\u3042\u308b\u3044\u306f<a style=\"color: #000080;\" title=\"ICE\u5316\u5b66\u7642\u6cd5\u4f7f\u3044\u65b9\" href=\"\/sawamura\/pediattumor\/icechemothr\/\">ICE\u5316\u5b66\u7642\u6cd5<\/a><\/span><\/span><\/strong>\u3068\u3044\u3046\u306e\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u304b\u3051\u304b\u305f\u306f\uff0c\u75c5\u7406\u7d44\u7e54\u306b\u3088\u3063\u3066\u5168\u304f\u9055\u3063\u3066\u304d\u307e\u3059<\/li>\n<li>\u64ad\u7a2e\u3057\u3084\u3059\u3044\u816b\u760d\u3067\u306f\u5168\u90e8\u306e\u8133\u3068\u810a\u9ac4\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u5f8c\u907a\u75c7\u306f\u624b\u8853\u3068\u653e\u5c04\u7dda<\/strong><\/span>\u3067\u304d\u307e\u308a\u307e\u3059\u304b\u3089\uff0c\u305d\u308c\u3092\u3067\u304d\u308b\u9650\u308a\u4f4e\u4fb5\u8972\u306b\u62bc\u3055\u3048\u308b\u306e\u304c\u6cbb\u7642\u306e\u30b3\u30c4\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u5185\u5206\u6ccc\uff08\u30db\u30eb\u30e2\u30f3\uff09\u969c\u5bb3<\/strong><\/span>\u3092\u6301\u3064\u60a3\u8005\u3055\u3093\u304c\u591a\u3044\u306e\u3067\u5185\u5206\u6ccc\u306e\u5c02\u9580\u5bb6\u306b\u8a3a\u3066\u3082\u3089\u3046\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u5c3f\u5d29\u75c7\uff0cGHD\u306a\u3069\u306e\u5185\u5206\u6ccc\u969c\u5bb3\u304c\u3042\u308b\u5834\u5408\u306b\uff0cMRI\u3067\u8996\u5e8a\u4e0b\u90e8\u4e0b\u5782\u4f53\u306b\u816b\u760d\u304c\u898b\u3048\u306a\u3044\u3053\u3068\u304c\u3042\u308a\u307e\u3059\uff0c\u305d\u308c\u306f\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3059\uff0c<strong><span style=\"color: #000080;\">occult germinoma<\/span><\/strong>\u3068\u3044\u3044\u307e\u3059<\/li>\n<li>\u6c34\u982d\u75c7\u3092\u6539\u5584\u3059\u308b\u306e\u306b\u306f\u69d8\u3005\u306a\u65b9\u6cd5\u304c\u3042\u308a\u307e\u3059\u304c<span style=\"color: #000080;\"><a style=\"color: #000080;\" title=\"\u9577\u671f\u7559\u7f6e\u578b\u8133\u5ba4\u30c9\u30ec\u30ca\u30fc\u30b8\" href=\"\/sawamura\/surgtech\/drainage\/\"><strong>\u30b7\u30e3\u30f3\u30c8\u624b\u8853\u3092\u3057\u306a\u3044<\/strong><\/a><span style=\"color: #000000;\">\u30b3\u30c4\u304c\u3042\u308a\u307e\u3059<\/span><\/span><\/li>\n<li>\u3061\u306a\u307f\u306b\u6fa4\u6751\u306f\u3053\u306e\u816b\u760d\u306e\u7814\u7a76\u3067\u7c73\u56fd\u8133\u795e\u7d4c\u5916\u79d1\u5b66\u4f1a\u306e\u30de\u30cf\u30ec\u30fc\u8cde\u3092\u3082\u3089\u3044\u307e\u3057\u305f(^O^)<\/li>\n<li>\u5730\u57df\u5dee\u304c\u3042\u308a\uff0c\u30a2\u30b8\u30a2\u4eba\u306e\u767a\u751f\u983b\u5ea6\u306f\u6b27\u7c73\u4eba\u306e\u6570\u500d\u3067\u3059<\/li>\n<\/ul>\n<h5><strong><span style=\"color: #333333; font-family: minmoji; font-size: medium;\"><span style=\"caret-color: #333333;\">2021\u5e74WHO\u5206\u985e\uff1a<\/span><\/span><\/strong>\u5927\u307e\u304b\u306a\u6cbb\u7642\u65b9\u91dd<\/h5>\n<p>\u4e0a\u304b\u3089\u9806\u756a\u306b\u6cbb\u308a\u3084\u3059\u3044\u816b\u760d\u3067\u3059\uff0c\u4e0b\u7dda\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u305d\u308c\u305e\u308c\u306e\u30da\u30fc\u30b8\u306b\u98db\u3073\u307e\u3059<\/p>\n<h4><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u5947\u5f62\u816b teratomas\" href=\"\/sawamura\/pediattumor\/teratoma\/\">\u6210\u719f\u5947\u5f62\u816b<\/a>\u00a0mature teratoma<\/strong><\/span><\/h4>\n<p>\u624b\u8853\u3067\u5b8c\u5168\u6458\u51fa\u3059\u308c\u3070\u6cbb\u308a\u307e\u3059\uff0c\u9006\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u3082\u5316\u5b66\u7642\u6cd5\u3082\u52b9\u304d\u307e\u305b\u3093\u3001\u5916\u79d1\u533b\u306e\u9ad8\u5ea6\u306a\u6280\u8853\u304c\u6c42\u3081\u3089\u308c\u307e\u3059<\/p>\n<h4><span style=\"color: #000080;\"><strong style=\"color: #ff0000;\"><a style=\"color: #000080;\" title=\"\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u80da\u816b\uff09\" href=\"\/sawamura\/pediattumor\/germinoma\/\">\u80da\u816b \u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/a><span style=\"color: #000080;\">\u00a0germinoma<\/span><\/strong><\/span><\/h4>\n<p>\u3067\u304d\u308c\u3070\u751f\u691c\u624b\u8853\u3092\u884c\u3063\u3066\u75c5\u7406\u8a3a\u65ad\u3092\u3057\u3066\uff0c\u5316\u5b66\u7642\u6cd5\u3092\u3057\u3066\u304b\u3089\u4f4e\u7dda\u91cf\u5168\u8133\u5ba4\u7167\u5c04\u3057\u307e\u3059\u3001\u305d\u308c\u3067\u6cbb\u308a\u307e\u3059<\/p>\n<h4><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u5947\u5f62\u816b teratomas\" href=\"\/sawamura\/pediattumor\/teratoma\/\">\u672a\u719f\u5947\u5f62\u816b<\/a>\u00a0immature teratoma<\/strong><\/span><\/h4>\n<p>\u75c5\u7406\u8a3a\u65ad\u3092\u3057\u3066\uff0c\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3092\u3057\u307e\u3059\u304c\uff0c\u6b8b\u3063\u305f\u816b\u760d\u3092\u6458\u51fa\u3057\u306a\u3044\u3068\u9ad8\u7387\u306b\u518d\u767a\uff08\u518d\u71c3\uff09\u3057\u307e\u3059\u3001\u3053\u306e\u7fa4\u3060\u3051\u3067\u3082\u3001\u4f4e\u60aa\u5236\u5ea6\u306e\u3082\u306e\u304b\u3089\u9ad8\u60aa\u5236\u5ea6\u306e\u3082\u306e\u307e\u3067\u3042\u308a\u307e\u3059\u3001\u751f\u691c\u8853\u306e\u307f\u3067\u306f\u5224\u65ad\u3067\u304d\u306a\u3044\u60aa\u6027\u5ea6\u304c\u3042\u308a\u3001\u6cbb\u7642\u9078\u629e\u306b\u82e6\u616e\u3057\u307e\u3059<\/p>\n<h4><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/germcelltumors\/mixedgermcelltumor\/\">\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d<\/a>\uff0cmixed germ cell tumor<br \/>\n<\/strong><strong>(<a style=\"color: #000080;\" href=\"\/sawamura\/home\/mixedgermcelltumor\/\">\u5947\u5f62\u816b\u3068\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u6df7\u5408\u578b teratoma mixed with germinoma)<\/a><\/strong><\/span><\/h4>\n<p>\u3069\u306e\u3088\u3046\u306a\u816b\u760d\u304c\u6df7\u3058\u3063\u3066\u3044\u308b\u304b\uff0c\u75c5\u7406\u8a3a\u65ad\u304c\u6700\u3082\u5927\u5207\u3067\u3059\u3002\u6df7\u3058\u3063\u3066\u3044\u308b\u3082\u306e\u306e\u4e2d\u3067\u6700\u3082\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u75c5\u7406\u6240\u898b\u306b\u3042\u308f\u305b\u3066\u6cbb\u7642\u8a08\u753b\u3092\u7acb\u3066\u307e\u3059\u3002\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3068\u672a\u719f\u5947\u5f62\u816b\u306e\u6df7\u5408\u578b\u304c\u591a\u3044\u3067\u3059<\/p>\n<h4><span style=\"color: #000080;\"><strong>\u5375\u9ec4\u56a2\u816b\u00a0yolk sac tumor AFP\u7523\u751f\u816b\u760d<\/strong><\/span><\/h4>\n<p>AFP\u304c\u975e\u5e38\u306b\u9ad8\u3044\u3068\u304d\u306f\u751f\u691c\u624b\u8853\u306f\u5fc5\u8981\u3042\u308a\u307e\u305b\u3093\uff0c\u3068\u308a\u3042\u3048\u305a\u5316\u5b66\u7642\u6cd5\u3092\uff11\u30b3\u30fc\u30b9\u3057\u3066\u5316\u5b66\u7642\u6cd5\u53cd\u5fdc\u6027\u3092\u898b\u6975\u3081\u3066\uff0c\u8ffd\u52a0\u306e\u5316\u5b66\u7642\u6cd5\u3084\u8133\u810a\u9ac4\u7167\u5c04\uff08\u5c40\u6240\u8ffd\u52a0\u7167\u5c04\uff09\u3092\u3057\u3066\u304b\u3089\uff0c\u6b8b\u3063\u305f\u816b\u760d\u3092\u958b\u982d\u624b\u8853\u3067\u5168\u90e8\u53d6\u308a\u307e\u3059<\/p>\n<h4><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/germcelltumors\/teratoma\/\">\u60aa\u6027\u8ee2\u5316\u3092\u4f34\u3046\u5947\u5f62\u816b<\/a>\u00a0teratoma with somatic type malignancy<\/strong><\/span><\/h4>\n<p>\u3081\u3063\u305f\u306b\u306a\u3044\u816b\u760d\u3067\u3059\uff0c\u624b\u8853\u6458\u51fa\u3068\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3092\u3057\u307e\u3059\u304c\uff0c\u9ad8\u7dda\u91cf\u306e\u5c40\u6240\u7167\u5c04\u304c\u5fc5\u8981\u3067\u3059<\/p>\n<h4><span style=\"color: #000080;\"><strong>\u80ce\u5150\u6027\u764c\u00a0embryonal carcinoma<\/strong><\/span><\/h4>\n<p>\u3053\u308c\u304c\u7591\u308f\u308c\u305f\u6642\u306b\u306f\u307e\u305a\u5f37\u529b\u306a\u653e\u5c04\u7dda\u6cbb\u7642\uff0c\u305d\u308c\u304b\u3089\u5316\u5b66\u7642\u6cd5\u304c\u5fc5\u8981\u3067\u3059\uff0c\u751f\u5b58\u5272\u5408\u304c\u3068\u3066\u3082\u4f4e\u3044\u306e\u3067\u3067\u304d\u308b\u6cbb\u7642\u306f\u4f55\u3067\u3082\u3057\u307e\u3059<\/p>\n<h4><span style=\"color: #000080;\"><strong>\u7d68\u6bdb\u764c\u00a0choriocarcinoma<\/strong><\/span><\/h4>\n<p>\u7d14\u578b\u306f\u3082\u306e\u3059\u3054\u304f\u73cd\u3057\u304f\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u306e\u4e00\u90e8\u50cf\u3068\u3057\u3066\u898b\u3089\u308c\u308b\u3053\u3068\u306e\u65b9\u304c\u591a\u3044\u3067\u3059\uff0cHCG\u304c\u6570\u5343\u304b\u3089\u6570\u4e07\u306e\u5024\u306b\u306a\u308a\u307e\u3059\uff0c\u3053\u308c\u304c\u7591\u308f\u308c\u305f\u6642\u306b\u306f\u5f37\u529b\u306a\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u5316\u5b66\u7642\u6cd5\u304c\u5fc5\u8981\u3067\u3059\uff0c\u751f\u5b58\u5272\u5408\u304c\u3068\u3066\u3082\u4f4e\u3044\u306e\u3067\u3067\u304d\u308b\u6cbb\u7642\u306f\u4f55\u3067\u3082\u3057\u307e\u3059<\/p>\n<h5>\u3053\u308c\u3089\u306e\u816b\u760d\u304c\u6df7\u3058\u3063\u3066\u3044\u308b\u3082\u306e\u304c\u591a\u3044\u306e\u3067\u3068\u3066\u3082\u8907\u96d1\u306b\u306a\u308a\u307e\u3059<br \/>\n\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u65b9\u306e\u816b\u760d\u306b\u7126\u70b9\u3092\u5f53\u3066\u3066\u6cbb\u7642\u6cd5\u3092\u9078\u629e\u3057\u307e\u3059<\/h5>\n<h5>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3092\u9664\u3051\u3070\uff0c<span style=\"color: #ff0000;\">\u5927\u90e8\u5206\u304c\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d<\/span>\u3068\u3044\u3046\u8a3a\u65ad\u306b\u306a\u308a\u307e\u3059<\/h5>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/immatteratwk.jpg\" rel=\"attachment wp-att-8541\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-8541\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/immatteratwk-292x300.jpg\" alt=\"immatteratwk\" width=\"292\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/immatteratwk-292x300.jpg 292w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/immatteratwk.jpg 345w\" sizes=\"auto, (max-width: 292px) 100vw, 292px\" \/><\/a><br \/>\n14\u6b73\u306e\u5c11\u5e74\u306b\u767a\u751f\u3057\u305f\u677e\u679c\u4f53\u672a\u719f\u5947\u5f62\u816b\u3067\u3059<br \/>\nAFP 130ng\/ml, HCG-beta 30mIU\u3067\u3057\u305f<br \/>\n\u5316\u5b66\u7642\u6cd5\u306fICE (CDDP, VP-16, IFO)<br \/>\n\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u5168\u8133\u5ba4\u3068\u5c40\u6240\u7167\u5c04<br \/>\n\u5947\u5f62\u816b\u306a\u306e\u3067\uff0c\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u306e\u5f8c\u3067\u6b8b\u3063\u305f\u816b\u760d\u306b\u306f\uff0c\u958b\u982d\u624b\u8853\u3067\u5168\u6458\u51fa\u304c\u5fc5\u8981\u3067\u3059<\/p>\n<p>\u5168\u822c\u7684\u306b\u5c0f\u5150\u8133\u816b\u760d\u306e\u6cbb\u7642\u7814\u7a76\u4f53\u5236\u306f\u6b27\u7c73\u306b\u9045\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u6771\u5357\u30a2\u30b8\u30a2\u3067\u306e\u80da\u7d30\u80de\u816b\u760d\u306e\u767a\u751f\u983b\u5ea6\u306f\u6b27\u7c73\u306e3\u304b\u30895\u500d\u306b\u3042\u305f\u308b\u305f\u3081\u306b\uff0c\u6cbb\u7642\u306b\u95a2\u3057\u3066\u306f\u65e5\u672c\u304c\u6b27\u7c73\u3092\u30ea\u30fc\u30c9\u3057\u3066\u3044\u307e\u3059\u3002\u79c1\u3082\u3053\u306e\u816b\u760d\u306b\u5bfe\u3057\u3066\u306f\u305f\u304f\u3055\u3093\u306e\u8ad6\u6587\u3092\u66f8\u304d\u307e\u3057\u305f<\/p>\n<h5><span style=\"color: #ff0000;\"><strong><span style=\"color: #000080;\">\u816b\u760d\u30de\u30fc\u30ab\u30fc\u3000<\/span>\u8840\u6db2\u3068\u9ac4\u6db2\u306e AFP \u3068 HCG<\/strong><\/span><\/h5>\n<ul>\n<li>\u9ad8\u3044\u30ec\u30d9\u30eb\u306eAFP\u306f\uff0c\u5375\u9ec4\u56a2\u7a2e\u304b\u3089\u7523\u751f\u3055\u308c\u307e\u3059<\/li>\n<li>\u80ce\u5150\u6027\u764c\u3068\u672a\u719f\u5947\u5f62\u816b\u3067\u3082\u4f4e\u30ec\u30d9\u30eb\u306eAFP\u304c\u6e2c\u5b9a\u3055\u308c\u307e\u3059<\/li>\n<li>\u6975\u3081\u3066\u9ad8\u3044\u30ec\u30d9\u30eb\u306eHCG\u306f\uff0c\u7d68\u6bdb\u764c\u306e\u5b58\u5728\u3092\u793a\u3057\u307e\u3059<\/li>\n<li>\u80ce\u5150\u6027\u764c\u3067\u3082\u9ad8\u30ec\u30d9\u30eb\u306eHCG\u304c\u691c\u51fa\u3055\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\uff0c\u4f4e\u30ec\u30d9\u30eb\u306eHCG\u3092\u7523\u751f\u3057\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u6cbb\u9a13\u306b\u304a\u3044\u3066\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u30ab\u30c3\u30c8\u30aa\u30d5\u30ec\u30d9\u30eb\u306f\uff0cAFP\u306710-25 ng\/ml\uff0cHCG\u306750-100 IU\/L<\/strong><\/span>\u3068\u4eee\u5b9a\u3055\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u75c5\u7406\u8a3a\u65ad\u3084\u6cbb\u7642\u65b9\u91dd\u3092\u5206\u3051\u308bAFP\u3068HCG\u306e\u30ab\u30c3\u30c8\u30aa\u30d5\u30ec\u30d9\u30eb\u306f\u660e\u3089\u304b\u3067\u306f\u3042\u308a\u307e\u305b<\/strong><strong>\u3093<\/strong><\/span><\/li>\n<\/ul>\n<h5><a title=\"\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u80da\u816b\uff09germinoma\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/germcelltumors\/germinoma\/\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u80da\u816b\uff09ger<span style=\"color: #000080;\">minoma\u306f\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af<\/span><\/a><\/h5>\n<h5>\u8a3a\u65ad\u3068\u6cbb\u7642\u306f\u3068\u3066\u3082\u96e3\u3057\u3044\u3067\u3059\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u307b\u3068\u3093\u3069\u306a\u306e\u3067\uff0c<span style=\"color: #ff0000;\">\u307e\u305a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u3068\u3053\u308d\u3092\u8aad\u3093\u3067\u52c9\u5f37\u3057\u3066\u4e0b\u3055\u3044<\/span>\uff0c\u305d\u306e\u5f8c\u306b\u3082\u3069\u3063\u3066\u4e0b\u306e\u9805\u76ee\u3092\u8aad\u3093\u3067\u304f\u3060\u3055\u3044<\/h5>\n<h1><strong>\u6cbb\u7642\u9078\u629e\u306e\u305f\u3081\u306e\u5206\u985e<\/strong><\/h1>\n<p>\u80da\u7d30\u80de\u816b\u760d\u3068\u3044\u3063\u3066\u3082\u3044\u308d\u3044\u308d\u306a\u816b\u760d\u306e\u96c6\u307e\u308a\u3067\u3059\u304b\u3089\uff0cWHO\u75c5\u7406\u5206\u985e\u306b\u3088\u3063\u3066\u9069\u5207\u306a\u6cbb\u7642\u65b9\u91dd\u3092\u6c7a\u3081\u308b\u3055\u3048\u96e3\u3057\u3044\u3067\u3059\u3002\u6cbb\u7642\u6cd5\u306e\u304a\u3088\u305d\u306e\u9078\u629e\u306e\u305f\u3081\u306b\uff0c\u7d44\u7e54\u578b\u306b\u3088\u3063\u3066\u4e88\u5f8c\u826f\u597d\u7fa4\uff0c\u4e88\u5f8c\u4e2d\u9593\u7fa4\uff0c\u4e88\u5f8c\u4e0d\u826f\u7fa4\u306e\uff13\u7fa4\u306b\u5206\u985e\u3057\u3066\u300c\u304a\u3088\u305d\u300d\u306e\u76ee\u5b89\u3068\u3057\u307e\u3057\u305f\u3002<\/p>\n<p>\u3053\u306e\u5206\u985e\u306f1995\u5e74\u306b\u6fa4\u6751\u304c\u4e16\u754c\u3067\u521d\u3081\u3066\u4f5c\u6210\u3057\u305f\u3082\u306e\u3067\u3059\u3002\u5f53\u6642\u306eImpact Factor 5.3\u306eCurrent Opinion in Neurology\u306b\u304d\u3061\u3093\u3068\u82f1\u6587\u767a\u8868\u3057\u3066\u3044\u307e\u3059\u306e\u3067\u78ba\u304b\u3081\u3066\u304f\u3060\u3055\u3044 (*^o^*)<br \/>\n\u539f\u8457\u306e\u767a\u8868\u304b\u3089\u3082\u304620\u5e74\u4ee5\u4e0a\u305f\u3061\u307e\u3059\u306e\u3067modification\u3057\u3066\u3044\u307e\u3059\u30022022\u5e74\u6642\u70b9\u3067\u306f\uff0c\u3053\u306e\u5206\u985e\u3088\u308a\u3055\u3089\u306b\u7d30\u304b\u304f\u5206\u3051\u3066\u8003\u3048\u3066\u6cbb\u7642\u6cd5\u3092\u9078\u629e\u3059\u308b\u3079\u304d\u3060\u3068\u8003\u3048\u3066\u3044\u307e\u3059\u3002<\/p>\n<h5><span class=\"highlight\">Sawamura Y: Current<\/span>\u00a0diagnosis and treatment of central nervous system germ cell tumors.\u00a0Curr Opin Neurol\u00a0419-423, 1996<\/h5>\n<ul class=\"papers\">\n<li><span style=\"color: #000080;\"><strong>1. \u4e88\u5f8c\u826f\u597d\u7fa4\u3000Good Prognostic Group<\/strong><\/span>\n<ul>\n<li>germinoma (elevated serum HCG-beta &lt; 100mIU)<\/li>\n<li>mature teratoma<\/li>\n<\/ul>\n<\/li>\n<li><span style=\"color: #000080;\"><strong>2. \u4e2d\u9593\u7fa4\u3000Intermediate Prognostic Group<\/strong><\/span>\n<ul>\n<li>immature teratoma<\/li>\n<li>mixed germ cell tumors consisted of germinoma with either mature or immature teratoma<\/li>\n<\/ul>\n<\/li>\n<li><span style=\"color: #000080;\"><strong>3. \u4e88\u5f8c\u4e0d\u826f\u7fa4\u3000Poor Prognostic Group<\/strong><\/span>\n<ul>\n<li>embryonal carcinoma<\/li>\n<li>yolk sac tumor<\/li>\n<li>choriocarcinoma<\/li>\n<li>immature teratoma with high malignancy<\/li>\n<li>mixed germ cell tumors including a component of embryonal carcinoma, yolk sac tumor, choriocarcinoma, or teratoma with malignant transformation<\/li>\n<li>teratoma with malignant transformation including a component of such as squamous cell carcinoma, adenocarcinoma, or other sarcomas<\/li>\n<\/ul>\n<\/li>\n<li>\n<h5><span style=\"color: #ff0000;\"><strong>\u4e88\u5f8c\u826f\u597d\u7fa4<\/strong><\/span><\/h5>\n<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color: #333333; font-family: minmoji; font-size: 16.00160026550293px;\">\u80da\u816b\uff08\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff09\u3068\u6210\u719f\u5947\u5f62\u816b\u3067\u3059<\/span><\/li>\n<li><span style=\"color: #333333; font-family: minmoji; font-size: 16.00160026550293px;\">80-90%\u306e10\u5e74\u751f\u5b58\u5272\u5408\u304c\u671f\u5f85\u3067\u304d\u308b\u7fa4\u3067\u3059\u304b\u3089\uff0c<span style=\"color: #000080;\"><strong>\u6cbb\u7652\u3092\u76ee\u6307\u3059\u3068\u3068\u3082\u306b\u6cbb\u7642\u5f8c\u907a\u75c7\u3092\u3067\u304d\u3046\u308b\u9650\u308a\u6700\u5c0f\u9650\u5ea6<\/strong><\/span>\u3068\u306a\u308b\u3088\u3046\u306a\u6cbb\u7642\u65b9\u91dd\u3092\u4f5c\u6210\u3057\u307e\u3059<\/span><\/li>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u80da\u7d30\u80de\u816b\u760d\u306e\u7d0470%\u3092\u5360\u3081\u307e\u3059\u304b\u3089\uff0c\u6210\u719f\u5947\u5f62\u816b\u3092\u5165\u308c\u308b\u30684\u5206\u306e\uff13\u304f\u3089\u3044\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u307e\u305f15\u6b73\u3092\u30d4\u30fc\u30af\u3068\u3057\u3066\u601d\u6625\u671f\u306b\u591a\u3044\u816b\u760d\u3067\u3059\u304c\uff0c\u5947\u5f62\u816b\u306f5\u6b73\u4ee5\u4e0b\u306e\u5c0f\u5150\u306b\u3082\u7a00\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #000080;\"><strong>\u6210\u719f\u5947\u5f62\u816b\u306f\uff0c\u958b\u982d\u624b\u8853\u306b\u3088\u308b\u6458\u51fa\u306e\u307f\u304c\u6cbb\u7642\u65b9\u6cd5<\/strong><\/span>\u3067\u4ed6\u306e\u6cbb\u7642\u9078\u629e\u80a2\u306f\u3042\u308a\u307e\u305b\u3093\u304b\u3089\uff0c\u8133\u795e\u7d4c\u5916\u79d1\u533b\u306e\u624b\u8853\u6280\u8853\u3060\u3051\u304c\u305f\u3088\u308a\u3067\u3059<\/li>\n<li>\u304b\u3064\u3066\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u6a19\u6e96\u6cbb\u7642\u306f\uff0c\u5168\u8133\u5ba4\u3042\u308b\u3044\u306f\u5168\u8133\u810a\u9ac4\u3092\u542b\u3080\u9818\u57df\u306b\u816b\u760d\u7dda\u91cf\u3068\u3057\u306645\uff5e55Gy\u3092\u7528\u3044\u308b\u3082\u306e\u3067\u3057\u305f\u3002\u3053\u306e\u5927\u91cf\u306e\u653e\u5c04\u7dda\u3092\u4f7f\u3046\u6cbb\u7642\u6cd5\u3067\u306f\uff0c\u9577\u671f\u751f\u5b58\u4f8b\u306b\u304a\u3044\u3066\u7cbe\u795e\u767a\u9054\u9045\u6ede\uff08\u77e5\u80fd\u4f4e\u4e0b\u30fb\u8a8d\u77e5\u6a5f\u80fd\u306e\u4f4e\u4e0b\uff09\uff0c\u9593\u8133\u4e0b\u5782\u4f53\u6a5f\u80fd\u969c\u5bb3\uff0c\u653e\u5c04\u7dda\u8a98\u767a\u4e8c\u6b21\u816b\u760d\uff0c\u8133\u4e3b\u5e79\u52d5\u8108\u9589\u585e\u306a\u3069\u306e\u9045\u767a\u6027\u653e\u5c04\u7dda\u969c\u5bb3\u306e\u767a\u751f\u304c\u554f\u984c\u3068\u306a\u308a\u307e\u3057\u305f<\/li>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u5316\u5b66\u7642\u6cd5\u3078\u306e\u611f\u53d7\u6027\u304c\u975e\u5e38\u306b\u9ad8\u304f\u3066\uff0c\u7d44\u7e54\u8a3a\u65ad\u78ba\u5b9a\u5f8c\u306b\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3048\u3070\uff0c\u5927\u304d\u306a\u3082\u306e\u3067\u3042\u3063\u3066\u3082\u4f8b\u5916\u306a\u304f\u816b\u760d\u306f\u307b\u307c\u6d88\u5931\u3057\u307e\u3059<\/li>\n<li>\u3067\u3082\uff0c<span style=\"color: #000080;\"><strong>\u5316\u5b66\u7642\u6cd5\u5358\u72ec\u6cbb\u7642\u3067\u306f\u304b\u306a\u308a\u9ad8\u983b\u5ea6\u306b\u518d\u767a<\/strong><\/span>\u304c\u8d77\u3063\u3066\u3057\u307e\u3044\u307e\u3059<\/li>\n<li>MRI\u3067\u4e00\u898b\u3057\u305f\u3068\u3053\u308d\u9650\u5c40\u6027\u816b\u760d\u306b\u898b\u3048\u307e\u3059\u304c\uff0c\u75c5\u7406\u7d44\u7e54\u5b66\u7684\u306b\u306f\u8133\u5ba4\u58c1\u306a\u3069\u306b\u304b\u306a\u308a\u5e83\u7bc4\u306b\u6d78\u6f64 <span style=\"color: #000080;\"><strong>\u8133\u5ba4\u4e0a\u8863\u4e0b\u6d78\u6f64<\/strong><\/span>\u00a0<span style=\"color: #000080;\"><strong>subependymal infiltration<\/strong> <\/span>\u3057\u3066\u3044\u308b\u306e\u3067\u5c11\u306a\u304f\u3068\u3082<span style=\"color: #ff0000;\"><strong>\u5168\u8133\u5ba4\u9818\u57df whole ventricle<\/strong><\/span> \u306b\u7167\u5c04\u91ce\u3092\u8a2d\u5b9a\u3059\u308b\u5fc5\u8981\u304c\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u304c\u306f\u3063\u304d\u308a\u3057\u3066\u304d\u307e\u3057\u305f<\/li>\n<li>\u751f\u691c\u8853\u3067\u7d44\u7e54\u8a3a\u65ad\u3092\u78ba\u5b9a\u3057\u305f\u5f8c\u306b\uff0c\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u3068\u30a8\u30c8\u30dd\u30b7\u30c9\u3092\u7528\u3044\u308bCARE\u5316\u5b66\u7642\u6cd5\u304b\uff0cICE\u5316\u5b66\u7642\u6cd5\u3092\uff13\u30b3\u30fc\u30b9\u884c\u3063\u3066\u304b\u3089\u5168\u8133\u5ba4\u7cfb\u306b\u4f4e\u7dda\u91cf\u7167\u5c04\uff0824Gy\/12\u5206\u5272\u3042\u308b\u3044\u306f25.2Gy\/14\u5206\u5272\uff09\u3092\u3057\u307e\u3059<\/li>\n<li>\u677e\u8c37\u73ed\u306e\u767a\u8868\u3067\u306f\uff0c\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u50245\u5e74\u306e\u6642\u70b9\u306b\u3066\u6cbb\u7642\u8a55\u4fa1\u53ef\u80fd\u306a130\u4f8b\u306b\u304a\u3044\u3066\uff0c\u7121\u5897\u60aa\u751f\u5b58\u5272\u540891%\uff0c\u5168\u751f\u5b58\u5272\u540898%\u3068\u3044\u3046\u826f\u3044\u6210\u7e3e\u3092\u51fa\u3057\uff0c\u3055\u3089\u306b\u3053\u306e\u3046\u3061120\u4f8b(86%)\u304c\u793e\u4f1a\u5fa9\u5e30\u3092\u3057\u3066\u3044\u307e\u3059 (\u307b\u3093\u3068\u304b\u306a\u30fc\u30fc?? \u3053\u3093\u306a\u306b\u9ad8\u304f\u306a\u3044\u304b\u3082&#8211;??)<\/li>\n<\/ul>\n<ul class=\"papers\">\n<li>\n<h5><strong><span style=\"color: #ff0000;\">\u4e88\u5f8c\u4e2d\u9593\u7fa4<\/span><\/strong><\/h5>\n<\/li>\n<\/ul>\n<ul>\n<li>\uff15\u5e74\u751f\u5b58\u5272\u5408\u306f70%\u7a0b\u5ea6\u3067\u3059<\/li>\n<li>\u672a\u719f\u5947\u5f62\u816b\u3068\u6cbb\u308a\u3084\u3059\u3044\u30bf\u30a4\u30d7\u306e\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\uff08\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3068\u6210\u719f\u3042\u308b\u3044\u306f\u672a\u719f\u5947\u5f62\u816b\u3068\u306e\u6df7\u5408\u578b\u306e\u307f\uff09\u3067\u3059<\/li>\n<li>\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u672a\u719f\u5947\u5f62\u816b\u306f\u6642\u3068\u3057\u3066\u9ac4\u6db2\u64ad\u7a2e\u306a\u3069\u3082\u3057\u307e\u3059\u304b\u3089\u5b89\u6613\u306b\u8003\u3048\u3066\u6cbb\u7642\u3092\u9032\u3081\u306a\u3044\u307b\u3046\u304c\u3044\u3044\u3067\u3059<\/li>\n<li>\u9577\u671f\u3067\u307f\u308c\u307030%\u304c\u6b7b\u4ea1\u3059\u308b\u3068\u3044\u3046\u306e\u306f\u304a\u305d\u3089\u304f<span style=\"color: #000080;\"><strong>\u60aa\u6027\u5ea6\u304c\u9ad8\u3044\u30bf\u30a4\u30d7\u306e\u672a\u719f\u5947\u5f62\u816b<\/strong><\/span>\u306e\u305f\u3081\u3067\uff0c\u672a\u719f\u5947\u5f62\u816b\u306b\u306f\u3055\u307e\u3056\u307e\u306a\u60aa\u5236\u5ea6\u306e\u3082\u306e\u304c\u3042\u308b\u3068\u3044\u3046\u3053\u3068\u3092\u5ff5\u982d\u306b\u6cbb\u7642\u3092\u9032\u3081\u3066\u3044\u304d\u307e\u3059<\/li>\n<li>\u304b\u3064\u3066\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u75c5\u7406\u7d44\u7e54\u8a3a\u3067\u307f\u3089\u308c\u308bHCG\u967d\u6027\u5de8\u7d30\u80de\u3092\u542b\u3080\u3082\u306e\u3092 germinoma with STGC\u00a0(germinoma with syncytiotrophoblastic giant cells)\u3068\u3057\u3066\u4e88\u5f8c\u4e2d\u9593\u7fa4\u306b\u5206\u985e\u3057\u3066\u3044\u307e\u3057\u305f\uff0c\u305d\u308c\u4ee5\u5916\u3092pure germinoma\u3068\u547c\u3073\u307e\u3057\u305f\uff0c1990\u5e74\u4ee3\u307e\u3067\u306f\uff0cHCG\u3092\u7523\u751f\u3059\u308b\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u518d\u767a\u3057\u3084\u3059\u3044\u3068\u4fe1\u3058\u3089\u308c\u3066\u3044\u305f\u304b\u3089\u3067\u3059\u3002\u3057\u304b\u3057\uff0c\u591a\u5c11HCG\u304c\u9ad8\u5024\u3092\u793a\u3059\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u304d\u3061\u3093\u3068\u3057\u305f\u6cbb\u7642\u304c\u3067\u304d\u308c\u3070\u518d\u767a\u5272\u5408\u306f\u9ad8\u304f\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3082\u5224\u308a\u307e\u3057\u305f\u3002\u3067\u3059\u304b\u3089\uff0c2000\u5e74\u3053\u308d\u304b\u3089\u306f\u5168\u3066\u306egerminoma\u306f\u4e88\u5f8c\u826f\u597d\u7fa4\u3068\u306a\u308a\u307e\u3057\u305f<\/li>\n<li>\u4e88\u5f8c\u4e2d\u9593\u7fa4\u306b\u306f\u8efd\u5ea6\u306e\u8840\u6e05AFP\u4e0a\u6607\u4f8b\uff08\u6570\u767eng\/ml\uff09\u3082\u542b\u307e\u308c\u307e\u3059\u3002\u4f4e\u60aa\u6027\u5ea6\u306e\u672a\u719f\u5947\u5f62\u816b\u304cAFP\u3092\u7523\u751f\u3059\u308b\u304b\u3089\u3067\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u5f8c\u306b\u6b8b\u308b\u5947\u5f62\u816b\u306f\uff0c\u53ef\u80fd\u306a\u9650\u308a\u958b\u982d\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u307e\u3059 <span style=\"color: #ff0000;\"><strong>second look surgery<\/strong><\/span><\/li>\n<\/ul>\n<ul class=\"papers\">\n<li>\n<h5><span style=\"color: #ff0000;\"><strong>\u4e88\u5f8c\u4e0d\u826f\u7fa4<\/strong><\/span><\/h5>\n<\/li>\n<\/ul>\n<ul>\n<li>\u80da\u7d30\u80de\u816b\u760d\u306e10%\u4ee5\u4e0b\u3067\u73cd\u3057\u3044\u3082\u306e\u3067\u3059\u3002\u6b7b\u4ea1\u5272\u5408\u304c\u3068\u3066\u3082\u9ad8\u3044\u7fa4\u3067\u3059<\/li>\n<li>\u6a5f\u80fd\u4e88\u5f8c\u306e\u640d\u5931\uff08\u3042\u308b\u7a0b\u5ea6\u306e\u5f8c\u907a\u75c7\uff09\u3088\u308a\u3082\u751f\u547d\u4e88\u5f8c\u306b\u91cd\u70b9\u3092\u304a\u3044\u3066\uff0c<span style=\"color: #000080;\"><strong>\u500b\u3005\u306e\u60a3\u8005\u306b\u304a\u3044\u3066\u4e0e\u3048\u3089\u308c\u308b\u9650\u308a\u306e\u521d\u671f\u6cbb\u7642\u3092\u3057\u307e\u3059<\/strong><\/span><\/li>\n<li>\u751f\u691c\u8853\u3084\u816b\u760d\u6458\u51fa\u624b\u8853\u306e\u30ea\u30b9\u30af\u306f\u9ad8\u3044\u3067\u3059<\/li>\n<li>\u677e\u679c\u4f53\u3084\u8996\u5e8a\u4e0b\u90e8\u3068\u3044\u3046\u6df1\u90e8\u306b\u3042\u308a\u8133\u7d44\u7e54\u306b\u6d78\u6f64\u3057\uff0c\u304b\u306a\u308a\u306e\u816b\u760d\u51fa\u8840\u3092\u4f34\u3044\u307e\u3059\u304b\u3089\u5168\u6458\u51fa\u3067\u304d\u308b\u3082\u306e\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u80ce\u5150\u6027\u764c\uff0c\u5375\u9ec4\u56a2\u816b\uff0c\u7d68\u6bdb\u764c\u306a\u3069\u81f4\u6b7b\u7387\u304c\u9ad8\u3044\u4e88\u5f8c\u4e0d\u826f\u7fa4\u3067\uff0c<span style=\"color: #ff0000;\"><strong>HCG-beta\u3042\u308b\u3044\u306fAFP\u3068\u3044\u3046\u816b\u760d\u30de\u30fc\u30ab\u30fc\u304c\u304b\u306a\u308a\u306e\u9ad8\u5024\u3092\u793a\u3059\u4f8b\u3067\u306f\uff0c\u624b\u8853\u6458\u51fa\u3084\u751f\u691c\u8853\u306a\u3057\u3067\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3092\u958b\u59cb\u3059\u308b\u3053\u3068\u3082\u591a\u3044<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u3053\u308c\u3089\u306e\u30de\u30fc\u30ab\u30fc\u304c\u6975\u3081\u3066\u9ad8\u5024\u306e\u5834\u5408\u306b\u306f\uff0c<span style=\"color: #000080;\"><strong>\u751f\u691c\u624b\u8853\u3092\u305b\u305a\u306b\u307e\u305a\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3092\u5148\u884c\u3055\u305b\u3066\uff0c\u816b\u760d\u304c\u5c0f\u3055\u304f\u306a\u3063\u305f\u3068\u3053\u308d\u3067\u5168\u6458\u51fa\u3057\u307e\u3059\uff08\u3053\u308c\u306f\u718a\u672c\u5927\u5b66\u306b\u3044\u305f\u751f\u5869\u5148\u751f\u304c\u63d0\u6848\u3057\u305f\u6cbb\u7642\u6cd5\u3067\u3059\uff09<\/strong><\/span><\/li>\n<li>\u307e\u305f\uff0c\u624b\u8853\u3067\u53d6\u308a\u6b8b\u3057\u305f\u6b8b\u5b58\u816b\u760d\u304c\u75c5\u7406\u8a3a\u65ad\u3092\u307e\u3063\u3066\u3044\u308b2\u9031\u9593\u304f\u3089\u3044\u306e\u9593\u306b\u5897\u5927\u3057\u3066\u3057\u307e\u3046\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u304b\u3089\uff0c\u521d\u6bb5\u968e\u6cbb\u7642\u3068\u3057\u3066\u306f\u7a4d\u6975\u7684\u306a\u624b\u8853\u6458\u51fa\u306f\u3057\u307e\u305b\u3093<\/li>\n<li>\u3055\u3089\u306b\uff0c\u624b\u8853\u3067\u816b\u760d\u3092\u5d29\u305b\u3070\u816b\u760d\u7d30\u80de\u304c\u9ac4\u6db2\u4e2d\u306b\u6563\u3063\u3066\uff0c\u9ac4\u6db2\u64ad\u7a2e\u3092\u8a98\u767a\u3057\u307e\u3059<\/li>\n<li>AFP\u304c1000ng\/ml\u3092\u8d85\u3048\u308b\u816b\u760d\u3067\u306f\uff0c\u901a\u5e38\u5316\u5b66\u7642\u6cd5\u3092\u958b\u59cb\u3057\u3066\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u7528\u3044\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u4f55\u308c\u306b\u3057\u3066\u3082\u5f37\u529b\u306a\u5316\u5b66\u7642\u6cd5\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3051\u308c\u3070\u52a9\u304b\u3089\u306a\u3044\u306e\u3067\uff0c\u751f\u691c\u306b\u3088\u308b\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u3084\u6458\u51fa\u8853\u305d\u306e\u3082\u306e\u306b\u610f\u7fa9\u304c\u898b\u51fa\u305b\u306a\u3044\u306e\u3067\u3059<\/li>\n<li>\u624b\u8853\u306b\u3088\u308b\u64ad\u816b\uff08\u8ee2\u79fb\uff09\u306e\u8a98\u767a\u3092\u9632\u3050\u3068\u3044\u3046\u5229\u70b9\u304c\u3042\u308a\u3055\u3089\u306b\uff0cneo-adjuvant chemoradiaiton therapy\u306b\u3088\u3063\u3066\u51fa\u8840\u306e\u6e1b\u5c11\u3068\u816b\u760d\u306e\u7e2e\u5c0f\u3067\u6700\u7d42\u7684\u306a\u816b\u760d\u6458\u51fa\u8853\u3092\u5bb9\u6613\u306b\u3059\u308b\u306e\u3082\u76ee\u7684\u3067\u3059<\/li>\n<li>\u79c1\u306f\u4e88\u5f8c\u4e0d\u826f\u7fa4\u306b\uff0c\u30a4\u30db\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\u3092\u7528\u3044\u308b<span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/icechemo\/\">ICE\u5316\u5b66\u7642\u6cd5<\/a><\/strong><\/span>\u3092\u4f7f\u7528\u3057\u3066\u304d\u307e\u3057\u305f<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u306f\uff0c<span style=\"color: #000080;\"><strong>\u8133\u810a\u9ac4\u7167\u5c04<\/strong><\/span>\u3068\u816b\u760d\u5c40\u6240\u7167\u5c04\u3092\u7528\u3044\u307e\u3059<\/li>\n<li>\u8133\u810a\u9ac4\u7167\u5c04\u306f\uff0c\u9650\u754c\u91cf\u306b\u8fd1\u304436\u30b0\u30ec\u30a4\u304c\u7528\u3044\u3089\u308c\u307e\u3059\u304c\uff0c\u3053\u3053\u306e\u75c7\u4f8b\u306b\u3088\u3063\u3066\u6e1b\u91cf\u3055\u308c\u308b\u3053\u3068\u3082\u591a\u3044\u3067\u3059<\/li>\n<\/ul>\n<h5>\u5316\u5b66\u7642\u6cd5<\/h5>\n<p><span style=\"color: #000080;\"><strong>CDDP<\/strong><\/span> \u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u304b <strong><span style=\"color: #000080;\">CBDCA<\/span><\/strong> \u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u3092\u57fa\u5264\u3068\u3057\u305f\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u304c\u7528\u3044\u3089\u308c\u308c\u307e\u3059\u3002\u30a8\u30c8\u30dd\u30b7\u30c9\uff0c\u30b7\u30af\u30ed\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff0c\u30a4\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\u304c\u591a\u304f\u306e\u30ec\u30b8\u30e1\u30f3\u3067\u4f75\u7528\u3055\u308c\u307e\u3059\u3002<br \/>\n\u518d\u767a\u4f8b\u3084\u521d\u671f\u6cbb\u7642\u306b\u62b5\u6297\u6027\u306e\u9ad8\u60aa\u6027\u5ea6\u816b\u760d\u306b\u306f\uff0c\u30c1\u30aa\u30c6\u30d1\uff0c\u30a8\u30c8\u30dd\u30b7\u30c9\uff0c\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u3092\u7528\u3044\u308b\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u304c\u4f7f\u7528\u3055\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u6cbb\u7652\u5272\u5408\u306f\u4f4e\u3044\u3067\u3059\u3002<\/p>\n<h5><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/icechemo\/\">ICE\u5316\u5b66\u7642\u6cd5<\/a><\/span><\/h5>\n<p>ICE\u5316\u5b66\u7642\u6cd5\u306e\u52b9\u679c\u306fJ Clin Oncol\u3068\u3044\u3046\u6a29\u5a01\u3042\u308b\u96d1\u8a8c\u306b\u767a\u8868\u3057\u3066\u3044\u307e\u3059\u306e\u3067\u898b\u3066\u304f\u3060\u3055\u3044\u3002Aoyama H, Sawamura Y, et al.: Induction chemotherapy followed by low-dose involved-field radiotherapy for intracranial germ cell tumors. J Clin Oncol 20: 857-865, 2002\u3002<br \/>\n\u6ce8\u610f\u3057\u3066\u3044\u305f\u3060\u304d\u305f\u3044\u306e\u306f\uff0c<span style=\"color: #ff0000;\"><strong>\u80da\u7d30\u80de\u816b\u760d\u306b\u5bfe\u3059\u308b\u30aa\u30ea\u30b8\u30ca\u30eb\u306eICE\u5316\u5b66\u7642\u6cd5\u3068\u3044\u3046\u306e\u306f\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u3092\u4f7f\u7528\u3059\u308b\u3082\u306e\u3067\u3042\u3063\u3066\uff0c\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u306f<\/strong><\/span><span style=\"color: #ff0000;\"><strong>\u4f7f\u3044\u307e\u305b\u3093\u3002<\/strong><span style=\"color: #000000;\">\u3082\u3063\u3068\u3082\u65e9\u671f\u306e\u539f\u8457\u306f\uff0c1998\u5e74\u306bJ Neurosurg\u3068\u3044\u3046\u7c73\u56fd\u8133\u795e\u7d4c\u5916\u79d1\u5b66\u4f1a\u306e\u6a5f\u95a2\u8a8c\u306b\u304d\u3061\u3093\u3068\u767a\u8868\u3057\u3066\u3044\u307e\u3059\u3002<br \/>\n\u3053\u306e\u30ec\u30b8\u30e1\u30f3\u3067\u306f\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u30921\u65e5 20mg\/m2\u30675\u65e5\u9593\u4f7f\u7528\u3057\u307e\u3059\u3002\u9ad8\u6fc3\u5ea6\u306e\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u6295\u4e0e\u3068\u306a\u3089\u306a\u3044\u306e\u3067\uff0c\u814e\u6bd2\u6027\u3084\u8074\u6bd2\u6027\u306f\u304b\u306a\u308a\u4f4e\u3044\u3082\u306e\u3067\u3059\u30023\u22124\u30b3\u30fc\u30b9\u4ee5\u5185\u306b\u3067\u3042\u308c\u3070\uff0c\u9045\u767a\u6027\u6709\u5bb3\u4e8b\u8c61\u306f\u307b\u3068\u3093\u3069\u554f\u984c\u3068\u306a\u3089\u306a\u3044\u3067\u3059\u30021\u65e5\u3042\u305f\u308a\u306e\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u6295\u4e0e\u304c\u591a\u3044\u30ec\u30b8\u30e1\u30f3\u3092\u7528\u3044\u308b\u3068\u3068\uff0c\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u4f7f\u7528\u3088\u308a\u3082\u6709\u5bb3\u6bd2\u6027\u306f\u9ad8\u304f\u306a\u308a\u307e\u3059\u3002\u5c3f\u5d29\u75c7\u3092\u5408\u4f75\u3059\u308b\u3068\u304d\u306b\u306f\uff0c\u30c7\u30b9\u30e2\u30d7\u30ec\u30c3\u30b7\u30f3\u3067\u5c3f\u5d29\u75c7\u3092\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3057\u306a\u304c\u3089hydration\u3092\u3057\u307e\u3059\u30025\u65e5\u9593\u5206\u5272\u6295\u4e0e\u30ec\u30b8\u30e1\u30f3\u306a\u306e\u3067hydration\u306f\u5fc5\u8981\u3067\u3059\u304c\uff0chyper-hydration\u306f\u5fc5\u8981\u304c\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u3092\u7406\u89e3\u3057\u3066\u7528\u3044\u3066\u304f\u3060\u3055\u3044\u3002<\/span><\/span><\/p>\n<h5>\u624b\u8853<\/h5>\n<ul>\n<li>\u5916\u79d1\u7684\u5e72\u6e09\u306f\uff0c\u8a3a\u65ad\u3068\u6cbb\u7642\u306e\u76ee\u7684\u3092\u306f\u3063\u304d\u308a\u5206\u3051\u3066\u5224\u65ad\u3057\u307e\u3059<\/li>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3042\u308c\u3070\u751f\u691c\u8853\u306e\u307f\uff0c\u3053\u308c\u306f\u8a3a\u65ad\u3067\u3059<\/li>\n<li>\u6210\u719f\u5947\u5f62\u816b\u3067\u3042\u308c\u3070\uff0c\u958b\u982d\u624b\u8853\u306b\u3088\u308b\u5b8c\u5168\u6458\u51fa\u304c\u521d\u56de\u624b\u8853\u3068\u306a\u308a\u307e\u3059\uff0c\u3053\u308c\u306f\u6cbb\u7642\u3067\u3059<\/li>\n<li>\u624b\u8853\u524d\u8a3a\u65ad\u3067\uff0c\u6210\u719f\u5947\u5f62\u816b\u3068\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u6df7\u3058\u3063\u3066\u3044\u308b\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u3067\u306f\uff0c\u958b\u982d\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u3066\uff0c\u75c5\u7406\u8a3a\u65ad\u3092\u614e\u91cd\u306b\u884c\u3044\u307e\u3059\uff0c\u305d\u306e\u5f8c\u306b\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306b\u7126\u70b9\u3092\u3042\u3066\u305f\u6cbb\u7642\u3092\u304a\u3053\u306a\u3044\u307e\u3059\uff0c\u3053\u308c\u306f\u6210\u719f\u5947\u5f62\u816b\u306b\u5bfe\u3059\u308b\u6839\u6cbb\u6cbb\u7642\u3068\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306b\u5bfe\u3059\u308b\u8a3a\u65ad\u3068\u306a\u308a\u307e\u3059<\/li>\n<li>\u816b\u760d\u30de\u30fc\u30ab\u30fc\u304c\u9ad8\u5024\u306e\u5834\u5408\u306f\u751f\u691c\u624b\u8853\u3055\u3048\u3057\u306a\u3044\u30b1\u30fc\u30b9\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u4f8b\u3048\u3070\uff0cAFP\u304c6,000\u3092\u8d85\u3048\u3066\u3044\u305f\u3089\uff0c\u751f\u691c\u8853\u3082\u3057\u307e\u305b\u3093\uff0c\u307e\u305a\u5375\u9ec4\u56a2\u816b\u3068\u3057\u3066\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3092\u958b\u59cb\u3057\u307e\u3059<\/li>\n<\/ul>\n<h5>\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u7167\u5c04\u91ce\uff08\u9818\u57df\uff09<\/h5>\n<p><strong><span style=\"color: #000080;\"><span style=\"text-decoration: underline;\">IF-RT involved field radiotherapy \u5c40\u6240\u7167\u5c04<\/span><br \/>\n<\/span><\/strong><span style=\"color: #333333;\">\u3000\u816b\u760d\u306e\u3042\u308b\u90e8\u4f4d\u3060\u3051\u306b\u9650\u5c40\u3057\u305f\u7167\u5c04\u3067\u3059\uff0c\u4e00\u9023\u306e\u6cbb\u7642\u5f8c\u306b\u308f\u305a\u304b\u306b\u90e8\u5206\u7684\u306b\u6b8b\u3063\u305f\u816b\u760d\u306b\u8ffd\u52a0\u7167\u5c04\u3059\u308b\u3068\u304d\u306a\u3069\u306b\u7528\u3044\u3089\u308c\u307e\u3059\u3002\u6458\u51fa\u3067\u304d\u306a\u3044\u6210\u719f\u5947\u5f62\u816b\u3084\u60aa\u6027\u5ea6\u306e\u4f4e\u3044\u5947\u5f62\u816b\u306b\u306f\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u7528\u3044\u3066\u884c\u3044\u307e\u3059<\/span><\/p>\n<p><span style=\"text-decoration: underline;\"><strong><span style=\"color: #000080; text-decoration: underline;\">WVI whole ventricular irradiation \u5168\u8133\u5ba4\u7167\u5c04<br \/>\n<\/span><\/strong><\/span><span style=\"color: #333333;\">\u3000\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306b\u7528\u3044\u3089\u308c\u307e\u3059<\/span><\/p>\n<p><span style=\"text-decoration: underline;\"><strong><span style=\"color: #000080; text-decoration: underline;\">WBRT whole brain radiation therapy \u5168\u8133\u7167\u5c04<br \/>\n<\/span><\/strong><\/span><span style=\"color: #333333;\">\u3000\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306b\u7528\u3044\u3089\u308c\u307e\u3059\uff0c\u5074\u982d\u89d2\u304b\u3089\u518d\u767a\u3059\u308b\u304b\u3089 HA-WBRT (hippocampus-avoidance whole-brain radiation therapy)\u306f\u7528\u3044\u307e\u305b\u3093<\/span><\/p>\n<p><span style=\"text-decoration: underline;\"><strong><span style=\"color: #000080; text-decoration: underline;\">CSI craniospinal irradiatioin \u8133\u810a\u9ac4\u7167\u5c04<br \/>\n<\/span><\/strong><\/span><span style=\"color: #333333;\">\u3000\u9ad8\u60aa\u6027\u5ea6\u80da\u7d30\u80de\u816b\u760d\u306b\u7528\u3044\u3089\u308c\u307e\u3059\u3002\u80ce\u5150\u6027\u764c\uff0c\u7d68\u6bdb\u764c\uff0c\u5375\u9ec4\u56a2\u7a2e\uff0c\u9ad8\u60aa\u6027\u5ea6\u672a\u719f\u5947\u5f62\u816b\uff0c\u4ed6\u306e\u764c\u3084\u8089\u816b\u3092\u542b\u3080\u5947\u5f62\u816b\uff0c\u9ac4\u6db2\u64ad\u7a2e\u304c\u78ba\u5b9a\u7684\u306a\u30b8\u30e3\u30fc\u30df\u30fc\u30ce\u30fc\u30de\u30e4\u672a\u719f\u5947\u5f62\u816b<\/span><\/p>\n<h5>\u5206\u985e\u3068\u6cbb\u7642\u30a2\u30eb\u30b4\u30ea\u30ba\u30e0<\/h5>\n<ul class=\"papers\">\n<li>\u80da\u7d30\u80de\u816b\u760d\u306e\u75c5\u7406\uff0c\u30de\u30fc\u30ab\u30fc\u5024\uff0c\u767a\u751f\u90e8\u4f4d\uff0c\u5e74\u9f62\uff0c\u816b\u760d\u30b5\u30a4\u30ba\uff0c\u9ac4\u6db2\u64ad\u7a2e\u306e\u6709\u7121\uff0c\u8133\u5ba4\u58c1\u6d78\u6f64\u306e\u7a0b\u5ea6\u306b\u3088\u3063\u3066\u5fc5\u8981\u306a\u6cbb\u7642\u65b9\u6cd5\u3068\uff0c\u52a0\u3048\u308b\u3053\u3068\u306e\u53ef\u80fd\u306a\u653e\u5c04\u7dda\u7dda\u91cf\u306f\u304b\u306a\u308a\u7570\u306a\u3063\u3066\u304d\u307e\u3059\u3002\u8907\u96d1\u3059\u304e\u3066\uff0c\u80da\u7d30\u80de\u816b\u760d\u306e\u6cbb\u7642\u9078\u629e\u80a2\u306e\u30a2\u30eb\u30b4\u30ea\u30ba\u30e0\u306f\u66f8\u304f\u3053\u3068\u304c\u3067\u304d\u307e\u305b\u3093\u3002<\/li>\n<li>\n<h5>\u7c73\u56fd\u3067\u306e\u81e8\u5e8a\u8a66\u9a13\u306b\u3088\u308b\u8aa4\u8b2c<\/h5>\n<\/li>\n<li>\u7c73\u56fd\u3067\u306f\u982d\u84cb\u5185\u80da\u7d30\u80de\u816b\u760d\u3092\uff0cgerminomatous germ cell tumors (GGCTs) \u3068\u00a0nongerminomatous germ cell tumors (NGGCTs) \u306b\u5206\u3051\u3066\u306a\u3093\u3067\u3082\u8003\u3048\u307e\u3059\u3002\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3068\u305d\u308c\u4ee5\u5916\u306e\u80da\u7d30\u80de\u816b\u760d\u3068\u3044\u3044\u3046\u610f\u5473\u3067\u3059\u3002\u3053\u3053\u3067\u306f\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u4ee5\u5916\u306e2-3\u5272\u3092\u5360\u3081\u308b\u80da\u7d30\u80de\u816b\u760d\u3092\u4e00\u7dd2\u304f\u305f\u306b\u3057\u3066\u6cbb\u7642\u65b9\u91dd\u304c\u7acb\u3066\u3089\u308c\u307e\u3059\u3002\u306a\u305c\u306a\u3089\u767b\u9332\u75c7\u4f8b\u304c\u5c11\u306a\u3044\u3068\u307e\u3068\u307e\u3063\u305f\u6210\u7e3e\u304c\u51fa\u306a\u3044\u304b\u3089\u3067\u3059\u3002\u6bcd\u96c6\u56e3\u6570\u3092\u5927\u304d\u304f\u3059\u308b\u305f\u3081\u306b\u3072\u3063\u304f\u308b\u3081\u308b\u30fd(\uff9f\u0414\uff9f;)\uff89!! \u00a0\u4f8b\u3048\u3070\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3068\u6210\u719f\u5947\u5f62\u816b\u3068\u3044\u3046\u3068\u3066\u3082\u6cbb\u308a\u3084\u3059\u3044\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u3082\uff0c\u80ce\u5150\u6027\u764c\u3068\u5375\u9ec4\u56a2\u816b\u3092\u542b\u3080\u672a\u719f\u5947\u5f62\u816b\u304b\u3089\u306a\u308b\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u3082\u540c\u3058\u7fa4\u306b\u306a\u308a\u307e\u3059\u3002\u305d\u3093\u306a\u99ac\u9e7f\u306a&#8212;-(\uff89\uff9f\u03bf\uff9f)\uff89 \uff75\uff75\uff75\uff75\uff6b\uff6b\uff6b\uff6b\uff6b\uff6b-.<\/li>\n<\/ul>\n<h1>\u5375\u9ec4\u306e\u3046\u816b yolk sac tumor AFP\u7523\u751f\u816b\u760d<\/h1>\n<ul>\n<li>yolk sac tumor\u306f\uff0c\u80ce\u751f\u521d\u671f\u306e\u5375\u9ec4\u56a2 (embryonic yolk sac)\u3092\u56f2\u3080\u80ce\u751f\u5185\u80da\u8449 (embryonic endoderm)\u7531\u6765\u306e\u816b\u760d\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u7a00\u306a\u816b\u760d\u3067\u3042\u308a\uff0c\u8996\u5e8a\u4e0b\u90e8\u3088\u308a\u3082<span style=\"color: #000080;\"><strong>\u677e\u679c\u4f53\u306b\u597d\u767a\u3059\u308b<\/strong><\/span>\u50be\u5411\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u7d14\u7c8b\u578b\u306f\u3068\u3066\u3082\u307e\u308c\u3067\u3059<\/li>\n<li>\u8840\u6db2\u4e2d\u3042\u308b\u3044\u306f<span style=\"color: #ff0000;\"><strong>\u9ac4\u6db2\u4e2d\u306eAFP\u304c1000ng\/ml\u3092\u8d8a\u3048\uff0c\u6642\u306b\u306f\u6570\u4e07\u306e\u5024\u3092\u3068\u308b<\/strong><\/span>\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u672a\u719f\u5947\u5f62\u816b\u306e\u4e2d\u306b\u3053\u306e\u7d44\u7e54\u578b\u304c\u6df7\u5728\u3059\u308b\uff0c<span style=\"color: #ff0000;\"><strong>\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u306e\u4e00\u90e8<\/strong><\/span>\u3068\u3057\u3066\u898b\u3089\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>AFP\u304c1000ng\/ml\u3092\u8d8a\u3048\u308b\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u3042\u308b\u3044\u306f\u672a\u719f\u5947\u5f62\u816b\u306f\uff0c\u3069\u3053\u304b\u306byolk sac tumor\u306e\u7d44\u7e54\u50cf\u304c\u90e8\u5206\u7684\u306b\u6df7\u5728\u3059\u308b\u3053\u3068\u3068\u8003\u3048\u3066\u6cbb\u7642\u3057\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u9ac4\u6db2\u64ad\u7a2e<\/strong><\/span>\u3059\u308b\u6027\u8cea\u304c\u3042\u308a\u307e\u3059\u304b\u3089\uff0cMRI\u306eT1\u5f37\u8abf\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u753b\u50cf\u306b\u3066\uff0c\u5168\u8133\u810a\u9ac4\u3092\u691c\u7d22\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u767a\u75c7\uff11\u5e74\u4ee5\u5185\u306e\u6b7b\u4ea1\u7387\u306f\u9ad8\u3044\u3067\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u5f37\u529b\u306a\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u5316\u5b66\u7642\u6cd5\u304c\u6b20\u304b\u305b\u307e\u305b\u3093<\/li>\n<li>\u751f\u691c\u8853\u306b\u3088\u308b\u78ba\u5b9a\u8a3a\u65ad\u3092\u307e\u305a\u8003\u616e\u3057\u307e\u3059\u304c\uff0cAFP\u304c\u304b\u306a\u308a\u306e\u9ad8\u5024\u3067\u3042\u308c\u3070\u75c5\u7406\u8a3a\u65ad\u306a\u3057\u3067\u6cbb\u7642\u306b\u8e0f\u307f\u8fbc\u3080\u3053\u3068\u3082\u591a\u3044\u3067\u3059<\/li>\n<li>\u6cbb\u7642\u52b9\u679c\u306f\u8840\u4e2d\u306eAFP\u3092\u6e2c\u5b9a\u3059\u308b\u3053\u3068\u3067\u7684\u78ba\u306b\u5224\u65ad\u3055\u308c\u307e\u3059<\/li>\n<li>AFP\u306e\u5024\u304c\u6b63\u5e38\u5316\u3057\u3066\u3082\uff0cMRI\u3067\u816b\u760d\u30b5\u30a4\u30ba\u306e\u7e2e\u5c0f\u304c\u898b\u3089\u308c\u306a\u3044\u3068\u304d\u306b\u306f\uff0cteratoma\u3068\u306e\u6df7\u5408\u816b\u760d\u3092\u7591\u3046\u3079\u304d\u3067\u3059<\/li>\n<li>\u9ad8\u60aa\u6027\u5ea6\u80da\u7d30\u80de\u816b\u760d\u306e\u4e2d\u3067\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u53cd\u5fdc\u6027\u306f\u9ad8\u3044\u3068\u8a00\u3048\u307e\u3059<\/li>\n<li>\u8853\u524d\u5316\u5b66\u7642\u6cd5 (neoadjuvant chemotherapy)\u3084\u8853\u524d\u7167\u5c04\u3092\u884c\u3063\u3066\u816b\u760d\u30b5\u30a4\u30ba\u3092\u7e2e\u5c0f\u3055\u305b\u3066\u304b\u3089\uff0c\u816b\u760d\u306e\u5168\u6458\u51fa\u3092\u884c\u3046\u3068\u3044\u3046\u624b\u6bb5\u3082\u6709\u52b9\u3067\u3059<\/li>\n<li>AFP\u7523\u751f\u816b\u760d\u7d30\u80de\u306f\uff0cHCG\u7523\u751f\u6027\u306echoriocarcinoma\u3084embryonal carcinoma\u3068\u6bd4\u3079\u3066\uff0c\u6bd4\u8f03\u7684\u9ad8\u3044\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u611f\u53d7\u6027\u3092\u6709\u3057\u3066\u3044\u307e\u3059<\/li>\n<li>\u9577\u671f\u751f\u5b58\u4f8b\u306e\u5831\u544a\u306f\u591a\u3044\u3067\u3059<\/li>\n<li>\u9ac4\u6db2\u64ad\u7a2e\u3067\u767a\u75c7\u3057\u305f\u4f8b\u3084\u64ad\u7a2e\u304c\u5236\u5fa1\u3067\u304d\u306a\u304b\u3063\u305f\u4f8b\u3067\u306f\uff0c\u60a3\u5150\u306f\u9ad8\u7387\u306b\u6b7b\u306e\u8ee2\u5e30\u3092\u305f\u3069\u308a\u307e\u3059<\/li>\n<\/ul>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20684\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm2-300x294.jpg\" alt=\"\" width=\"300\" height=\"294\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm2-300x294.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm2-550x538.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm2-768x752.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm2.jpg 1259w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20685\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm3-300x294.jpg\" alt=\"\" width=\"300\" height=\"294\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm3-300x294.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm3-550x538.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm3-768x751.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/yolksacm3.jpg 1250w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u7d44\u7e54\u5b66\u7684\u306b\u306f\uff0c\u5186\u67f1\u69d8\u306a\u3044\u3057\u6955\u5186\u5f62\u306e<span style=\"color: #000080;\"><strong>\u4e0a\u76ae\u69d8\u7d30\u80de\u306e\u7db2\u72b6\u914d\u5217\u69cb\u9020<\/strong><\/span>\u3092\u793a\u3059\u816b\u760d\u3067\u3042\u308a\uff0c\u4e00\u90e8\u306b<span style=\"color: #ff0000;\"><strong>Schiller-Dubal body<\/strong><\/span>\u3068\u547c\u3070\u308c\u308b\u8840\u7ba1\u5468\u56f2\u306b\u96c6\u65cf\u3059\u308b\u7279\u5fb4\u7684\u306a\u7d30\u80de\u914d\u5217\u304c\u898b\u3089\u308c\u307e\u3059\u3002\u3053\u308c\u306f\uff0c\u4e00\u5c64\u3042\u308b\u3044\u306f\u591a\u5c64\u306e\u4e0a\u76ae\u69d8\u7d30\u80de\u304c\uff0c\u4e2d\u5fc3\u3068\u306a\u308b\u8840\u7ba1\u3092\u3084\u3084\u96e2\u308c\u3066\u53d6\u308a\u56f2\u3080\u3088\u3046\u306b\u4e26\u3076\u69cb\u9020\u3067\u3059\u3002\u307e\u305f\uff0cPAS\u967d\u6027\u306e\u597d\u9178\u6027\u7403\u72b6\u4f53\u304c\u898b\u3089\u308c<span style=\"color: #ff0000;\"><strong>AFP\u304c\u5f37\u967d\u6027<\/strong><\/span>\u3068\u306a\u308a\u307e\u3059<\/p>\n<h1><span style=\"color: #000080;\">\u7d68\u6bdb\u764c choriocarcinoma<\/span><\/h1>\n<h4>\u5927\u307e\u304b\u306a\u3053\u3068<\/h4>\n<ul>\n<li><span style=\"color: #000080;\"><strong>\u3068\u3066\u3082\u3081\u305a\u3089\u3057\u3044\u60aa\u6027<\/strong><strong>\u816b\u760d<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u982d\u75db\u3084\u5614\u5410\uff0c\u304a\u3057\u3063\u3053\u304c\u305f\u304f\u3055\u3093\u51fa\u3066\u6c34\u3092\u305f\u304f\u3055\u3093\u98f2\u3080\uff0c\u5c0f\u3055\u3044\u5b50\u4f9b\u306a\u306e\u306b\u6027\u65e9\u719f\u3059\u308b\u306a\u3069\u3067\u307f\u3064\u304b\u308a\u307e\u3059<\/li>\n<li>\u8840\u6db2\u306e\u4e2d\u306e\u30db\u30eb\u30e2\u30f3 <span style=\"color: #000080;\"><strong>HCG<\/strong>\u00a0<strong>\u30a8\u30a4\u30c1\u30b7\u30fc\u30b8\u30fc<\/strong><\/span> human chorionic gonadotropin \u30d2\u30c8\u7d68\u6bdb\u6027\u30b4\u30ca\u30c9\u30c8\u30ed\u30d4\u30f3\u3068\u3044\u3046\u306e\u304c\u3068\u3066\u3082\u9ad8\u3044\u5024\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>HCG\u304c1,000\u3092\u8d85\u3048\u305f\u3068\u304d\u306b\u306f\u7591\u3046\u3079\u304d\u3067\u3057\u3087\u3046<\/li>\n<li>\u7d14\u7c8b\u306a\u7d68\u6bdb\u304c\u3093 choriocarcinoma\u306f\uff0c\u982d\u84cb\u5185\u80da\u7d30\u80de\u816b\u760d\u306e\u4e2d\u3067\u6700\u3082\u7a00\u306a\u816b\u760d\u3067\u3059<\/li>\n<li><strong><a href=\"\/sawamura\/pediattumor\/germcelltumors\/mixedgermcelltumor\/\">\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d mixed germ cell tumor<\/a><\/strong>\u306e\u90e8\u5206\u50cf\u3068\u3057\u3066\u898b\u3089\u308c\u308b\u3053\u3068\u306e\u65b9\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u672a\u719f\u5947\u5f62\u816b\u3067\u3082HCG\u304c1,000\u7a0b\u5ea6\u306b\u4e0a\u6607\u3057\u307e\u3059\u306e\u3067\uff0cHCG\u304c\u9ad8\u304f\u3066\u3082\u7d68\u6bdb\u304c\u3093\u3068\u65ad\u5b9a\u3067\u304d\u307e\u305b\u3093<\/li>\n<li>\u672a\u719f\u5947\u5f62\u816b\u3068\u7d68\u6bdb\u304c\u3093\u3067\u306f\u6cbb\u7642\u3082\u4e88\u5f8c\u3082\u304b\u306a\u308a\u7570\u306a\u308a\u307e\u3059\u306e\u3067\u6ce8\u610f\uff01<\/li>\n<li>\u7537\u5150\u306b\u591a\u304f\u767a\u751f\u3057\u307e\u3059<\/li>\n<li>\u7d044\u5206\u306e3\u304c<span style=\"color: #000080;\"><strong>\u677e\u679c\u4f53\u539f\u767a<\/strong><\/span>\u816b\u760d\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u816b\u760d\u5185\u51fa\u8840<\/strong><\/span>\u3067\u6025\u6fc0\u3067\u9ad8\u5ea6\u306e\u982d\u75db\uff0c\u3042\u308b\u3044\u306f\u7a81\u7136\u306e\u610f\u8b58\u969c\u5bb3\u3068\u306a\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u6cbb\u7642\u306f\uff0c\u653e\u5c04\u7dda\uff0c\u5236\u304c\u3093\u5264\uff0c\u958b\u982d\u624b\u8853\u3067\u3042\u3089\u3086\u308b\u53ef\u80fd\u306a\u9650\u308a\u306e\u624b\u6bb5\u3092\u3064\u304f\u3057\u307e\u3059<\/li>\n<li>\u3067\u3082\u9577\u671f\u751f\u5b58\u7387\u306f\u3068\u3066\u3082\u4f4e\u304f\u306610%\u4ee5\u4e0b\u3067\u3059<\/li>\n<\/ul>\n<h4>\u75c7\u72b6<\/h4>\n<ul>\n<li>\u677e\u679c\u4f53\u816b\u760d\u306f\u6c34\u982d\u75c7\u306b\u3088\u308b\u982d\u75db\u3068\u5614\u5410\uff0c\u8996\u5e8a\u4e0b\u90e8\u816b\u760d\u306f\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3057\u307e\u3059<\/li>\n<li>\u816b\u760d\u5185\u51fa\u8840\u3067\u767a\u75c7\u3057\u305f\u308a\uff0c\u3042\u308b\u3044\u306f\u6cbb\u7642\u4e2d\u306b\u51fa\u8840\u3067\u75c7\u72b6\u306e\u60aa\u5316\u3092\u898b\u308b\u3053\u3068\u3082\u591a\u3044\u306e\u304c\u7279\u5fb4\u3067\u3059<\/li>\n<li>\u3053\u306e\u5834\u5408\u306b\u306f\uff0c\u8133\u5352\u4e2d\u306e\u3088\u3046\u306a\u6025\u6fc0\u306a\u75c7\u72b6\u306e\u60aa\u5316\u3092\u751f\u3058\u307e\u3059<\/li>\n<li>\u8996\u529b\u8996\u91ce\u969c\u5bb3\u3084\u76ae\u819a\u306e\u8272\u7d20\u6c88\u7740\u306a\u3069\u307f\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u8840\u6e05\u4e2dHCG\u304c\u9ad8\u5024\u3068\u306a\u308b\u305f\u3081\u306b\u601d\u6625\u671f\u65e9\u767a\u75c7\u3067\u767a\u75c7\u3057\u305f\u5831\u544a\u3082\u6563\u898b\u3055\u308c\u307e\u3059\u304c\uff0c\u307f\u306a\u7537\u5150\u3067\u3059<\/li>\n<\/ul>\n<h4>\u8a3a\u65ad<\/h4>\n<ul>\n<li>\u691c\u67fb\u6240\u898b\u3067\u6700\u3082\u91cd\u8981\u306a\u70b9\u306f\uff0c\u8840\u6e05\u3042\u308b\u3044\u306f\u9ac4\u6db2\u4e2d\u306eHCG\u304c\u6975\u3081\u3066\u9ad8\u5024\u3092\u793a\u3059\u3053\u3068\u3067\u3059<\/li>\n<li>\u8840\u6e05\u4e2dHCG\u306f10,000 mIU\/ml\u307b\u3069\u306b\u3082\u306a\u308a\u307e\u3059\uff0c\u9ac4\u6db2\u4e2d\u3067\u306f\u6570\u767e\u3068\u3044\u3046\u5024\u3067\u3059<\/li>\n<li>CT\u3068MRI\u3092\u3057\u307e\u3059<\/li>\n<li>\u816b\u760d\u306e\u5185\u90e8\u3067\u51fa\u8840\u3092\u751f\u3058\u3066\u3044\u308b\u306e\u304c\u6700\u5927\u306e\u7279\u5fb4\u3067\u3059<\/li>\n<li>\u816b\u760d\u5468\u8fba\u6d6e\u816b\u306f\u5f37\u3044\u3067\u3059<\/li>\n<li>\u8840\u7ba1\u306b\u5bcc\u3080\u3067\u3059\u304b\u3089MRA, CTA\u3067\u816b\u760d\u8840\u7ba1\u3068\u816b\u760d\u6fc3\u67d3\u50cf\u304c\u898b\u3089\u308c\u307e\u3059<\/li>\n<li>\u8133\u8840\u7ba1\u64ae\u5f71 DSA\u3092\u884c\u308f\u306a\u304f\u3066\u3082\u7d50\u679c\u306f\u898b\u3048\u3066\u3044\u307e\u3059\u306e\u3067\u3057\u307e\u305b\u3093<\/li>\n<li>\u82e5\u5e74\u6210\u4eba\u7537\u6027\u3042\u308b\u3044\u306f\u7537\u5150\u306e\u677e\u679c\u4f53\u304b\u8996\u5e8a\u4e0b\u90e8\u306b\u767a\u751f\u3057\u305f\u816b\u760d\u3067\uff0c\u816b\u760d\u5185\u51fa\u8840\u3092\u4f34\u3044HCG\u304c1,000 mIU\/ml\u4ee5\u4e0a\u306e\u9ad8\u5024\u3092\u8a8d\u3081\u308b\u5834\u5408\u306b\u306f\u7d68\u6bdb\u304c\u3093\u3092\u5f37\u304f\u7591\u3044\u307e\u3059<\/li>\n<li>\u4e00\u3064\u306e\u80da\u7d30\u80de\u816b\u760d\u306b\uff0cgerminoma, teratoma, choriocarcinoma, embryonal carcinoma\u304c\u3059\u3079\u3066\u6df7\u5728\u3059\u308b\u4f8b\u3082\u3042\u308a\u307e\u3059\u306e\u3067\uff0c\u816b\u760d\u306e\u3054\u304f\u308f\u305a\u304b\u306a\u90e8\u5206\u3057\u304b\u3068\u308c\u306a\u3044\u6642\u306e\u75c5\u7406\u8a3a\u65ad\u306f\u614e\u91cd\u306b\u8003\u3048\u307e\u3059<\/li>\n<\/ul>\n<p class=\"imgCenter\"><a class=\"fancyboxforwp\" href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct9.gif\" data-fancybox=\"gallery\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct9.gif\" alt=\"\u8996\u5e8a\u4e0b\u90e8\u306b\u767a\u751f\u3057\u305fchoriocarcinoma\u306eMRI\u50cf\" width=\"627\" height=\"228\" \/><\/a><\/p>\n<p>\u5973\u5150\u306e\u8996\u5e8a\u4e0b\u90e8\u306b\u767a\u751f\u3057\u305fchoriocarcinoma\u306eMRI\uff1aT1\u5f37\u8abf\u50cf\uff08\u5de6\u5074\uff09\u3067\u306f\u816b\u760d\u5185\u51fa\u8840\u304c\u9ad8\u4fe1\u53f7\u57df\u3068\u3057\u3066\u6349\u3048\u3089\u308c\uff0cT2\u5f37\u8abf\u50cf\uff08\u4e2d\u592e\uff09\u3067\u306f\u8996\u7d22\u304b\u3089\u5927\u8133\u57fa\u5e95\u6838\uff0c\u4e2d\u8133\u306e\u816b\u760d\u5468\u8fba\u6d6e\u816b\u304c\u898b\u3089\u308c\u307e\u3059\u3002\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u50cf\uff08\u53f3\u5074\uff09\u3067\u306f\uff0c\u8996\u5e8a\u4e0b\u90e8\u304b\u3089\u30c8\u30eb\u30b3\u978d\u3078\u4f38\u5c55\u3059\u308b\u4e0d\u5747\u4e00\u306a\u816b\u760d\u90e8\u5206\u5897\u5f37\u3092\u8a8d\u3081\u307e\u3059\u3002\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u80da\u7d30\u80de\u816b\u760d\u306e\u7279\u5fb4\u7684\u306aMRI\u50cf\u3068\u3044\u3048\u307e\u3059\u3002\u8840\u6e05HCG-beta\u306f20,000 mIU\/ml\u3092\u8d85\u3048\u308b\u5024\u3067\u3042\u308a\uff0c\u691c\u67fb\u5024\u306e\u307f\u3067choriocarcinoma\u3068\u3044\u3048\u308b\u3088\u3046\u306a\u5178\u578b\u4f8b\u3067\u3057\u305f\u3002<\/p>\n<h4>\u6ce8\u610f<\/h4>\n<ul>\n<li>\u7d14\u7c8b\u306a\u7d68\u6bdb\u304c\u3093\uff0c\u3042\u308b\u3044\u306f\u7d68\u6bdb\u304c\u3093\u306e\u8981\u7d20\u304c\u5927\u90e8\u5206\u3092\u5360\u3081\u308b\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d(HCG\u306e\u30ec\u30d9\u30eb\u304c1,000\u3092\u8d85\u3048\u308b\uff09\u306f\uff0c\u96e3\u6cbb\u6027\u3067\u307b\u3068\u3093\u3069\u52a9\u304b\u3089\u306a\u3044\u3068\u8003\u3048\u307e\u3059\uff0c\u3067\u3059\u304b\u3089\u6cbb\u7642\u306e\u526f\u4f5c\u7528\u3092\u8003\u3048\u306a\u3044\u3067\u306a\u3093\u3067\u3082\u3057\u307e\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u672a\u719f\u5947\u5f62\u816b\u3084\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u306e\u4e00\u90e8\u5206\u3060\u3051\uff0c\u7d68\u6bdb\u304c\u3093\u7d44\u7e54\u304c\u308f\u305a\u304b\u306b\u6df7\u3058\u308b\u3082\u306e\u306f\u6cbb\u308b\u78ba\u7387\u304c\u9ad8\u3044\u816b\u760d\u3068\u8a00\u3048\u307e\u3059\uff0c\u3067\u3059\u304b\u3089\u9ad8\u7dda\u91cf\u7167\u5c04\u306b\u3088\u308b\u8a8d\u77e5\u6a5f\u80fd\u4f4e\u4e0b\uff08\u9ad8\u6b21\u8133\u6a5f\u80fd\u969c\u5bb3\uff09\u304c\u9ad8\u5ea6\u306b\u306a\u3089\u306a\u3044\u3088\u3046\u306b\uff0c\u653e\u5c04\u7dda\u7167\u5c04\u91ce\u3068\u7dda\u91cf\u3092\u53ef\u80fd\u306a\u9650\u308a\u6291\u3048\u3066\u6cbb\u7642\u3057\u307e\u3059<\/li>\n<\/ul>\n<h4>\u6cbb\u7642<\/h4>\n<ul>\n<li>\u78ba\u7acb\u3055\u308c\u305f\u3042\u308b\u3044\u306f\u4fe1\u983c\u306b\u8db3\u308b\u6cbb\u7642\u6cd5\u306f\u6587\u732e\u3092\u63a2\u3057\u3066\u3082\u3042\u308a\u307e\u305b\u3093\uff0c\u624b\u63a2\u308a\u3067\u3057\u307e\u3059<\/li>\n<li>\u5171\u540c\u7814\u7a76\u3067non-germinomatou germinoma\u3068\u304b\uff0c\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u3068\u304b\uff0c\u4e88\u5f8c\u4e0d\u826f\u7fa4\u5ec3\u7d30\u80de\u816b\u760d\u3068\u304b\u306e\u30d7\u30ed\u30c8\u30b3\u30fc\u30eb\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u305d\u308c\u306f\u306a\u306b\u3082\u8d85\u96e3\u6cbb\u6027\u3068\u3082\u8a00\u3048\u308b\u7d68\u6bdb\u304c\u3093\u3092\u76ee\u7684\u3068\u3057\u305f\u30ec\u30b8\u30e1\u30f3\u3067\u306f\u306a\u3044\u306e\u3067\u3042\u3066\u306b\u306f\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u6cbb\u7642\u95a2\u9023\u6709\u5bb3\u4e8b\u8c61\u3092\u3042\u307e\u308a\u8003\u3048\u305a\u306b\uff0c\u751f\u547d\u4e88\u5f8c\u3092\u7b2c\u4e00\u7fa9\u306b\u8003\u616e\u3057\u3066\uff0c\u5b8c\u5168\u7de9\u89e3\u5c0e\u5165\u3092\u76ee\u7684\u3068\u3057\u305f\u5bc6\u5ea6\u306e\u9ad8\u3044\u521d\u671f\u6cbb\u7642\u8a08\u753b\u3092\u7acb\u3066\u308b\u3079\u304d\u3067\u3059<\/li>\n<li>HCG\u304c\u6570\u5343-10,000\u3092\u8d85\u3048\u308b\u3088\u3046\u306a\u6642\u306b\u306f\u75c5\u7406\u8a3a\u65ad\u306e\u5fc5\u8981\u304c\u306a\u3044\u306e\u3067\uff0c<span style=\"color: #000080;\"><strong>\u8a3a\u65ad\u3042\u308b\u3044\u306f\u816b\u760d\u6e1b\u8377\u306e\u76ee\u7684\u3067\u306e\u5916\u79d1\u624b\u8853\u3068\u3044\u3046\u624b\u6bb5\u306f\u4e0d\u8981<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u3082\u653e\u5c04\u7dda\u6cbb\u7642\u3082\u3057\u306a\u3044\u3067\uff0c\u958b\u982d\u624b\u8853\u3067\u6458\u51fa\u306b\u5165\u308b\u3068\uff0c\u3082\u306e\u3059\u3054\u304f\u51fa\u8840\u3057\u3066\u53ce\u62fe\u304c\u3064\u304b\u306a\u304f\u306a\u308a\u307e\u3059<\/li>\n<li>\u307e\u305f\uff0c\u5b8c\u5168\u6458\u51fa\u3059\u308b\u3053\u3068\u306f\u4e0d\u53ef\u80fd\u3067\uff0c\u5916\u79d1\u624b\u8853\u3067\u6cbb\u7652\u3059\u308b\u3082\u306e\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u3067\u3059\u304b\u3089\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u306e\u958b\u59cb\u3092\u6025\u3050\u305f\u3081\u306b\u3082\uff0c\u521d\u671f\u6cbb\u7642\u3067\u4fb5\u8972\u7684\u306a\u958b\u982d\u8853\u3092\u3059\u308b\u610f\u5473\u304c\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u3069\u306e\u3088\u3046\u306a\u5316\u5b66\u7642\u6cd5\u3092\u7528\u3044\u3066\u3082\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u6b20\u304b\u305b\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #000080;\"><strong>\u8133\u810a\u9ac4\u7167\u5c04\u3068\u816b\u760d\u5c40\u6240\u7167\u5c04<\/strong><\/span>\u3092\u3057\u307e\u3059<\/li>\n<li>\u816b\u760d\u7dda\u91cf\u306f\u81a0\u82bd\u816b\u76f8\u5f53\u306e60Gy\u304c\u307b\u3057\u3044\u306e\u3067\u3059\u304c\uff0c\u8996\u5e8a\u4e0b\u90e8\u306b\u306f\u305d\u306e\u3088\u3046\u306a\u5927\u304d\u306a\u7dda\u91cf\u306f\u4f7f\u3048\u307e\u305b\u3093<\/li>\n<li><strong>\u5c0e\u5165\u5316\u5b66\u7642\u6cd5<\/strong>\u306f\uff0ccisplatin, carboplatin, etoposide, ifosfamide, bleomycine, vinblastine\u306a\u3069\u304c\u7528\u3044\u3089\u308c\u307e\u3059<\/li>\n<li>\u5b50\u5bae\u306b\u767a\u751f\u3059\u308b\u7d68\u6bdb\u764c\u306b\u306f\u591a\u5264\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u304c\u6709\u52b9\u3067\u9577\u671f\u751f\u5b58\u5272\u5408\u3082\u9ad8\u3044\u306e\u3067\u3059\u304c\uff0c\u982d\u84cb\u5185\u539f\u767a\u7d68\u6bdb\u764c\u306b\u540c\u3058\u6cbb\u7642\u306f\u3067\u304d\u307e\u305b\u3093<\/li>\n<li>\u5bfe\u3057\u3066\uff0cgenitourinary tract (\u5c3f\u8def\u6027\u5668\u764c)\u3068\u3057\u3066\u306erefractory germ cell tumor \u9ad8\u60aa\u6027\u5ea6\uff08\u5316\u5b66\u7642\u6cd5\u62b5\u6297\u6027\uff09\u80da\u7d30\u80de\u816b\u760d\u3078\u306e\u5316\u5b66\u7642\u6cd5\u306f\u4f1d\u7d71\u7684\u306b\u982d\u84cb\u5185\u60aa\u6027\u80da\u7d30\u80de\u816b\u760d\u3078\u5fdc\u7528\u3055\u308c\u3066\u304d\u307e\u3057\u305f<\/li>\n<li>\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u3092\u57fa\u5264\u3068\u3059\u308b\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u3067\u3059\u304c\uff0c\u4ee3\u8868\u7684\u306a\u3082\u306e\u306b\uff0cBEP (bleomycin, etoposide, cisplatin) 4\u30b3\u30fc\u30b9\u306a\u3069\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>1990\u5e74\u4ee3\u304b\u3089\u65e5\u672c\u3067\u306f<strong><a href=\"\/sawamura\/pediattumor\/icechemo\/\">ICE (ifosfamide, cisplatine, etoposide)\u5316\u5b66\u7642\u6cd5 <\/a><\/strong>6\u30b3\u30fc\u30b9\u304c\u6700\u3082\u5e83\u304f\u7528\u3044\u3089\u308c\u3066\u304d\u307e\u3057\u305f<\/li>\n<li>\u8fd1\u5e74\u306f\uff0c<span style=\"color: #000080;\"><strong>\u672b\u68a2\u8840\u5e79\u7d30\u80de\u6551\u63f4\u3092\u884c\u3046\u5927\u91cf\u5316\u5b66\u7642\u6cd5<\/strong><\/span>\u304c\u884c\u308f\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u305d\u308c\u3067\u3082\u9577\u671f\u751f\u5b58\u4f8b\u306e\u5831\u544a\u306f\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093\u306e\u3067\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u306e\u771f\u306e\u6709\u7528\u6027\u306f\u3044\u307e\u3060\u4e0d\u660e\u3068\u8a00\u3048\u307e\u3059<\/li>\n<li>\u5c3f\u8def\u6027\u5668\u306e\u7d68\u6bdb\u304c\u3093\u3068\u540c\u69d8\u306e\u8003\u3048\u65b9\u3067\u3059\u304c\uff0c\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u306e\u5f8c\u3067\u816b\u760d\u304c\u6b8b\u5b58\u3057\u3066\u3044\u308b\u5834\u5408\u306b\u306f\uff0c\u958b\u982d\u624b\u8853\u3067\u6458\u51fa\u3057\u307e\u3059 (second-look surgery)<\/li>\n<li>\u5bdb\u89e3\u304c\u5f97\u3089\u308c\u305a\u9032\u884c\u3057\u305f\u3068\u304d\u3042\u308b\u3044\u306f\u518d\u767a\u3092\u8a8d\u3081\u305f\u3068\u304d\u306b\u6709\u52b9\u306a\u6cbb\u7642\u624b\u6bb5\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u9ac4\u6db2\u64ad\u7a2e\u304c\u751f\u3058\u305f\u5834\u5408\u3082\u6551\u547d\u306e\u624b\u6bb5\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<\/ul>\n<h4>\u4e88\u5f8c<\/h4>\n<ul>\n<li>\u7d14\u578b\u306e\u982d\u84cb\u5185\u539f\u767a\u7d68\u6bdb\u764c\u306e\u4e88\u5f8c\u306f\u4e0d\u826f\u3067\uff0c\u751f\u5b58\u4f8b\u306f\u75c7\u4f8b\u5831\u544a\u3068\u3057\u3066\u7a00\u306b\u8a18\u8f09\u3055\u308c\u308b\u7a0b\u5ea6\u3067\u3059<\/li>\n<li>\u5bdb\u89e3\u5c0e\u5165\u3067\u304d\u3066\u3082\u77ed\u671f\u9593\u306e\u3046\u3061\u306b\u518d\u767a\u3092\u307f\u308b\u53ef\u80fd\u6027\u306f\u6975\u3081\u3066\u9ad8\u3044\u3068\u3044\u3048\u307e\u3059<\/li>\n<li>HCG\u306e\u5024\u3068MRI\u3067\u7d4c\u904e\u89b3\u5bdf\u3057\u307e\u3059<\/li>\n<li>\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u80da\u7d30\u80de\u816b\u760d\u306b\u5bfe\u3059\u308b\u5f37\u529b\u306a\u88dc\u52a9\u7642\u6cd5\u306f\uff0c\u60a3\u5150\u306b\u5927\u304d\u306a\u7cbe\u795e\u7684\u30fb\u8eab\u4f53\u7684\u8ca0\u62c5\u3092\u4e0e\u3048\u307e\u3059\uff0c\u9000\u9662\u5f8c\u306e\u5fa9\u5b66\u306e\u305f\u3081\u306e\u7cbe\u795e\u9762\u3067\u306e\u30b1\u30a2\u304c\u5927\u5207\u3067\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u3088\u308b\u9045\u767a\u6027\u8a8d\u77e5\u6a5f\u80fd\u4f4e\u4e0b\uff0c\u816b\u760d\u3042\u308b\u3044\u306f\u6cbb\u7642\u5408\u4f75\u75c7\u3068\u3057\u3066\u306e\u8996\u5e8a\u4e0b\u90e8\u4e0b\u5782\u4f53\u969c\u5bb3\uff0c\u5316\u5b66\u7642\u6cd5\u306b\u8d77\u56e0\u3059\u308b\u539f\u767a\u6027\u6027\u817a\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u3084\uff12\u6b21\u764c\uff08\u767d\u8840\u75c5\u306e\u767a\u75c7\uff09\u306a\u3069\u8003\u616e\u3057\u306a\u304c\u3089\u7d4c\u904e\u3092\u898b\u307e\u3059<\/li>\n<\/ul>\n<h4>\u75c5\u7406<\/h4>\n<ul>\n<li>trophoblast\u306b\u7531\u6765\u3059\u308b\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u816b\u760d\u3067\u3042\u308a\uff0csyncytiotrophoblast\u3084cytotrophoblast\u304c\u6df7\u5408\u3059\u308b\u7570\u578b\u7d30\u80de\u5897\u6b96\u304b\u3089\u306a\u308a\u307e\u3059<\/li>\n<li>synchtiotrophoblast\u306f\uff0c\u6297HCG\u6297\u4f53\u3092\u7528\u3044\u308b\u67d3\u8272\u3067\u6fc3\u67d3\u3057\u307e\u3059<\/li>\n<li>\u591a\u304f\u306e\u6838\u5206\u88c2\u50cf\u3092\u542b\u307f\uff0c\u8840\u7ba1\u306b\u5bcc\u3080\u6613\u51fa\u8840\u6027\u306e\u816b\u760d\u3067\u3042\u308a\uff0c\u816b\u760d\u5185\u306b\u306f\u65b0\u65e7\u306e\u51fa\u8840\u5de3\u3084\u58ca\u6b7b\u304c\u8a8d\u3081\u3089\u308c\u307e\u3059<\/li>\n<\/ul>\n<p class=\"imgCenter\"><a class=\"fancyboxforwp\" href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct10.gif\" data-fancybox=\"gallery\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct10.gif\" alt=\"\u8996\u5e8a\u4e0b\u90e8\u306b\u767a\u751f\u3057\u305fchoriocarcinoma\u306e\u75c5\u7406\u50cf\" width=\"652\" height=\"193\" \/><\/a><\/p>\n<p>\u8996\u5e8a\u4e0b\u90e8\u306b\u767a\u751f\u3057\u305fchoriocarcinoma\u306e\u75c5\u7406\u50cf\uff08\u5de6\u304b\u3089HE\u67d3\u8272, HCG\u67d3\u8272, PLAP\u67d3\u8272\uff09\uff1a\u816b\u760d\u306e\u5927\u90e8\u5206\u306bHCG\u967d\u6027\u7d30\u80de\u304c\u8a8d\u3081\u3089\u308c\u307e\u3059\u304c\uff0c\u4e00\u90e8\u3067\u306fPLAP\u967d\u6027\u306egerminoma\u7d30\u80de\u69d8\u306e\u816b\u760d\u7d30\u80de\u3082\u6563\u898b\u3055\u308c\u307e\u3059\u3002<\/p>\n<h4>\u598a\u5a20\u306b\u3088\u3063\u3066\u751f\u3058\u308b\u80ce\u76e4\u7531\u6765\u306e\u7d68\u6bdb\u764c\u00a0gestational trophoblastic disease (GTD)<\/h4>\n<p>\u6027\u817a\u539f\u767a\uff08\u5b50\u5bae\u80ce\u76e4\uff09\u306e\u7d68\u6bdb\u304c\u3093\u304c\u8133\u8ee2\u79fb\u3092\u6765\u3059\u983b\u5ea6\u306f\uff0c\u8133\u539f\u767a\u7d68\u6bdb\u304c\u3093\u306e\u767a\u751f\u983b\u5ea6\u3092\u9059\u304b\u306b\u4e0a\u56de\u308b\u305f\u3081\u306b\uff0c\u5973\u6027\u3067\u982d\u84cb\u5185\u7d68\u6bdb\u304c\u3093\u306e\u8a3a\u65ad\u3092\u5f97\u305f\u5834\u5408\u306b\u306f\uff0c\u8133\u539f\u767a\u816b\u760d\u3088\u308a\u3082\u8ee2\u79fb\u6027\u8133\u816b\u760d\u3092\u8003\u3048\u307e\u3059\u3002\u8996\u5e8a\u4e0b\u90e8\uff0c\u677e\u679c\u4f53\uff0c\u5927\u8133\u57fa\u5e95\u6838\u4ee5\u5916\u306e\u7d68\u6bdb\u304c\u3093\u306f\u8ee2\u79fb\u6027\u3067\u3059\u3002\u9006\u306b\u7a00\u3067\u3059\u304c\uff0c \u8133\u539f\u767a\u7d68\u6bdb\u764c\u306e\u3046\u3061\u7d041\/3\u304c\u80ba\u306b\u8ee2\u79fb\u3057\u307e\u3059\u3002\u307b\u3068\u3093\u3069\u306e\u7d68\u6bdb\u304c\u3093\u306f\u598a\u5a20\u6027\u3067\u3059\u304c\uff0c\u5316\u5b66\u7642\u6cd5\u306790%\u304f\u3089\u3044\u306b\u5bdb\u89e3\u304c\u5f97\u3089\u308c\u307e\u3059\u3002\u3067\u3082\u8133\u8ee2\u79fb\u3092\u751f\u3058\u308b\u3068\u6cbb\u7642\u304c\u6210\u529f\u3059\u308b\u3053\u3068\u306f\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<h4><strong>choriocarcinoma syndrome<\/strong><\/h4>\n<p>\u7d68\u6bdb\u764c\u306e\u8ee2\u79fb\u5de3\u304b\u3089\u306e\u91cd\u7be4\u306a\u51fa\u8840\u306e\u3053\u3068\u3092\u8a00\u3044\u307e\u3059\u3002\u540c\u6642\u306b\uff0cHCG-beta\u306e\u9ad8\u5ea6\u306e\u4e0a\u6607\u304c\u751f\u3058\u307e\u3059\u3002\u8133\u306b\u8ee2\u79fb\u3057\u305f\u7d68\u6bdb\u764c\u306f\u3053\u306e\u3088\u3046\u306a\u75c5\u614b\u3067\u767a\u75c7\u3057\u307e\u3059\u3002<\/p>\n<h1><span style=\"color: #000080;\">\u80ce\u5150\u6027\u304c\u3093 embryonal carcinoma<\/span><\/h1>\n<ul>\n<li>embryonal carcinoma\u306f\uff0c\u80ce\u751f\u521d\u671f\u306eembryonic ectoderm (\u80ce\u751f\u5916\u80da\u8449) \u306eembryonic pluripotential stem cell\u304c\u764c\u5316\u3057\u305f\u7d30\u80de\u914d\u5217\u306b\u985e\u4f3c\u3057\u305f\u7d44\u7e54\u5f62\u614b\u3092\u3068\u308b\u60aa\u6027\u816b\u760d\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u6975\u3081\u3066\u7a00\u306b\u7d14\u7c8b\u306a\u8133\u539f\u767a\u306eembryonal carcinoma\u306e\u5831\u544a\u304c\u3042\u3068\u3044\u3046\u7a0b\u5ea6\u306e\u983b\u5ea6\u3067\u3059<\/li>\n<li>\u4e2d\u67a2\u795e\u7d4c\u7cfb\u306b\u304a\u3044\u3066\u306f\u777e\u4e38\u306b\u767a\u751f\u3059\u308b\u3088\u3046\u306a\u7d14\u7c8b\u306aembryonal carcinoma\u306e\u8a3a\u65ad\u3092\u5f97\u3089\u308c\u308b\u3053\u3068\u306f\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u795e\u7d4c\u7d44\u7e54\u306b\u6d78\u6f64\u6027\u5897\u6b96\u3092\u3057\uff0c\u51fa\u8840\u3084\u58ca\u6b7b\u50cf\u3092\u542b\u307f\u591a\u6570\u306e\u6838\u5206\u88c2\u50cf\u3092\u6709\u3057\u7279\u5fb4\u7684\u306a\u7d30\u80de\u914d\u5217\u3092\u793a\u3055\u306a\u3044\u3053\u3068\u3082\u591a\u304f\uff0cimmature teratoma\u306e\u60aa\u6027\u578b\u3084choriocarcinoma\u3068\u6df7\u5728\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>CK(cytokeratin)\uff0cPLAP\uff0cAFP\uff0cHCG\u306f\uff0c\u90e8\u5206\u7684\u306b\u967d\u6027\u6240\u898b\u3092\u793a\u3059\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>AFP\u5f37\u967d\u6027\u306e\u90e8\u5206\u304c\u3042\u308c\u3070\uff0cyolk sac tumor\u3068\u306e\u5408\u4f75\u3092\u8003\u616e\u3057\u307e\u3059<\/li>\n<li>\u677e\u679c\u4f53\u306b\u767a\u751f\u3059\u308b\u3053\u3068\u304c\u591a\u304f\uff0c\u816b\u760d\u5897\u5927\u901f\u5ea6\u304c\u304b\u306a\u308a\u65e9\u304f\uff0cMRI\u3067\u306f1\u9031\u9593\u3067\u3059\u3054\u304f\u5927\u304d\u304f\u306a\u3063\u305f\u3068\u3044\u3046\u3088\u3046\u306a\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u5883\u754c\u660e\u77ad\u306a\u816b\u760d\u3067\uff0c\u77f3\u7070\u5316\u3092\u4f34\u3046\u3053\u3068\u3082\u3042\u308a\uff0cT1\u5f37\u8abf\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u50cf\u3067\u306f\u5f37\u304f\u5897\u5f37\u3055\u308c\u307e\u3059<\/li>\n<li>germinoma\u3068\u306e\u9451\u5225\u8a3a\u65ad\u304c\u96e3\u3057\u3044\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u304c\uff0c\u5897\u5927\u901f\u5ea6\u304c\u5168\u7136\u9055\u3044\u307e\u3059<\/li>\n<li>\u9ad8\u7387\u306b\u9ac4\u6db2\u64ad\u7a2e\u3059\u308b\u306e\u3067\uff0cembryonal carcinoma\u3092\u7591\u3063\u305f\u3068\u304d\u306b\u306f\u5fc5\u305a\u5168\u8133\u810a\u9ac4\u3092\u542b\u3080\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37MRI\u3092\u64ae\u50cf\u3057\u307e\u3059<\/li>\n<li>\u9ac4\u6db2\u64ad\u7a2e\u306e\u51fa\u73fe\u3068\u9032\u884c\u3082\u65e9\u3044\u306e\u3067\uff0c\u6cbb\u7642\u7d4c\u904e\u4e2d\u3082\u8133\u304b\u3089\u8170\u4ed9\u690e\u307e\u3067\u3092\u542b\u3080MRI\u3092\u983b\u56de\u306b\u53cd\u5fa9\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>5\u5e74\u751f\u5b58\u5272\u5408\u306f10-40%\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u305f\u3068\u3048\u521d\u56de\u6cbb\u7642\u306b\u6210\u529f\u3057\u3066\u5b8c\u5168\u7de9\u89e3\u3092\u5f97\u305f\u3068\u3057\u3066\u3082\u9ad8\u7387\u306b\u518d\u767a\u3057\u307e\u3059<\/li>\n<li>\u539f\u767a\u90e8\u4f4d\u5468\u8fba\u8133\u3078\u306e\u76f4\u63a5\u6d78\u6f64\u3068\u9ac4\u6db2\u3092\u4ecb\u3057\u305f\u8ee2\u79fb\u3067\u81f4\u6b7b\u7684\u7d4c\u904e\u3092\u305f\u3069\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u5168\u8133\u810a\u9ac4\u3092\u542b\u3080\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u5f37\u529b\u306a\u5316\u5b66\u7642\u6cd5\u3092\u3057\u307e\u3059\u304c\uff0c\u6a19\u6e96\u6cbb\u7642\u3068\u8a00\u308f\u308c\u308b\u3082\u306e\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u75c5\u52e2\u306e\u9032\u884c\u304c\u65e9\u3044\u306e\u3067\uff0c\u653e\u5c04\u7dda\u7167\u5c04\u306f\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u304c\u3064\u304d\u6b21\u7b2c\u65e9\u6025\u306b\u958b\u59cb\u3057\u307e\u3059<\/li>\n<li>\u624b\u8853\u6458\u51fa\u306e\u610f\u7fa9\u306f\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u307e\u305f\uff0c\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u306e\u5f8c\u306b\u5c0f\u3055\u306a\u6458\u51fa\u53ef\u80fd\u75c5\u5909\u304c\u6b8b\u5b58\u3059\u308b\u5834\u5408\u306b\u306f\u518d\u624b\u8853\u3092\u8a08\u753b\u3057\u307e\u3059<\/li>\n<\/ul>\n<p class=\"imgCenter\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct8.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct8.gif\" alt=\"\u677e\u679c\u4f53\u90e8\u3068\u8996\u5e8a\u4e0b\u90e8\u306b\u767a\u751f\u3057\u305fmixed germ cell tumor\u306e\u5897\u5f37MRI\" width=\"480\" height=\"176\" \/><\/a><\/p>\n<p>\u677e\u679c\u4f53\u90e8\u3068\u8996\u5e8a\u4e0b\u90e8\u306b\u767a\u751f\u3057\u305fmixed germ cell tumor\u306e\u5897\u5f37MRI\uff08\u5de6\u5074\uff09\u3002\u5b9a\u4f4d\u7684\u751f\u691c\u8853\u306b\u3088\u308aimmature teratoma\u3068embryonal carcinoma\u306e\u6df7\u3058\u308b\u75c5\u7406\u50cf\u304c\u307f\u3089\u308c\u307e\u3057\u305f\u3002\uff11\u30b3\u30fc\u30b9\u306eICE\u5316\u5b66\u7642\u6cd5\u3068\u653e\u5c04\u7dda\u6cbb\u7642 54Gy \u306b\u3088\u308a\u816b\u760d\u306f\u8457\u660e\u306b\u7e2e\u5c0f\u3057\uff08\u4e2d\u592e\uff09\uff0c\u6cbb\u7642\uff18\u30f6\u6708\u5f8c\u306b\u306f\u66f4\u306b\u9000\u7e2e\u3057\u3066\u3044\u308b\u50cf\u304c\u8a8d\u3081\u3089\u308c\u307e\u3059\uff08\u53f3\u5074\uff09\u3002teratoma\u306b\u304a\u3044\u3066\uff0c\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u306e\u5f8c\u306b\u816b\u760d\u306e\u5b8c\u5168\u6d88\u5931\u3092\u8a8d\u3081\u308b\u3053\u3068\u306f\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093\u304b\u3089\uff0c\u6b8b\u5b58\u816b\u760d\u306f\u6458\u51fa\u3057\u305f\u3044\u306e\u3067\u3059\u304c\uff0c\u8996\u5e8a\u4e0b\u90e8\u30b2\u767a\u751f\u306a\u306e\u3067\u9021\u5de1\u3057\u307e\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20682\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym2-300x201.jpg\" alt=\"\" width=\"300\" height=\"201\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym2-300x201.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym2-550x368.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym2-768x514.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym2.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20683\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym1-300x201.jpg\" alt=\"\" width=\"300\" height=\"201\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym1-300x201.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym1-550x368.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym1-768x514.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/embryonalcaym1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u677e\u679c\u4f53\u306e\u80ce\u5150\u6027\u304c\u3093\u3067\u3059\uff08\u5de6\uff09\uff0c\u64ad\u7a2e\u3057\u3066\u5c0f\u8133\u8868\u9762\u306b\u7d50\u7bc0\u3092\u4f5c\u308a\u307e\u3057\u305f\uff08\u53f3\uff09<\/p>\n<hr \/>\n<h1>\u6982\u8ad6<\/h1>\n<ul>\n<li>\u80da\u7d30\u80de\u816b\u760d germ cell tumors \u306f\uff0c\u5c0f\u5150\u671f\u3068\u9752\u5e74\u671f\u306b\uff0c\u751f\u6b96\u5668\uff08\u7cbe\u5de3\uff0c\u5375\u5de3\uff09\u3068\u4f53\u4e2d\u5fc3\u7dda\u306b\u5f53\u305f\u308b\u90e8\u4f4d\uff0c\u3059\u306a\u308f\u3061\u7e26\u9694\uff0c\u5f8c\u8179\u819c\uff0c\u677e\u679c\u4f53\uff0c\u795e\u7d4c\u4e0b\u5782\u4f53\u90e8\u306a\u3069\u306b\u767a\u751f\u3057\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>primordial germ cells \uff08\u539f\u751f\u6b96\u7d30\u80de\uff09<\/strong><\/span>\u3092\u8d77\u539f\u3068\u3057\u3066\u767a\u751f\u3059\u308b\u816b\u760d\u3067\u3042\u308b\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u80ce\u751f\u521d\u671f\u306bprimordial germ cells\u306f\u69d8\u3005\u306a\u81d3\u5668\u306b\u5206\u5e03\u3057\u307e\u3059\u304c\uff0c\u306a\u305c\u7e26\u9694\u3068\u9593\u8133\u677e\u679c\u4f53\u90e8(<strong><span style=\"color: #000080;\">diencephalopineal region<\/span><\/strong>)\u306b\u304a\u3044\u3066\u505c\u7559\u3057\u816b\u760d\u5316\u3059\u308b\u304b\u306f\u4e0d\u660e\u3067\u3059<\/li>\n<li>\u4e2d\u67a2\u795e\u7d4c\u7cfb\uff08\u982d\u84cb\u5185\uff09\u539f\u767a\u80da\u7d30\u80de\u816b\u760d (primary CNS (intracranial) germ cell tumors) \u306f\u751f\u6b96\u5668\u539f\u767a\u306e\u3082\u306e\u3068\u8f03\u3079\u308b\u3068\u983b\u5ea6\u306f\u304b\u306a\u308a\u4f4e\u3044\u3067\u3059<\/li>\n<li>\u6027\u6b96\u5668\u3042\u308b\u3044\u306f\u4ed6\u81d3\u5668\u306b\u767a\u751f\u3059\u308b\u80da\u7d30\u80de\u816b\u760d\u3068\u306f\uff0c\u75c5\u7406\u7d44\u7e54\u5b66\u7684\u306b\u3082\u751f\u7269\u5b66\u7684\u306b\u3082\u307b\u307c\u540c\u69d8\u306e\u6027\u8cea\u3092\u793a\u3057\u307e\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u6570\u306e\u591a\u3044\u6ccc\u5c3f\u751f\u6b96\u5668\u7cfb\u7d71\u306b\u767a\u751f\u3057\u305f\u591a\u304f\u306e\u60aa\u6027\u80da\u7d30\u80de\u816b\u760d\u306e\u6cbb\u7642\u3092\u53c2\u8003\u306b\u3057\u3066\uff0c\u982d\u84cb\u5185\u80da\u7d30\u80de\u816b\u760d\u306e\u6cbb\u7642\u304c\u767a\u5c55\u3057\u3066\u304d\u307e\u3057\u305f<\/li>\n<li>\u7279\u306b\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u816b\u760d refractory germ cell tumors\u306b\u5bfe\u3057\u3066\u306e\u5316\u5b66\u7642\u6cd5\u304c\u53c2\u8003\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u3057\u304b\u3057\u5927\u304d\u306a\u9055\u3044\u3082\u3042\u3063\u3066\uff0c\u751f\u6b96\u5668\u539f\u767a\u816b\u760d\u304c\u9ad8\u983b\u5ea6\u306b\u30ea\u30f3\u30d1\u7bc0\u3042\u308b\u3044\u306f\u591a\u81d3\u5668\u306b\u8ee2\u79fb\u3059\u308b\u3053\u3068\u306b\u5bfe\u3057\uff0c\u4e2d\u67a2\u795e\u7d4c\u7cfb\u539f\u767a\u80da\u7d30\u80de\u816b\u760d\u306e\u6700\u5927\u306e\u7279\u5fb4\u306f\u4e2d\u67a2\u795e\u7d4c\u5916\u3078\u306e\u8ee2\u79fb\u304c\u4f8b\u5916\u7684\u306a\u3053\u3068\u3067\u3059<\/li>\n<\/ul>\n<h4><strong>WHO\u306e\u5206\u985e (2021\u5e74)<\/strong><\/h4>\n<p><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u80da\u7d30\u80de\u816b\u760d\" href=\"\/sawamura\/pediattumor\/germ\/\">Mature teratoma\u3000\u6210\u719f\u5947\u5f62\u816b<\/a><br \/>\n<a style=\"color: #000080;\" title=\"\u80da\u7d30\u80de\u816b\u760d\" href=\"\/sawamura\/pediattumor\/germ\/\">Immature teratoma\u3000\u672a\u719f\u5947\u5f62\u816b<br \/>\n<\/a><\/strong><\/span><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u80da\u7d30\u80de\u816b\u760d\" href=\"\/sawamura\/pediattumor\/germ\/\">Teratoma with somatic type malignancy\u3000\u60aa\u6027\u8ee2\u5316\u3092\u4f34\u3046\u3082\u306e<\/a><br \/>\n<\/strong><strong style=\"color: #333333;\"><a style=\"color: #000080;\" title=\"\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u80da\u816b\uff09\" href=\"\/sawamura\/pediattumor\/germinoma\/\">Germi<\/a><a style=\"color: #000080;\" title=\"\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u80da\u816b\uff09\" href=\"\/sawamura\/pediattumor\/germinoma\/\">noma\u3000\u80da\u816b\u3000\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/a><\/strong><strong><br \/>\n<\/strong><\/span><strong><span style=\"color: #000080;\">Embryonal carcinoma\u3000\u80ce\u5150\u6027\u764c<a style=\"color: #000080;\" title=\"\u80da\u7d30\u80de\u816b\u760d\" href=\"\/sawamura\/pediattumor\/germ\/\"><br \/>\n<\/a><\/span><\/strong><strong><span style=\"color: #000080;\"><a style=\"color: #000080;\" title=\"\u80da\u7d30\u80de\u816b\u760d\" href=\"\/sawamura\/pediattumor\/germ\/\">Yolk sac tumo<\/a>r\u3000\u5375\u9ec4\u56a2\u816b\u760d<a style=\"color: #000080;\" title=\"\u80da\u7d30\u80de\u816b\u760d\" href=\"\/sawamura\/pediattumor\/germ\/\"><br \/>\n<\/a><\/span><\/strong><strong><span style=\"color: #000080;\">Choriocarcinoma\u3000\u7d68\u6bdb\u764c<br \/>\n<\/span><\/strong><strong><span style=\"color: #333399;\">Mixed germ cell tumors\u3000\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d<\/span><\/strong><\/p>\n<h4>\u80da\u7d30\u80de\u816b\u760d\u306e\u767a\u751f\u983b\u5ea6<\/h4>\n<p>\u4e2d\u67a2\u795e\u7d4c\u7cfb\u80da\u7d30\u80de\u816b\u760d\u306e\u767a\u751f\u983b\u5ea6\u306f\uff0c\u6771\u30a2\u30b8\u30a2\u3067\u306f\u6b27\u7c73\u306e\uff13\uff5e\uff15\u500d\u3067\u3059\u3002germinoma\u3068mature teratoma\u3092\u9664\u3051\u3070\u7d14\u578b\u306f\u5c11\u306a\u304f\uff0c\u8a73\u7d30\u306b\u7d44\u7e54\u50cf\u3092\u691c\u8a0e\u3059\u308c\u3070mixed germ cell tumor\u306e\u983b\u5ea6\u304c\u9ad8\u304f\u306a\u308a\u307e\u3059\u3002\u4f8b\u3048\u3070\uff0cimmature teratoma\u306bgerminoma\u304c\u6df7\u5728\u3059\u308b\u75c7\u4f8b\u3067\u306f\uff0cmixed germ cell tumor\u3068\u75c5\u7406\u8a3a\u65ad\u3055\u308c\u308b\u3079\u304d\u3067\u3042\u308a\uff0c\u8a3a\u65ad\u3068\u6cbb\u7642\u306f\uff0cgerminoma\u3068immature teratoma\u306e\u4e21\u8005\u306e\u6027\u8cea\u3092\u8e0f\u307e\u3048\u3066\u884c\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u307e\u305f\u7d14\u7c8b\u306aembryonal carcinoma\uff0cchoriocarcinoma\u306e\u983b\u5ea6\u6975\u3081\u3066\u4f4e\u3044\u3082\u306e\u3067\u3059\u3002malignant teratoma\u3068\u3055\u308c\u308b\u3082\u306e\u306e\u5b9a\u7fa9\u306f\u660e\u3089\u304b\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u767a\u751f\u983b\u5ea6\u3068\u90e8\u4f4d\u306b\u306f\u6027\u5dee\u304c\u3042\u308a\uff0c\u677e\u679c\u4f53\u539f\u767a\u816b\u760d\u306f\u7537\u5150\u306b\u591a\u304f\u5973\u5150\u306b\u5c11\u306a\u3044\u3067\u3059\u3002\u767a\u751f\u90e8\u4f4d\u306f\uff0c80%\u4ee5\u4e0a\u304c\u7b2c\u4e09\u8133\u5ba4\u8fd1\u508d\u3059\u306a\u308f\u3061\uff0c\u8996\u5e8a\u4e0b\u90e8\u30fb\u4e0b\u5782\u4f53\u5f8c\u8449 (neurohypophyseal germ cell tumors) \u3068\u677e\u679c\u4f53 (pineal germ cell tumors) \u306e\uff12\u3064\u306e\u90e8\u4f4d\u306b\u96c6\u4e2d\u3057\u307e\u3059\u3002\u4e21\u90e8\u4f4d\u306b\u540c\u6642\u306b\u767a\u751f\u3059\u308b (<span style=\"color: #ff0000;\"><strong>synchronous tumor, bifocal tumor<\/strong><\/span>) \u3053\u3068\u306f\u3081\u305a\u3089\u3057\u304f\u3042\u308a\u307e\u305b\u3093\u3002\u5973\u5150\u306b\u767a\u751f\u3059\u308bgerminoma\u306f\uff0c\u8996\u5e8a\u4e0b\u90e8\u306b\u591a\u304f\u677e\u679c\u4f53\u90e8\u306f\u6975\u3081\u3066\u7a00\u3067\u3059\u3002\u5927\u8133\u57fa\u5e95\u6838\uff0c\u8996\u5e8a\uff0c\u8133\u5e79\u90e8\uff0c\u810a\u9ac4\uff0c\u5c0f\u8133\u306b\u3082\u539f\u767a\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n<p>\u6642\u3092\u7d4c\u3066\u80da\u7d30\u80de\u816b\u760d\u304c\u4e2d\u67a2\u795e\u7d4c\u7cfb\u306b\uff12\u5ea6\u767a\u751f\u3059\u308b\u3053\u3068\u304c\u3042\u308a\uff0c\u3053\u308c\u3092metachronous germ cell tumor\u3068\u547c\u79f0\u3057\u307e\u3059\u3002\u4f8b\u3048\u3070\uff0c\u5c0f\u5150\u671f\u306b\u677e\u679c\u4f53\u90e8teratoma\u304c\u767a\u751f\u3057\u305d\u308c\u304c\u6cbb\u7652\u3057\uff0c10\u5e74\u3092\u7d4c\u3066\u601d\u6625\u671f\u306b\u795e\u7d4c\u4e0b\u5782\u4f53\u90e8\u306bgerminoma\u304c\u65b0\u305f\u306b\u767a\u751f\u3059\u308b\u5834\u5408\u306a\u3069\u3067\u3059\u3002\u3053\u306e<span style=\"color: #ff0000;\"><strong>metachronous germ cell tumor<\/strong><\/span> \u3068\u518d\u767a\u3068\u306e\u53b3\u5bc6\u306a\u610f\u5473\u3067\u306e\u9451\u5225\u306f\u96e3\u3057\u3044\u3067\u3059\u3002<\/p>\n<h4>\u81e8\u5e8a\u75c7\u72b6<\/h4>\n<ul>\n<li>\u81e8\u5e8a\u75c7\u5019\u306f\u816b\u760d\u306e\u767a\u751f\u3059\u308b\u8133\u306e\u90e8\u4f4d\u306b\u4f9d\u5b58\u3057\u307e\u3059\u304c\uff0c\u305d\u308c\u305e\u308c\u306e\u816b\u760d\u578b\u306b\u3088\u3063\u3066\u3082\u82e5\u5e72\u7570\u306a\u308a\u307e\u3059<\/li>\n<li>\u677e\u679c\u4f53\u306e\u80da\u7d30\u80de\u816b\u760d\u306e\u5927\u90e8\u5206\u306f\uff0c\u7b2c\u4e09\u8133\u5ba4\u5f8c\u65b9\u304b\u3089\u4e2d\u8133\u6c34\u9053\u306e\u9589\u585e\u306b\u3088\u308b\u9589\u585e\u6027\u6c34\u982d\u75c7\u3092\u751f\u3058\u307e\u3059\u3002\u982d\u75db\u3068\u5614\u5410\uff0c\u8efd\u5ea6\u306e\u8907\u8996\uff0c\u8efd\u5ea6\u306e\u610f\u8b58\u969c\u5bb3\u304c\u521d\u767a\u75c7\u72b6\u3068\u306a\u308a\u307e\u3059\u3002\u304b\u3064\u3066\u306f\u9ad8\u5ea6\u306e\u6c34\u982d\u75c7\u306e\u305f\u3081Parinoud\u75c7\u5019\u306a\u3069\u3092\u5448\u3057\u3066\u5165\u9662\u3059\u308b\u4f8b\u3082\u3042\u308a\u307e\u3057\u305f\u304c\uff0c\u6700\u8fd1\u3067\u306f\u4e2d\u8133\u88ab\u84cb\u306e\u5727\u8feb\u75c7\u72b6\u3067\u3042\u308b\u773c\u7403\u904b\u52d5\u969c\u5bb3\u307e\u3067\u9032\u884c\u3057\u3066\u3044\u308b\u4f8b\u306f\u5c11\u306a\u3044\u3067\u3059<\/li>\n<li>\u8996\u5e8a\u4e0b\u90e8\u304b\u3089\u4e0b\u5782\u4f53\u5f8c\u8449\u3092\u767a\u751f\u6bcd\u5730\u3068\u3059\u308b\u80da\u7d30\u80de\u816b\u760d\u306f\uff0c\u591a\u98f2\u30fb\u591a\u5c3f\uff08\u4e2d\u67a2\u6027\u5c3f\u5d29\u75c7\uff09\u3067\u767a\u75c7\u3059\u308b\u3053\u3068\u6700\u3082\u591a\u3044\u3067\u3059\u3002\u4e0b\u5782\u4f53\u524d\u8449\u307e\u3067\u816b\u760d\u304c\u6d78\u6f64\u3059\u308c\u3070\uff0c\u6210\u9577\u30db\u30eb\u30e2\u30f3\u306e\u5206\u6ccc\u4f4e\u4e0b\u306b\u3088\u308b\u4f4e\u8eab\u9577\u306a\u3069\u306e\u524d\u8449\u4e0d\u5168\u3067\u767a\u898b\u3055\u308c\u308b\u4f8b\u3082\u3042\u308a\u307e\u3059\u3002\u524d\u8449\u4e0d\u5168\u306b\u3088\u308b\u526f\u814e\u6a5f\u80fd\u4f4e\u4e0b\u3067\u5c3f\u5d29\u75c7\u304c\u4e0d\u9855\u5316\u3057\u3066\u3044\u308b\u5834\u5408\u306f\uff0c\u526f\u814e\u76ae\u8cea\u30b9\u30c6\u30ed\u30a4\u30c9\u30db\u30eb\u30e2\u30f3\u306e\u88dc\u5145\u3067\u5c3f\u5d29\u75c7\u304c\u9855\u5728\u5316\u3057\u3066\u5c3f\u6bd4\u91cd\u304c\u4f4e\u4e0b\u3057\u5c3f\u91cf\u306e\u8457\u660e\u306a\u5897\u52a0\u304c\u751f\u3058\u307e\u3059\u3002\u9ad8\u5ea6\u306e\u9593\u8133\u4e0b\u5782\u4f53\u4e0d\u5168\u3067\u306e\u30ca\u30c8\u30ea\u30a6\u30e0\u8abf\u7bc0\u969c\u5bb3\uff0c\u610f\u8b58\u969c\u5bb3\uff0c\u77e5\u80fd\u4f4e\u4e0b\u306a\u3069\u306e\u91cd\u75c7\u4f8b\u3082\u6642\u306b\u906d\u9047\u3057\u307e\u3059\u3002HCG\u7523\u751f\u816b\u760d\u3067\u306f\uff0c\u601d\u6625\u671f\u65e9\u767a\u75c7\u304c\u521d\u767a\u75c7\u72b6\u3068\u306a\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>germinoma\u306f\u672c\u6765\u6d78\u6f64\u6027\u306e\u816b\u760d\u3067\uff0c\u8996\u795e\u7d4c\u4ea4\u53c9\u3092\u4fb5\u3059\u3053\u3068\u304c\u3042\u308a\uff0c\u8996\u529b\u30fb\u8996\u91ce\u969c\u5bb3\u3092\u5408\u4f75\u3057\u3066\u3044\u308b\u3053\u3068\u3082\u7a00\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u8996\u529b\u304c\u4fdd\u305f\u308c\u3066\u3044\u308b\u4f8b\u306b\u304a\u3044\u3066\u3082\uff0c\u69d8\u3005\u306a\u8996\u91ce\u6b20\u640d\u3092\u5448\u3059\u308b\u75c7\u4f8b\u304c\u3042\u308b\u306e\u3067\uff0c\u5927\u304d\u306a\u816b\u760d\u3067\u306f\u8996\u91ce\u691c\u67fb\u306f\u5fc5\u305a\u884c\u3063\u3066\u304a\u3044\u305f\u65b9\u304c\u3088\u3044\u3067\u3057\u3087\u3046\u3002\u307e\u305f\uff0cgerminoma\u306f\u4e2d\u67a2\u795e\u7d4c\u7d44\u7e54\u3092\u7834\u58ca\u6027\u306b\u6d78\u6f64\u3057\u3066\uff0c\u8996\u529b\u30fb\u8996\u91ce\u969c\u5bb3\u304c\u4e0d\u53ef\u9006\u6027\u3068\u306a\u308b\u306e\u3067\uff0c\u8a3a\u65ad\u3068\u6cbb\u7642\u3092\u9045\u3089\u305b\u3066\u306f\u306a\u308a\u307e\u305b\u3093\u3002<\/li>\n<li>\u5927\u8133\u57fa\u5e95\u6838\u306e\u816b\u760d\u306f\u9ad8\u6b21\u8133\u6a5f\u80fd\u4f4e\u4e0b\uff0c\u9310\u4f53\u8def\u969c\u5bb3\u306b\u3088\u308b\u7247\u9ebb\u75fa\uff0c\u77e5\u7684\u6a5f\u80fd\u306e\u969c\u5bb3\uff0c\u6027\u683c\u5909\u5316\u306a\u3069\u3092\u5448\u3057\u307e\u3059\u3002\u521d\u671f\u306b\u306f\u5c40\u6240\u75c7\u5019\u306b\u4e4f\u3057\u3044\u3053\u3068\u3082\u3042\u308a\u304b\u306a\u308a\u9032\u884c\u3057\u3066\u304b\u3089\u3067\u306a\u3044\u3068\u767a\u898b\u3055\u308c\u306a\u3044\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u810a\u9ac4\u306b\u751f\u3058\u305f\u3082\u306e\u3067\u306f\u6a2a\u65ad\u6027\u5bfe\u9ebb\u75fa\u3084\u8180\u80f1\u76f4\u8178\u969c\u5bb3\u3082\u3042\u308a\uff0c\u8996\u5e8a\u3084\u5ef6\u9ac4\u306a\u3069\u3067\u3042\u308c\u3070\u305d\u308c\u3089\u306e\u90e8\u4f4d\u7279\u6709\u306e\u5c40\u6240\u75c7\u5019\u3067\u767a\u75c7\u3057\u307e\u3059\u3002<\/li>\n<\/ul>\n<h4>\u8840\u6db2\u30fb\u9ac4\u6db2\u691c\u67fb<\/h4>\n<ul>\n<li>\u8840\u6db2\u3068\u9ac4\u6db2\u4e2d\u306eAFP (alpha-feto protein)\u3068HCG-beta (human chorionic gonadotoropin-beta subunit) \u306e\u6e2c\u5b9a\u3092\u3057\u307e\u3059\u3002\u9ac4\u6db2\u691c\u67fb\u306f\u5fc5\u9808\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u304c\u53c2\u8003\u3068\u306a\u308a\u307e\u3059\u3002\u3053\u308c\u3089\u306e\u816b\u760d\u30de\u30fc\u30ab\u30fc\u3092\u591a\u304f\u5206\u6ccc\u3059\u308b\u3082\u306e\u307b\u3069\u60aa\u6027\u5ea6\u304c\u9ad8\u3044\u50be\u5411\u304c\u3042\u308a\u307e\u3059\u3002choriocarcinoma\u3067\u306eHCG-beta\u306f10,000 ng\/ml\u524d\u5f8c\uff0cyolk sac tumor\u3067\u306eAFP\u306f4,000 mIU\/ml\u524d\u5f8c\u3068\u304b\u306a\u308a\u306e\u9ad8\u5024\u3092\u793a\u3059\u816b\u760d\u3082\u3042\u308a\uff0c\u305d\u308c\u3060\u3051\u3067\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u304c\u4e0d\u8981\u3068\u306a\u308a\u307e\u3059\u3002germinoma\u4f8b\u3067\u306eHCG-beta\u306f\uff0c\u7cbe\u5ea6\u306e\u9ad8\u3044\u691c\u67fb\u6cd5\u3092\u7528\u3044\u308c\u3070\u307b\u3068\u3093\u3069\u306e\u4f8b\u3067\u967d\u6027\uff08\u7570\u5e38\u9ad8\u5024\uff09\u3068\u306a\u308a\u307e\u3059\u3002<\/li>\n<li>HCG-beta\u306f\u5fc5\u305a\u3057\u3082\u80da\u7d30\u80de\u816b\u760d\u7279\u7570\u7684\u3067\u306f\u306a\u304f\uff0c\u982d\u84cb\u54bd\u982d\u816b\u306a\u3069\u306e\u978d\u4e0a\u90e8\u816b\u760d\u3067\u3082\u4f8b\u5916\u7684\u306b\u967d\u6027\u3068\u306a\u308b\u75c7\u4f8b\u304c\u3042\u308b\u3053\u3068\u306b\u6ce8\u610f\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u9ac4\u6db2\u4e2d\u3067\u306ec-kit, PLAP\u306e\u6e2c\u5b9a\u3082\u75c5\u614b\u3068\u95a2\u9023\u3057\u3066\u80da\u7d30\u80de\u816b\u760d\u306e\u8a3a\u65ad\u306b\u6709\u7528\u3067\u3059\u3002HCG-beta\u306e\u5024\u306f\u8840\u6e05\u5024\u3088\u308a\u3082\u9ac4\u6db2\u4e2d\u306e\u65b9\u304c\u9ad8\u3044\u306e\u3067\u3067\u304d\u308c\u3070\u9ac4\u6db2\u306e\u6e2c\u5b9a\u3082\u884c\u3063\u305f\u65b9\u304c\u3088\u3044\u3067\u3057\u3087\u3046\u3002<\/li>\n<li>\u9ac4\u6db2\u306e\u816b\u760d\u30de\u30fc\u30ab\u30fc\u6e2c\u5b9a\u3068\u4f34\u306b\uff0c\u9ac4\u6db2\u7d30\u80de\u8a3a\u3067\u816b\u760d\u7d30\u80de\u306e\u6709\u7121\u3092\u307f\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002\u3057\u304b\u3057\u306a\u304c\u3089\uff0c\u3053\u306e\u9ac4\u6db2\u7d30\u80de\u8a3a\u306f\u7591\u967d\u6027\u3042\u308b\u3044\u306f\u507d\u9670\u6027\u306e\u983b\u5ea6\u304c\u9ad8\u3044\u306e\u3067\uff0c\u5b89\u6613\u306b\u9ac4\u6db2\u64ad\u7a2e\u3068\u8a3a\u65ad\u3057\u3066\u306f\u306a\u308a\u307e\u305b\u3093\u3002\u8133\u305b\u304d\u9ac4MRI\u3067\u8133\u5ba4\u7cfb\u4ee5\u5916\u306e\u8133\u305b\u304d\u9ac4\u8868\u9762\u306b\u7d50\u7bc0\u6027\u75c5\u5909\u304c\u8a8d\u3081\u3089\u308c\u305f\u6642\u306e\u307f\u306b\u64ad\u7a2e\u8ee2\u79fb\u3068\u5224\u65ad\u3057\u305f\u65b9\u304c\u3044\u3044\u3067\u3057\u3087\u3046\u3002\u9ac4\u6db2\u4e2d\u306b\u660e\u3089\u304b\u306a\u816b\u760d\u7d30\u80de\u306e\u6d6e\u904a\u304c\u3042\u308b\u6642\u306b\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u5168\u8133\u810a\u9ac4\u9818\u57df\u306b\u62e1\u5927\u3059\u308b\u3053\u3068\u304c\u5fc5\u8981\u3068\u306a\u308a\u307e\u3059\u3002<\/li>\n<li>\u80da\u7d30\u80de\u816b\u760d\u304c\u9593\u8133\u4e0b\u5782\u4f53\u306b\u767a\u751f\u3057\u305f\u5834\u5408\u306b\u306f\uff0c\u307b\u3068\u3093\u3069\u306e\u4f8b\u3067\u5c3f\u5d29\u75c7\u3084\u4e0b\u5782\u4f53\u524d\u8449\u969c\u5bb3\u3092\u751f\u3058\u3066\u3044\u308b\u306e\u3067\uff0c\u8ca0\u8377\u8a66\u9a13\u3092\u542b\u3081\u305f\u5185\u5206\u6ccc\u5b66\u7684\u306a\u691c\u67fb\u304c\u5fc5\u8981\u3067\u3059\u3002\u307e\u305f\uff0c\u5fc5\u8981\u306b\u5fdc\u3058\u3066\u6cbb\u7642\u958b\u59cb\u524d\u304b\u3089\u30db\u30eb\u30e2\u30f3\u88dc\u5145\u7642\u6cd5\u3092\u884c\u3044\u307e\u3059\u3002\u8996\u5e8a\u4e0b\u90e8\u969c\u5bb3\u3042\u308b\u3044\u306f\u5c3f\u5d29\u75c7\u306b\u7d9a\u767a\u3059\u308b\u4f4e\u30ca\u30c8\u30ea\u30a6\u30e0\u8840\u75c7\u3082\u6cbb\u7642\u4e2d\u306b\u751f\u3058\u308b\u3053\u3068\u304c\u5c11\u306a\u304f\u306a\u3044\u306e\u3067\uff0c\u96fb\u89e3\u8cea\u691c\u67fb\u3068\u305d\u306e\u88dc\u6b63\u3082\u5ff5\u982d\u306b\u5165\u308c\u307e\u3059\u3002\u4f8b\u3048\u677e\u679c\u4f53\u306b\u306e\u307f\u816b\u760d\u304c\u5b58\u5728\u3059\u308b\u4f8b\u3067\u3082\uff0cMRI\u3067\u306f\u307f\u3048\u306a\u3044\u816b\u760d (<span style=\"color: #000080;\"><strong>occult germinoma<\/strong><\/span>) \u304c\u795e\u7d4c\u4e0b\u5782\u4f53\u90e8\u306b\u5b58\u5728\u3059\u308b\u3053\u3068\u3082\u3042\u308b\u306e\u3067\u5185\u5206\u6ccc\u691c\u67fb\u306f\u5168\u4f8b\u306b\u884c\u308f\u308c\u308b\u3053\u3068\u304c\u63a8\u8cde\u3055\u308c\u307e\u3059\u3002<\/li>\n<\/ul>\n<h4>\u753b\u50cf\u8a3a\u65ad<\/h4>\n<ul>\n<li>\u753b\u50cf\u8a3a\u65ad\u306fMRI\u3067\u884c\u3044\u307e\u3059\u3002MRI\u3067\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3092\u7591\u3063\u305f\u3068\u304d\u306b\uff0c\u521d\u671f\u8a3a\u65ad\u3067\u306fCT\u691c\u67fb\u3092\u3057\u3066\u306f\u306a\u308a\u307e\u305b\u3093\u3002CT\u691c\u67fb\u3092\u884c\u3046\u3053\u3068\u3067\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u7d30\u80de\u304c\u6d88\u5931\u3057\u3066\uff0c\u751f\u691c\u8853\u3067\u306e\u75c5\u7406\u8aa4\u8a3a\u3092\u62db\u304f\u3053\u3068\u304c\u3042\u308b\u304b\u3089\u3067\u3059<\/li>\n<li>\u75c5\u7406\u50cf\u304c\u69d8\u3005\u3067\u3042\u308b\u305f\u3081\uff0c\u305d\u306e\u6240\u898b\u306b\u3082\u4e00\u5b9a\u306e\u3082\u306e\u306f\u3042\u308a\u307e\u305b\u3093\u3002mature teratoma\u3092\u9664\u304f\u5168\u3066\u306e\u80da\u7d30\u80de\u816b\u760d\u306f\u9ac4\u6db2\u3092\u4ecb\u3057\u3066\u9ac4\u8154\u5185\u64ad\u7a2e\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u306e\u3067\uff0c\u6cbb\u7642\u3092\u958b\u59cb\u3059\u308b\u524d\u306b\u306f\u5fc5\u305a\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u50cf\u5f37\u3092\u52a0\u3048\u305f\u5168\u8133\u5168\u810a\u9ac4\u306eMRI\u8a3a\u65ad\u3092\u884c\u306a\u3044\u307e\u3059\u3002\u305f\u3060\u3057\uff0cteratoma\u306b\u304a\u3051\u308b\u77f3\u7070\u5316\u306f\u8a3a\u65ad\u7684\u4fa1\u5024\u3092\u6709\u3059\u308b\u305f\u3081\u306b\uff0cMRI\u3067teratoma\u3092\u5f37\u304f\u7591\u3048\u3070CT scan\u3082\u884c\u3063\u305f\u65b9\u304c\u3088\u3044\u3067\u3057\u3087\u3046\u3002\u753b\u50cf\u4e0a\u3067\u306e\u8a3a\u65ad\u540d\u3067\u978d\u4e0a\u90e8 germinoma (suprasellar germinoma)\u3068\u3044\u3046\u7528\u8a9e\u304c\u9577\u304f\u4f7f\u7528\u3055\u308c\u3066\u304d\u307e\u3057\u305f\u304c\uff0c\u3053\u306e\u7528\u8a9e\u306f\u9069\u5207\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u7070\u767d\u9686\u8d77\uff0c\u4e0b\u5782\u4f53\u5f8c\u8449\u3084\u4e0b\u5782\u4f53\u67c4\u3092\u542b\u3080neurohypophysis\u306b\u767a\u751f\u3059\u308b\u3082\u306e\u304c\u591a\u304f\uff0cneurohypophyseal germinoma\u3068\u547c\u79f0\u3059\u308b\u306e\u304c\u6b63\u3057\u3044\u3067\u3059\u3002<\/li>\n<\/ul>\n<h3 class=\"setumei\"><span style=\"color: #000080;\">\u73cd\u3057\u3044\u816b\u760d\u578b\u306e\u5e74\u9f62\u5206\u5e03<\/span><\/h3>\n<p>\u4e0b\u56f3\u306b\u898b\u3089\u308c\u308b\u3088\u3046\u306b\uff0cembryonal carcinoma\u3068yolk sac tumor\u3068choriocarcinoma\u306e\u5e74\u9f62\u5206\u5e03\u306f\u985e\u4f3c\u3057\u307e\u3059\u3002germinoma\u3088\u308a\u306f\u3044\u304f\u3089\u304b\u5e74\u9f62\u5c64\u304c\u4f4e\u3044\u3067\u3059\u3002<\/p>\n<p class=\"imgCenter\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct7.gif\" alt=\"\u80da\u7d30\u80de\u816b\u760d\u306e\u5e74\u9f62\u5206\u5e03\" width=\"480\" height=\"327\" \/><\/p>\n<h5>\u6587\u732e\u60c5\u5831<\/h5>\n<div class=\"title-wrap\">\n<h4>\u30e8\u30fc\u30ed\u30c3\u30d1\u3067\u306e\u30b3\u30f3\u30bb\u30f3\u30b5\u30b9<\/h4>\n<p class=\"wi-article-title article-title-main accessible-content-title at-articleTitle\"><span class=\"al-author-name js-flyout-wrap\">Frappaz D:\u00a0<\/span>EANO, SNO and Euracan consensus review on the current management and future development of intracranial germ cell tumors in adolescents and young adults. Neuro Oncol 2021<br \/>\n\u8a3a\u65ad\u304b\u3089\u6cbb\u7642\u307e\u3067\u306e\u30b3\u30f3\u30bb\u30f3\u30b5\u30b9\u3092\u6982\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<\/div>\n<h4>\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306e\u518d\u767a\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u8a08\u753b\u306e\u4e0d\u6b63\u78ba\u6027\u3067\u306f\u306a\u3044<\/h4>\n<p><span class=\"docsum-authors full-authors\">Murphy ES:\u00a0<\/span>A Phase 2 Trial of Response-Based Radiation Therapy for Localized Central Nervous System Germ Cell Tumors: Patterns of Failure and Radiation Dosimetry for Nongerminomatous Germ Cell Tumors. Int J Radiat Oncol Biol Phys. 2022<br \/>\n\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u3068\u624b\u8853\u306b\u3088\u3063\u3066CR\/PR\u3068\u306a\u3063\u305f\u60a3\u5150\u306b30.6Gy\u306e\u5168\u8133\u5ba4\u7167\u5c04\u306854Gy\u307e\u3067\u306e\u816b\u760d\u5e8a\u7167\u5c04\u304c\u306a\u3055\u308c\u307e\u3057\u305f\u300266\u4f8b\u3067\u3053\u306e\u6cbb\u7642\u304c\u53ef\u80fd\u3067\u3057\u305f\u3002\u810a\u9ac46\u4f8b\uff0c\u8133\u810a\u9ac42\u4f8b\u3067\u518d\u767a\u304c\u751f\u3058\u3066\u3044\u307e\u3057\u305f\u304c\uff0c\u305d\u308c\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u8a08\u753b\u306e\u30df\u30b9\u306e\u305f\u3081\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u3053\u306e66\u4f8b\u306e\u7fa4\u306e\u4e2d\u306b\u810a\u9ac4\u64ad\u7a2e\u3092\u3059\u308b\u6027\u8cea\u3092\u6709\u3057\u3066\u3044\u305f\u816b\u760d\u304c\u3042\u308b\u305f\u3081\u3060\u3068\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4>\u5316\u5b66\u7642\u6cd5\u53cd\u5fdc\u6027\u3092\u307f\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u6291\u3048\u308b<\/h4>\n<p class=\"heading-title\">Fangusaro J: Phase II Trial of Response-Based Radiation Therapy for Patients With Localized CNS Nongerminomatous Germ Cell Tumors: A Children&#8217;s Oncology Group Study. Neuro Oncol, 2019<br \/>\n\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u4ee5\u5916\u306e\u60a3\u8005\u3055\u3093\u304c6\u30b3\u30fc\u30b9\u306e\u5316\u5b66\u7642\u6cd5 (CBDCA, VP-16, IFO\/VP-16)\u3092\u53d7\u3051\u307e\u3059\u3002CR\u3042\u308b\u3044\u306fPR\u3067second-look surgery\u3092\u53d7\u3051\u305f\u60a3\u8005\u3055\u3093\u306f\uff0c30.6Gy\u306e\u5168\u8133\u5ba4\u7167\u5c04\u306854Gy\u307e\u3067\u306e\u5c40\u6240\u7167\u5c04\u304c\u52a0\u3048\u3089\u308c\u307e\u3059\u3002\u305d\u306e\u4ed6\u306e\u4f8b\u3067\u306f\uff0c36Gy\u306e\u8133\u810a\u9ac4\u7167\u5c04\u306854Gy\u306e\u816b\u760d\u5e8a\u7167\u5c04\u3092\u53d7\u3051\u307e\u3059\u3002\u5e74\u9f62\u4e2d\u592e\u502411\u6b73\u3067107\u4f8b\u306e\u60a3\u8005\u3055\u3093\u304c\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u300266\u4f8b(62%)\u3067CR\/PR\u304c\u5f97\u3089\u308c\uff0c3\u5e74PFS\u304c88%\uff0c OS\u304c92%\u3067\u3057\u305f\u300210\u4f8b\u306b\u518d\u767a\u304c\u751f\u3058\uff0c8\u4f8b (12%) \u3067\u75c5\u52e2\u9032\u884c\u3057\u307e\u3057\u305f\u30026\u4f8b\u304c\u810a\u9ac4\u64ad\u7a2e\uff0c2\u4f8b\u304c\u5c40\u6240\u518d\u767a\u3068\u64ad\u7a2e\u3067\u3057\u305f\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u5316\u5b66\u7642\u6cd5\u3068\u6b8b\u5b58\u816b\u760d\u6458\u51fa\u306b\u6301\u3063\u3066\u884c\u3051\u305f\u60a3\u5150\u306b30.6Gy\u306e\u5168\u8133\u5ba4\u7167\u5c04\u306854Gy\u307e\u3067\u306e\u816b\u760d\u5e8a\u7167\u5c04\u306f\uff0c\u305d\u3082\u305d\u3082\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u6e1b\u91cf reduced RT \u3057\u3066\u3044\u308b\u3068\u306f\u8a00\u3048\u307e\u305b\u3093\u3002\u3053\u306e\u7dda\u91cf\u304c\u5168\u8133\u5ba4\u3068\u8996\u5e8a\u4e0b\u90e8\u4e0b\u5782\u4f53\uff0c\u8996\u5e8a\u306b\u5165\u308c\u3070\uff0c\u770b\u904e\u3067\u304d\u306a\u3044\u9045\u767a\u6027\u969c\u5bb3\u306f\u6b8b\u308a\u307e\u3059\u3002\u7d44\u7e54\u578b\u306e\u8a73\u7d30\u3092\u5206\u6790\u3059\u308c\u3070\uff0cover treatment\u3092\u53d7\u3051\u305f\u60a3\u5150\u304c\u591a\u304f\u3044\u308b\u3053\u3068\u3067\u3057\u3087\u3046\u3002<\/p>\n<h4>\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u3068\u6458\u51fa\u624b\u8853\u3092\u653e\u5c04\u7dda\u6cbb\u7642\u524d\u306b\u884c\u3046<\/h4>\n<p>Goldman S, et al.: Phase II Trial Assessing the Ability of Neoadjuvant Chemotherapy With or Without Second-Look Surgery to Eliminate Measurable Disease for Nongerminomatous Germ Cell Tumors: A Children&#8217;s Oncology Group Study. J Clin Oncol 33: 2464-2471, 2015<br \/>\n\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u4ee5\u5916\u306e\u80da\u7d30\u80de\u816b\u760d\u306b6\u30b3\u30fc\u30b918\u9031\u9593\u306e\u5c0e\u5165\u5316\u5b66\u7642\u6cd5 \uff08\u4ea4\u4e92\u306bCBDCA\/VP-16,\u00a0Cycles 1, 3, and 5, IFO\/VP-16, Cycles 2, 4, and 6)\u3092\u884c\u3044\uff0c\u3053\u306e\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u5f8c\u306b\u6b8b\u3063\u305f\u816b\u760d\u306f\u7a4d\u6975\u7684\u306b\u6458\u51fa\u304c\u884c\u308f\u308c\u307e\u3057\u305f(second-look surgery)\u3002CR\/PR (65%\u4ee5\u4e0a\u306e\u816b\u760d\u30b5\u30a4\u30ba\u7e2e\u5c0f\uff09\u3068\u306a\u3063\u305f\u60a3\u8005\u3055\u3093\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642 (daily 5 days a week for 5-6 weeks) \u304c\u3055\u308c\u307e\u3057\u305f\u3002PR \u4e0d\u5b8c\u5168\u594f\u52b9\u4ee5\u4e0b\u306e\u4f8b\u3067\u306f\uff0c\u5927\u91cf\u5316\u5b66\u7642\u6cd5 consolidation chemotherapy (PBSCR, thiotepa\/VP-16)\u3092\u52a0\u3048\uff0c\u305d\u306e\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u52a0\u3048\u3089\u308c\u3066\u3044\u307e\u3059\u3002<br \/>\n2002\u5e74\u304b\u30892008\u5e74\u306b\uff0c\u5e74\u9f62\u4e2d\u592e\u502412\u6b73\uff0c102\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u677e\u679c\u4f53\u304c54\uff05\uff0c\u978d\u4e0a\u90e8\u304c24\uff05\u3067\u3059\u3002\u5c0e\u5165\u5316\u5b66\u7642\u6cd5\u306e\u307f\u3067\uff0c69%\u306e\u60a3\u8005\u3055\u3093\u304cCR\/PR\u3068\u306a\u308a\u307e\u3057\u305f\u30025\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f84%\uff0c\u5168\u751f\u5b58\u5272\u5408\u306f93%\u3067\u3057\u305f\u3002\u518d\u767a\u306f16\u4eba\u3067\uff0c7\u4eba\u304c\u6b7b\u4ea1\u3057\u3066\u3044\u307e\u3059\u3002\u539f\u767a\u90e8\u4f4d\u306710\u4f8b\u306e\u518d\u767a\uff0c\u9060\u9694\u518d\u767a\u304c3\u4f8b\u3067\u3057\u305f\u3002\u753b\u50cf\u6240\u898b\u304c\u306a\u304f\u816b\u760d\u30de\u30fc\u30ab\u30fc\u3067\u9032\u884c\u304c\u78ba\u8a8d\u3055\u308c\u305f\u3082\u306e\u306f2\u4f8b\u3067\u3057\u305f\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u78ba\u304b\u306b\u826f\u3044\u6210\u7e3e\u3067\u3059\u3002\u3067\u3082\u3057\u304b\u3057\uff0cHistologically confirmed germinoma with elevation of serum\/CSF beta human chorionic gonadotropin (HCG) levels greater than 50 mIU\/mL\u304c\u542b\u307e\u308c\u3066\u3044\u307e\u3059\u3002\u3053\u306e\u816b\u760d\u7fa4\u306f\uff0c\u5358\u306a\u308b\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3078\u306e\u6cbb\u7642\u3060\u3051\u3067\u6cbb\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u4e88\u5f8c\u826f\u597d\u7fa4\u3067\u3059\u3002\u3053\u308c\u306b\u5bfe\u3057\u3066\u304b\u306a\u308a\u306e\u5f37\u5ea6\u306e\u9ad8\u3044\u6cbb\u7642\u304c\u306a\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u307e\u305f\u5168\u54e1\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u307e\u3059\u304c\uff0c\u77e5\u80fd\u4e88\u5f8c\u306b\u3082\u3063\u3068\u3082\u5f71\u97ff\u306e\u3042\u308b\u7167\u5c04\u91ce\u306e\u898f\u5b9a\u304c\u306f\u3063\u304d\u308a\u3057\u307e\u305b\u3093\u3002\u307e\u305f\u3055\u3089\u306b\uff0c45Gy-54Gy\u3082\u306e\u7167\u5c04\u7dda\u91cf\u304c\u7528\u3044\u3089\u308c\u3066\u3044\u3066\uff0c\u9577\u671f\u751f\u5b58\u3092\u5f97\u305f\u5834\u5408\u306e\uff12\u6b21\u816b\u760d\uff0c\u8a8d\u77e5\u6a5f\u80fd\u4f4e\u4e0b\uff0c\u8133\u8840\u7ba1\u969c\u5bb3\uff08\u52d5\u8108\u9589\u585e\uff09\u306a\u3069\u306e\u53ef\u80fd\u6027\u306f\u3068\u3066\u3082\u9ad8\u3044\u3082\u306e\u3068\u306a\u308b\u3067\u3057\u3087\u3046\u3002\u6cbb\u7642\u5f8c10\u5e74\u751f\u5b58\u3057\u305f\u60a3\u5150\u306b\u306e\u591a\u304f\u304c\u3068\u3066\u3082\u56f0\u3063\u305f\u72b6\u614b\u306b\u306a\u3063\u3066\u3044\u308b\u3068\u4e88\u6e2c\u3055\u308c\u307e\u3059\u300220\u5e74\u524d\u304b\u3089\u305d\u3046\u3067\u3059\u304c\uff0c\u6b27\u7c73\u3067\u306fHCG\u306e\u5024\u304c\u304b\u306a\u308a\u4f4e\u3044germinoma\u4ee5\u5916\u306e\u80da\u7d30\u80de\u816b\u760d\u3092\u307f\u3093\u306a\u4e00\u7dd2\u304f\u305f\u306b\u3057\u3066\u6cbb\u7642\u3057\u3088\u3046\u3068\u3057\u307e\u3059\u3002\u305d\u3046\u3057\u306a\u3044\u3068\u7814\u7a76\u306e\u305f\u3081\u306e\u6570 N\u304c\u96c6\u307e\u3089\u306a\u3044\u306e\u3067\u3057\u3087\u3046\u304c\uff0c\u305d\u308c\u3067\u306f\u9577\u671f\u751f\u5b58\u3057\u305f\u60a3\u5150\u306e\u793e\u4f1a\u7684\u306a\u81ea\u7acb\u304c\u5f97\u3089\u308c\u307e\u305b\u3093\u3002<\/p>\n<h4>\u6ce8\u610f\u3057\u3066\u8aad\u307e\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u6709\u540d\u306a\u8ad6\u6587<\/h4>\n<p><strong><span style=\"color: #000080;\">Kellie SJ<\/span>, et al.<\/strong>: Primary chemotherapy for intracranial nongerminomatous germ cell tumors: Results of the Second International CNS Germ Cell Study Group protocol. J Clin Oncol 22: 846-853, 2004<strong><br \/>\n<\/strong>20\u4eba\u306e\u80da\u7d30\u80de\u816b\u760d\uff08germinoma\u3092\u9664\u304f\uff09\u306e\u60a3\u8005\u3055\u3093\u304c\uff0cregimen A (CDDP, VP-16, CPM, BLM)\u3068regimen B (CBDCA, VP-16, BLM)\u306e\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u3066\u3044\u307e\u3059\u3002 \u5b8c\u5168\u5bdb\u89e3\u3068\u306a\u3089\u306a\u304b\u3063\u305f\u60a3\u8005\u3055\u3093\u3067\u624b\u8853\u304b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u306a\u3055\u308c\u307e\u3057\u305f\u3002<br \/>\n\u8ad6\u6587\u306e\u8981\u65e8\u3092\u8aad\u3080\u3068\uff0c\u8a55\u4fa1\u3067\u304d\u305f17\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e\u5185\u306716\u4eba (94%\u594f\u529f\u7387) \u304c\u6709\u52b9 (CR\/PR) \u306b\u306a\u3063\u3066\u3044\u307e\u3059\u30026.3\u5e74\u306e\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u5024\u306720\u4eba\u4e2d\u306e14\u4eba(60%)\u304c\u751f\u5b58\u3057\u3066\u3044\u307e\u3057\u305f\u3002\uff15\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f75%\uff0c\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f36%\u3067\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300d2004\u5e74\u306b\u767a\u8868\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c1994\u5e74\u306b\u8a08\u753b\u3055\u308c\u305f\u6cbb\u7642\u6cd5\u306e\u6210\u7e3e\u3067\u3059\u3002<span style=\"color: #000080;\"><strong><span style=\"color: #000080;\">\u3053\u306e\u8ad6\u6587\u306b\u66f8\u304b\u308c\u3066\u3044\u308b\u6cbb\u7642\u65b9\u91dd\u306f\u73fe\u5728\u3067\u306f\u5168\u304f\u8aa4\u3063\u305f\u3082\u306e\u3068\u8a00\u3048\u307e<\/span>\u3059<\/strong><\/span>\u306e\u3067\uff0c\u3053\u306e\u6cbb\u7642\u65b9\u91dd\u3092\u6a21\u5023\u3057\u3066\u306f\u306a\u308a\u307e\u305b\u3093\u3002\u8ad6\u6587\u3092\u3088\u304f\u8aad\u3080\u3068\u6cbb\u7642\u4e2d\u3068\u5f8c\u306e\u518d\u71c3\uff08\u5897\u60aa\uff09\u304c20\u4f8b\u4e2d\u306e14\u4f8b(70%)\u306b\u3082\u306a\u308a\u307e\u3059\u3002\u3053\u308c\u3089\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\u4e88\u5b9a\u3055\u308c\u305f\u5316\u5b66\u7642\u6cd5\u3092\u7d99\u7d9a\u305b\u305a\u306b\u624b\u8853\u3084\u653e\u5c04\u7dda\u6cbb\u7642\u3067rescue\u3055\u308c\u3066\u3044\u308b\u306e\u3067\u3059\u3002\u660e\u3089\u304b\u306b\u3053\u3053\u306b\u66f8\u304b\u308c\u3066\u3044\u308b\u5316\u5b66\u7642\u6cd5\u306e\u307f\u3067\u306f\u816b\u760d\u3092\u6291\u3048\u304d\u308c\u306a\u3044\u3067\u3059\u3002\u6b7b\u4ea1\u3057\u305f\uff16\u4eba\u306e\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\uff13\u4eba(HCG\/AFP\u7570\u5e38\u9ad8\u5024\uff09\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u3066\u304a\u3089\u305a\uff0c\uff11\u4eba(HCG&gt;3000)\u304c\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u3059\u300214\u540d\u306e\u751f\u5b58\u8005\u306e\u5185\u3067\uff19\u4eba\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u3066\u3044\u307e\u3059\u3002\u3053\u306e\u3053\u3068\u306f\u591a\u304f\u306e\u60a3\u8005\u3055\u3093\u3067\u7d50\u679c\u7684\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u907f\u3051\u5f97\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u306a\u306e\u3067\uff0c\u6700\u521d\u304b\u3089\u6cbb\u7642\u8a08\u753b\u306b\u7d44\u307f\u8fbc\u3080\u3079\u304d\u3067\u3059\u3002\u3053\u306e20\u4f8b\u306e\u4e2d\u306b\u306fAFP\u304c\u6b63\u5e38\u5024\u3067yolk sac tumor\u306e\u7d44\u7e54\u8a3a\u65ad\u3067\u3042\u3063\u305f\u308a\uff0c\u7d44\u7e54\u8a3a\u65ad\u304cgerminoma\u306e\u4f8b\u3082\u542b\u307e\u308c\u3066\u3044\u3066\uff0c\u305d\u3082\u305d\u3082\u6b63\u78ba\u306b\u8a3a\u65ad\u3055\u308c\u3066\u3044\u308b\u304b\u3069\u3046\u304b\u3082\u8003\u3048\u3055\u305b\u3089\u308c\u307e\u3059\u3002<br \/>\n<span style=\"color: #000080;\"><strong>germinoma\u3067\u3055\u3048\u5316\u5b66\u7642\u6cd5\u306e\u307f\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u306a\u3051\u308c\u3070\u518d\u767a\u3092\u6291\u5236\u3067\u304d\u306a\u3044\u3053\u3068\u306f\u77e5\u3089\u308c\u3066\u3044\u307e\u3059\u306e\u306b\uff0c\u3055\u3089\u306b\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u80da\u7d30\u80de\u816b\u760d\u7fa4\u3067\uff0c\u5316\u5b66\u7642\u6cd5\u306b\u53cd\u5fdc\u3059\u308c\u3070\u653e\u5c04\u7dda\u3092\u52a0\u3048\u306a\u3044\u3068\u3044\u3046\u521d\u671f\u6cbb\u7642\u65b9\u91dd\u3092\u7acb\u3066\u308b\u3053\u3068\u306f\u3067\u304d\u307e\u305b\u3093\u3002<\/strong><\/span>\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u80da\u7d30\u80de\u816b\u760d\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u512a\u5148\u7684\u306b\u8003\u616e\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u304c\uff0c\u3069\u306e\u7a0b\u5ea6\u306e\u8133\u810a\u9ac4\u7167\u5c04\uff08\u3042\u308b\u3044\u306f\u7b2c\uff13\u8133\u5ba4\u7167\u5c04\uff09\u3092\u7528\u3044\u308b\u304b\u3068\u3044\u3046\u3053\u3068\u3067\uff0c\u751f\u5b58\u306e\u8cea\uff08\u8a8d\u77e5\u6a5f\u80fd\u306e\u4e88\u5f8c\uff09\u304c\u6c7a\u307e\u308a\u307e\u3059\u3002<\/p>\n<hr \/>\n<h4>\u6587\u732e<\/h4>\n<ol>\n<li>Aoyama H, Shirato H, Ikeda J, Fujieda K, Miyasaka K, Sawamura Y: Induction chemotherapy followed by low-dose involved-field radiotherapy for intracranial germ cell tumors. 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Br J Cancer 78: 828-832, 1998<\/li>\n<li>Freilich RJ, Thompson SJ, Walker RW, et al: Adenocarcinomatous transformation of intracranial germ cell tumors. Am J Surg Pathol 19: 537-544, 1995<\/li>\n<li>Furuhata S, Yamada F, Fukuda S, Otani M, Toya S: Mixed germ cell tumor of the basal ganglia: a case report. Surg Neurol 41:490-493, 1994<\/li>\n<li>Goldman S, et al.: Phase II Trial Assessing the Ability of Neoadjuvant Chemotherapy With or Without Second-Look Surgery to Eliminate Measurable Disease for Nongerminomatous Germ Cell Tumors: A Children&#8217;s Oncology Group Study. J Clin Oncol 33: 2464-2471, 2015<\/li>\n<li>Haddock MG, Schild SE, Scheithauer BW, Schomberg PJ: Radiation therapy for histologically confirmed primary central nervous system germinoma. Int J Rad Oncol Biol Phy 38: 915-923, 1997<\/li>\n<li>Hinton S, Catalano PJ, Einhorn LH, Nichols CR, David Crawford E, Vogelzang N, Trump D, Loehrer PJ Sr: Cisplatin, etoposide and either bleomycin or ifosfamide in the treatment of disseminated germ cell tumors: final analysis of an intergroup trial. Cancer 97:1869-1875, 2003<\/li>\n<li>Hinton S, Catalano P, Einhorn LH, Loehrer PJ Sr Kuzel T, Vaughn D, Wilding G: Phase II study of paclitaxel plus gemcitabine in refractory germ cell tumors (E9897): A trial of the eastern cooperative oncology group. J Clin Oncol 20:1859-1863, 2002<\/li>\n<li>Jennings MT, Gelman R, Hochberg F et al:\u3000 Intracranial germ cell tumors. Natural history and pathogenesis.\u3000 J Neurosurg 63: 155-167,1985<\/li>\n<li>Kawakami Y, Yamada O, Tabuchi K, Ohmoto T, Nishimoto A: Primary intracranial choriocarcinoma. J Neurosurg 53:369-374, 1980<\/li>\n<li><\/li>\n<li>Kato T, Sawamura Y, Tada T, Murata J, Abe H, Shirato H, Fujieda K: Occult neurohypophyseal germinomas in patients presenting with central diabetes insipidus. Neurosurg Focus 5: 1-6, 1998<\/li>\n<li>Koyama S, Tsubokawa T, Katayama Y, Hirota H: Choriocarcinoma of the septum pellucidum: case report. Surg Neurol 35:478-482, 1991<\/li>\n<li>Ikeda J, Sawamura Y, Tada M, Abe H: Metachronous neurohypohyseal germinoma occuring eight years after total resection of mature teratoma. Surg Neurol 49: 205-209, 1998<\/li>\n<li>Kida Y, Kobayashi T, Yoshida J, Kato K, Kageyama N: Chemotherapy with cisplatin for AFP-secreting germ-cell tumors of the central nervous system. J Neurosurg. 65: 470-475, 1986<\/li>\n<li>Kochi M, Itoyama Y, Shiraishi S, Kitamura I, Marubayashi T, Ushio Y: Successful treatment of intracranial nongerminomatous malignant germ cell tumors by administering neoadjuvant chemotherapy and radiotherapy before excision of residual tumors. J Neurosurg 99: 106-114, 2003<\/li>\n<li>Merchant TE, Sherwood SH, Mulhern RK, Rose SR,- Thompson SJ, Sanford RA, Kun LE: CNS germinoma: Disease control and long-term functional outcome for 12 children treated with craniospinal irradiation. Int J Rad Oncol Biol Phys 46: 1171-1176, 2000<\/li>\n<li>Meagher-Villemure K: Pathology. Sawamura Y, Shirato H, de Tribolet N (eds), Springer-Verlag, Wien, 1998, pp. 17-36<\/li>\n<li>Matsutani M, Sano K, Takakura K, Fujimaki T, Nakamura O, Funata N, Seto T: Primary intracranial germ cell tumors &#8211; a clinical analysis of 153 histologically verified cases. J Neurosurg 86:446-455, 1997<\/li>\n<li>Miyanohara O, Takeshima H, Kaji M, Hirano H, Sawamura Y, Kochi M, Kuratsu J: Diagnostic significance of soluble c-kit in the cerebrospinal fluid of patients with germ cell tumor. J Neurosurg 97: 177-183, 2002<\/li>\n<li>Nichols CR, Catalano PJ, Crawford ED, Vogelzang NJ, Einhorn LH, Loehrer PJ: Randomized comparison of cisplatin and etoposide and either bleomycin or ifosfamide in treatment of advanced disseminated germ cell tumors: an Eastern Cooperative Oncology Group, Southwest Oncology Group, and Cancer and Leukemia Group B Study. J Clin Oncol 16: 1287-1293, 1998<\/li>\n<li>O&#8217;Callaghan AM, Katapodis O, Ellison DW, Theaker JM, Mead GM: The growing teratoma syndrome in a nongerminomatous germ cell tumor of the pineal gland: a case report and review. Cancer 80: 942-947, 1997<\/li>\n<li>Packer RJ, Sutton LN, Rorke LB, et al: Intracranial embryonal cell carcinoma. Cancer 54: 520-524, 1984<\/li>\n<li>Piamsomboon S, Kudelka AP, Termrungruanglert W, Vanbesien K, Edwards CL, Lifshitz S, Schomer DF, Champlin R, Mante RP, Kavanagh JJ, Verschraegen CF: Remission of refractory gestational trophoblastic disease in the brain with ifosfamide, carboplatin, and etoposide (ice) &#8211; first report and review of literature. Eur J Gynaecol Oncol 18:453-456, 1997<\/li>\n<li>Sawamura Y, Shirato H, Ikeda J, Tada M, Ishii M, Kato T, Abe H, Fujieda K: Induction Chemotherapy Followed by Reduced-Volume Irradiation for Newly Diagnosed CNS Germinoma. J Neurosurg 88: 66-72, 1998<\/li>\n<li>Sawamura Y: Current diagnosis and treatment of central nervous system germ cell tumours.\u3000 Curr Opin Neurol 9 (6): 419-423, 1996<\/li>\n<li>Sawamura Y, Ikeda J, Shirato H, Tada M, Abe H: Germ Cell Tumors of The Central Nervous System: Treatment Consideration Based on 111 Cases and their Long-Term Clinical Outcomes. Eur J Cancer 34: 104-110, 1998<\/li>\n<li>Sawamura Y, Shirato H, de Tribolet N: Recent advances in the treatment of central nervous system germ cell tumors. Adv Tech Stand Neurosurg 25: 141-159, 1999<\/li>\n<li>Sawamura Y, de Tribolet N, Ishii N, Abe H: Surgical Management of Primary Intracranial Germinomas: Diagnostic Surgery or Radical Resection ? J Neurosurg 87: 262-266, 1997<\/li>\n<li>Sawamura Y: Overview for management. in Intracranial Germ Cell Tumors. Sawamura Y, Shirato H, de Tribolet N (eds), Springer-Verlag, Wien, 1998, pp169-191<\/li>\n<li>Sawamura Y: Prognosis of central nervous system germ cell tumors. in Intracranial Germ Cell Tumors. Sawamura Y, Shirato H, de Tribolet N (eds), Springer-Verlag, Wien, 1998, pp155-168<\/li>\n<li>Sawamura Y, Ikeda J, Ishii N, Kato T, Tada T, Abe H, Shirato H: Combined irradiation and chemotherapy using ifosfamide, cisplatin, and etoposide for children with medulloblastoma\/posterior fossa primitive neuroectodermal tumor. Neurol Med Chirur (Tokyo) 36: 632-638, 1996<\/li>\n<li>Sawamura Y, Kato T, Ikeda J, Tada M, Shirato H: Teratomas of The Central Nervous System: Treatment Consideration Based on 34 Cases. J Neurosurg 89: 728-737, 1998<\/li>\n<li>Schechter NR, Mychalczak B, Jones W, Spriggs D: Prognosis of patients treated with whole-brain radiation therapy for metastatic gestational trophoblastic disease Gynecologic Oncology 168:183-192, 1998<\/li>\n<li>Schneider DT, Schuster AE, Fritsch MK, Calaminus G, Gobel U, Harms D, Lauer S, Olson T, Perlman EJ: Genetic analysis of mediastinal nonseminomatous germ cell tumors in children and adolescents. Genes Chromosomes Cancer 34: 115-25, 2002<\/li>\n<li>Shirato H, Nishio M, Sawamura Y, Myohjin M, Kitahara T, Nishioka T, Mizutani Y, Abe H, Miyasaka K: Analysis of long-term treatment of intracranial germinoma. Int J Radiation Oncology Biol Phys 37:511-515, 1997<\/li>\n<li>Sievers EL, Berger M, Geyer JR: Long-term survival of a patient with primary sellar choriocarcinoma with pulmonary metastases &#8211; a case report, Med Pediat Oncol 26:293-295, 1996<\/li>\n<li>Sudo A, Shiga T, Okajima M, Takano K, Terae S, Sawamura Y, Ohnishi A, Nagashima K, Saitoh S. Links: High Uptake on (11)C-methionine Positron Emission Tomographic Scan of Basal Ganglia Germinoma with Cerebral Hemiatrophy. AJNR Am J Neuroradiol. 24: 1909-1911, 2003<\/li>\n<li>Tapper D, Lack EE: Teratomas in infancy and childhood. Ann Surg 198: 398-410, 1983<\/li>\n<li>Ushio Y, Kochi M, Kuratsu J, Itoyama Y,- Marubayashi T: Preliminary observations for a new treatment in children with primary intracranial yolk sac tumor or embryonal carcinoma. Report of five cases. J Neurosurg 90:133-137, 1999<\/li>\n<li>Yoshida K, Sawamura Y: Clinical Findings and Diagnosis, Ophthalmological manifestations. Sawamura Y, Shirato H, de Tribolet N (eds), Springer-Verlag, Wien, 1998, pp137-145<\/li>\n<li>Yoshida J, Sugita K, Kobayashi T, Takakura K, Shitara N, Matsutani M, Tanaka R,Nagai H, Yamada H, Yamashita J: Prognosis of intracranial germ cell tumours: effectiveness of chemotherapy\u3000 with cisplatin and etoposide (CDDP and VP-16) Acta Neurochir (Wien) 120: 111-117, 1993<\/li>\n<\/ol>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/book.png\" rel=\"attachment wp-att-8599\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-8599\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/book-448x600.png\" alt=\"book\" width=\"448\" height=\"600\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/book-448x600.png 448w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/book-224x300.png 224w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/book.png 587w\" sizes=\"auto, (max-width: 448px) 100vw, 448px\" \/><\/a><\/p>\n<p style=\"text-align: center;\">1998\u5e74\u306bSpringer\u304b\u3089\u51fa\u7248\u3057\u305f\u82f1\u6587\u306e\u6210\u66f8\u3067\u3059\u3002<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u982d\u84cb\u5185\u539f\u767a\uff08\u8133\uff09\u80da\u7d30\u80de\u816b\u760d\u306e\u75c5\u7406\u306f\u3059\u3054\u304f\u8907\u96d1\u3067\u3059 \u6cbb\u7642\u306f\u3053\u306e\u75c5\u6c17\u306b\u3068\u3063\u3066\u3082\u8a73\u3057\u3044\u5c02\u9580\u5bb6\u306b\u3057\u304b\u3067\u304d\u307e\u305b\u3093 \u5e73\u5747\u5e74\u9f62\u306f15\u6b73\u304f\u3089\u3044\u3067\u5b50\u4f9b\u306b\u591a\u3044\u816b\u760d\u3067\u3059 90%\u304c20\u6b73\u672a\u6e80\u306b\u767a\u751f\u3057\u307e\u3059 \u4e0b\u5782\u4f53\uff0c\u8996\u5e8a\u4e0b\u90e8\uff0c\u677e\u679c\u4f53\u3068\u3044\u3046\u5834\u6240\u306b\u3067\u304d [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-173","post","type-post","status-publish","format-standard","hentry","category-germcelltumors"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/173","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=173"}],"version-history":[{"count":90,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/173\/revisions"}],"predecessor-version":[{"id":23578,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/173\/revisions\/23578"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/media?parent=173"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/categories?post=173"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/tags?post=173"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}