{"id":177,"date":"2012-04-19T02:24:27","date_gmt":"2012-04-18T17:24:27","guid":{"rendered":"\/sawamura\/wp\/?p=177"},"modified":"2023-11-14T12:05:23","modified_gmt":"2023-11-14T03:05:23","slug":"germinoma","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/germcelltumors\/germinoma\/","title":{"rendered":"\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u80da\u816b\uff09germinoma"},"content":{"rendered":"<div class=\"setumei\">\n<h1>intracranial germinoma, CNS germinoma<\/h1>\n<h5 class=\"style1\"><span style=\"color: #000080;\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u518d\u767a\u306e\u76f8\u8ac7\u3092\u53d7\u3051\u308b\u3053\u3068\u304c\u3042\u308a<\/span><span style=\"color: #000080;\">\u307e\u3059<\/span><br \/>\n<span style=\"color: #000080;\"> \u653e\u5c04\u7dda\u6cbb\u7642\u306e\u9818\u57df\u304c\u72ed\u3044\uff08\u5c40\u6240\u7167\u5c04\uff09\u305f\u3081\u306b\u751f\u3058\u308b\u3053\u3068\u304c\u307b\u3068\u3093\u3069\u3067\u3059<strong style=\"color: #000080;\"><br \/>\n<\/strong><strong><span style=\"color: #ff0000;\">\u5168\u8133\u5ba4\u3082\u3057\u304f\u306f\u3088\u308a\u5e83\u3044\u7167\u5c04\u91ce\u3092\u9078\u3070\u306a\u3044\u3068\u3001\u9ad8\u7387\u306b\u518d\u767a\u3059\u308b\u816b\u760d<\/span>\u3067\u3059\u00a0<\/strong><\/span><\/h5>\n<h4>\u5927\u5207\u306a\u3053\u3068<\/h4>\n<ul>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u8133\u306b\u3067\u304d\u308b\u80da\u7d30\u80de\uff08\u306f\u3044\u3055\u3044\u307c\u3046\uff09\u816b\u760d\u306e70%\u3092\u5360\u3081\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u5e73\u5747\u5e74\u9f62\u306f15\u6b73<\/strong><\/span>\uff0c\u7537\u306e\u5b50\u306b\u591a\u3044\u816b\u760d\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u4e0b\u5782\u4f53\uff0c\u8996\u5e8a\u4e0b\u90e8\uff0c\u677e\u679c\u4f53\uff0c\u5927\u8133\u57fa\u5e95\u6838<\/strong><\/span>\u3068\u3044\u3046\u5834\u6240\u306b\u3067\u304d\u307e\u3059<\/li>\n<li>\u677e\u679c\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u6027\u5dee\u304c\u3042\u308a\uff0c\u7537\u5150\u306b\u591a\u3044\u3067\u3059<\/li>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u60aa\u6027\u816b\u760d\u3067\u3059\u304c\uff0c<span style=\"color: #000080;\"><strong>\u304d\u3061\u3093\u3068\u3057\u305f\u6cbb\u7642\u3092\u3059\u308c\u307095%\u4ee5\u4e0a\u306f\u6cbb\u308a\u307e\u3059<\/strong><\/span><\/li>\n<li>\u8a3a\u65ad\u306fMRI\u3067\u307b\u3068\u3093\u3069\u5206\u304b\u308a\u307e\u3059<\/li>\n<li>\u8a3a\u65ad\u306b\u5f71\u97ff\u304c\u51fa\u308b\u306e\u3067\uff0c<span style=\"color: #ff0000;\"><strong>\u8133\u8840\u7ba1\u64ae\u5f71\u3084CT\u306a\u3069\u306eX\u7dda\u691c\u67fb\u3092\u907f\u3051\u307e\u3059<\/strong><\/span><\/li>\n<li>\u624b\u8853\u306f\u7121\u7406\u306e\u306a\u3044<span style=\"color: #000080;\"><strong>\u751f\u691c\u8853\uff08\u3061\u3087\u3063\u3068\u53d6\u308b\uff09\u4ee5\u5916\u306b\u5fc5\u8981\u3042\u308a\u307e\u305b\u3093<\/strong><\/span><\/li>\n<li>\u624b\u8853\u3067\u305f\u304f\u3055\u3093\u53d6\u308b\u306e\u306f\u624b\u8853\u306e\u5371\u967a\u304c\u9ad8\u304f\u306a\u308b\u3060\u3051\u3067\u4f55\u306e\u5229\u76ca\u3082\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3092\u7591\u3063\u3066\u624b\u8853\u3092\u3059\u308b\u306e\u306a\u3089\u3067\u304d\u308b\u3060\u3051\u30ea\u30b9\u30af\u306e\u5c11\u306a\u3044\u624b\u6bb5\u3092\u9078\u3076\u3079\u304d\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u6c34\u982d\u75c7\u306b\u306f\u30b7\u30e3\u30f3\u30c8\u306f\u5fc5\u8981\u3042\u308a\u307e\u305b\u3093<\/strong><\/span>\u3057\uff0c\u884c\u3063\u3066\u306f\u3044\u3051\u307e\u305b\u3093<\/li>\n<li>\u5185\u8996\u93e1\u306b\u3088\u308b\u7b2c\uff13\u8133\u5ba4\u958b\u7a93\u8853\u3067\u6c34\u982d\u75c7\u3092\u6cbb\u3059\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u304c\uff0c\u3042\u308b\u7a0b\u5ea6\u306e\u30ea\u30b9\u30af\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u30b7\u30e3\u30f3\u30c8\u3092\u3069\u3046\u3057\u3066\u3082\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u3068\u5224\u65ad\u3057\u305f\u3089\uff0c\u305d\u3046\u3057\u306a\u3044\u3067<span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"\/sawamura\/surgtech\/drainage\/ \">\u9577\u671f\u7559\u7f6e\u578b\u306e\u8133\u5ba4\u30c9\u30ec\u30ca\u30fc\u30b8<\/a><\/strong><\/span>\u3092\u8a2d\u7f6e\u3057\u307e\u3059<\/li>\n<li><span style=\"color: #ff0000;\"><strong>MRI\u3067\u898b\u3048\u308b\u3088\u308a\uff0c\u5b9f\u969b\u306b\u306f\u816b\u760d\u306f\u5468\u56f2\u306b\u96a0\u308c\u3066\u5e83\u304c\u3063\u3066\u3044\u307e\u3059<\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong><a title=\"\u8133\u5ba4\u306e\u89e3\u5256\u56f3\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/anatomys\/temporal-2\/\">\u8133\u5ba4\u306e\u89e3\u5256\u56f3<\/a>\u306e\u58c1\u306b\u6cbf\u3063\u3066\u5e83\u304c\u3063\u3066\u3044\u304f<\/strong><\/span>\u6027\u8cea\u3092\u3082\u3063\u3066\u3044\u307e\u3059<\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3046\u307e\u304f\u7d44\u307f\u5408\u308f\u305b\u3066\u6cbb\u3059\u306e\u304c\u4e16\u754c\u6a19\u6e96\u306b\u306a\u308a\u307e\u3057\u305f<\/li>\n<li><span style=\"color: #000080;\"><strong>\uff11-\uff12\u30b3\u30fc\u30b9\u306e\u5316\u5b66\u7642\u6cd5\uff08\u5236\u304c\u3093\u5264\uff09\u3067\u307b\u3068\u3093\u3069\u7121\u304f\u306a\u308a\u307e\u3059\uff08\u6d88\u5931\uff09<\/strong><\/span>\u3057\u307e\u3059<\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u306f\uff13\u304b\u3089\uff14\u30b3\u30fc\u30b9\u3057\u307e\u3059\u304b\u3089\uff0c\uff13\u304b\u3089\uff14\u30f6\u6708\u304f\u3089\u3044\u304b\u304b\u308a\u307e\u3059<\/li>\n<li><a href=\"..\/braintumors\/radiation\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"color: #000000;\">\u653e\u5c04\u7dda\u6cbb\u7642\u306f<\/span><span style=\"color: #000080;\"><strong>\u4f4e\u3044\u7dda\u91cf\uff0823.4\u304b\u308925.2\u30b0\u30ec\u30a4\uff09\u3067\u5168\u8133\u5ba4\u3092\u30ab\u30d0\u30fc<\/strong><\/span><\/a>\u3067\u304d\u308b\u3088\u3046\u306b\u304b\u3051\u307e\u3059<\/li>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u6cbb\u7642\u306b<span style=\"color: #000080;\"><strong>\u5c40\u6240\u7167\u5c04\u3001\u62e1\u5927\u5c40\u6240\u3001\u5b9a\u4f4d\u7167\u5c04\u3001\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u3092\u4f7f\u3063\u3066\u306f\u306a\u308a\u307e\u305b\u3093<\/strong><\/span>\uff0c\u518d\u767a\u3057\u307e\u3059<\/li>\n<li>30\u30b0\u30ec\u30a4\u4ee5\u4e0a\u306e\u9ad8\u3044\u7dda\u91cf\u3067\u306f\u8133\u306e\u969c\u5bb3\uff08\u9ad8\u6b21\u8133\u6a5f\u80fd\u969c\u5bb3\u30fb\u8a8d\u77e5\u6a5f\u80fd\u30fb\u77e5\u80fd\u306e\u4f4e\u4e0b\uff0c\u4e0b\u5782\u4f53\u6a5f\u80fd\u4f4e\u4e0b\uff09\u304c\u51fa\u308b\u6050\u308c\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u5f8c\u907a\u75c7\u306f\u624b\u8853\u3068\u653e\u5c04\u7dda\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>\u591a\u3044\u91cf\u306e\u5316\u5b66\u7642\u6cd5\u3060\u3051\u3067\u6cbb\u305d\u3046\u3068\u3044\u3046\u8a66\u307f\u304c\u3042\u308a\u307e\u3057\u305f\u304c\u5931\u6557\u306b\u7d42\u308f\u308a\u307e\u3057\u305f<\/li>\n<li><span style=\"color: #000080;\"><strong>\u6975\u3081\u3066\u7a00\u306b\uff01 \u9ac4\u6db2\u306b\u306e\u3063\u3066\u810a\u9ac4\u306b\u64ad\u7a2e\uff08\u8ee2\u79fb\uff09\u3059\u308b<\/strong><\/span>\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u6cbb\u308a\u307e\u3059<\/li>\n<li>\u30e1\u30bd\u30c8\u30ec\u30ad\u30bb\u30fc\u30c8MTX\u306e\u9ac4\u8154\u5185\u6ce8\u5165\u306f\u3057\u306a\u304f\u3066\u3082\u6cbb\u308a\u307e\u3059\u3057\uff0c\u6709\u52b9\u6027\u306f\u5168\u304f\u793a\u3055\u308c\u3066\u3044\u306a\u3044\u306e\u3067\u3057\u3066\u306f\u3044\u3051\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #000080;\"><strong>\u5185\u5206\u6ccc\uff08\u4e0b\u5782\u4f53\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>2023\u5e74\u3001\u79c1\u304c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3092\u78ba\u5b9f\u306b\u6cbb\u305b\u308b\u3068\u8003\u3048\u308b\u6cbb\u7642\u6cd5\u306f\u3001ICE (IFO\/CDDP\/VP-16) \u5316\u5b66\u7642\u6cd53\u30b3\u30fc\u30b9\u306e\u5f8c\u3067\u300125.2\u30b0\u30ec\u30a414\u5206\u5272\u306e\u5168\u8133\u5ba4\u7167\u5c04\u3092\u52a0\u3048\u308b\u3053\u3068\u3067\u3059<\/li>\n<li>\u3053\u308c\u3067\u3001\u793e\u4f1a\u5fa9\u5e30\u3082\u3067\u304d\u307e\u3059\u3057\u3001\u9045\u767a\u6027\u969c\u5bb3\u3082\u306a\u304f\u3001\u307b\u307c\u6cbb\u7652\u3057\u307e\u3059<\/li>\n<li>10\u5e74\u9577\u671f\u751f\u5b58\u5272\u5408\u306f\u300c100\uff05\u306b\u8fd1\u3044\u300d\u3068\u671f\u5f85\u3067\u304d\u308b\u6642\u4ee3\u306b\u306a\u308a\u307e\u3057\u305f<\/li>\n<\/ul>\n<h5>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u6700\u5927\u306e\u7279\u5fb4\u306f<span style=\"color: #ff0000;\">\u8133\u5ba4\u4e0a\u8863\u4e0b\u6d78\u6f64<\/span> subependymal infiltration \u3067\u3059\u304b\u3089\u305d\u308c\u3092\u5ff5\u982d\u306b\u3044\u308d\u3044\u308d\u8003\u3048\u307e\u3059<\/h5>\n<hr \/>\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u8a3a\u65ad<\/h4>\n<h5>\u75c7\u72b6<\/h5>\n<ul>\n<li><span style=\"color: #000080;\"><strong>\u5c3f\u5d29\u75c7<\/strong><\/span>\uff08\u6c34\u3092\u305f\u304f\u3055\u3093\u98f2\u3080\uff09\u3067\u767a\u75c7\u3059\u308b\u3053\u3068\u304c\u6700\u3082\u591a\u3044\u3067\u3059<\/li>\n<li>\u8996\u4ea4\u53c9\u306b\u6d78\u6f64\u3059\u308b\u3082\u306e\u3067\u306f\uff0c\u8996\u529b\u4f4e\u4e0b\u3068\u8996\u91ce\u6b20\u640d\u304c\u3067\u307e\u3059<\/li>\n<li>\u677e\u679c\u4f53\u306b\u3067\u304d\u305f\u3082\u306e\u3067\u306f<span style=\"color: #000080;\"><strong>\u6c34\u982d\u75c7\u306b\u306a\u3063\u3066\u982d\u75db<\/strong><\/span>\uff0c\u5614\u5410\uff0c\u8907\u8996\uff08\u7269\u304c\uff12\u91cd\u306b\u307f\u3048\u308b\uff09\u304c\u3067\u307e\u3059<\/li>\n<li>\u5c0f\u5b66\u6821\u306b\u5165\u3063\u305f\u9803\u304b\u3089\u80cc\u304c\u4f38\u3073\u306a\u3044\uff08\u4f4e\u8eab\u9577\uff09<\/li>\n<li>\u3086\u3063\u304f\u308a\u624b\u8db3\u306e\u9ebb\u75fa\u304c\u9032\u3093\u3060\u308a\uff0c\u6027\u683c\u5909\u5316\uff08\u591a\u52d5\uff0cADHD\u306a\u3069\uff09\u304c\u60aa\u5316\u3059\u308b\u306e\u306f\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/li>\n<\/ul>\n<h5>MRI<\/h5>\n<ul>\n<li>\u6cbb\u7642\u306e\u524d\u306b\u5fc5\u305a\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u9020\u5f71\u5264\u3092\u4f7f\u3063\u3066<span style=\"color: #000080;\"><strong>\u5168\u90e8\u306e\u8133\u3068\u810a\u9ac4\u3092\u691c\u67fb<\/strong><\/span>\u3057\u307e\u3059<\/li>\n<\/ul>\n<h5>CT<\/h5>\n<ul>\n<li>\u884c\u3046\u5fc5\u8981\u304c\u306a\u3044\u3057\u57fa\u672c\u7684\u306b\u8a3a\u65ad\u306e\u305f\u3081\u306eX\u7ddaCT\u3092\u3057\u3066\u306f\u3044\u3051\u307e\u305b\u3093<\/li>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304bLCH\u304b\u3092\u7591\u3063\u305f\u3068\u304d\u306b<strong><span style=\"color: #ff0000;\">CT\u3092\u3059\u308b\u3068\uff0c\u305d\u308c\u3060\u3051\u306e\u88ab\u66dd\u3067\u816b\u760d\u7d30\u80de\u304c\u6d88\u3048\u3066\u3057\u307e\u3063\u3066\uff0c\u751f\u691c\u8853\u3067\u816b\u760d\u304c\u8a3c\u660e\u3055\u308c\u306a\u3044<\/span><\/strong>\u3068\u3044\u3046\u3053\u3068\u304c\u3057\u3070\u3057\u3070\u3042\u308b\u304b\u3089\u3067\u3059<\/li>\n<\/ul>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihmri-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-15386\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihmri-1-300x295.jpg\" alt=\"\" width=\"300\" height=\"295\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihmri-1-300x295.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihmri-1-550x542.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihmri-1-768x756.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihmri-1.jpg 794w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihct.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-15385\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihct-300x290.jpg\" alt=\"\" width=\"300\" height=\"290\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihct-300x290.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihct-550x531.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihct-768x742.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihct.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihct.jpg\"><br \/>\n<\/a><\/p>\n<p>10\u6b73\u304f\u3089\u3044\u304b\u3089\u8eab\u9577\u306e\u4f38\u3073\u304c\u9045\u304f\u306a\u3063\u3066\uff0c12\u6b73\u3067\u98df\u6b32\u4f4e\u4e0b\u3068\u4f53\u91cd\u6e1b\u5c11\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u5de6\u306eMRI\u306f\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u9020\u5f71MRI\u3067\uff0c\u8996\u5e8a\u4e0b\u90e8\u3068\u4e0b\u5782\u4f53\u3092\u4fb5\u3059\u795e\u7d4c\u4e0b\u5782\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3059\u3002CT\u3067\u306f\u5c0f\u3055\u306a\u77f3\u7070\u5316\uff08\u767d\u3044\u70b9\uff09\u304c\u307f\u3048\u307e\u3059\u3002CT\u691c\u67fb\u306f\u4e0d\u5fc5\u8981\u306a\u3082\u306e\u3067\u3057\u305f\u3002<\/p>\n<h5>\u816b\u760d\u30de\u30fc\u30ab\u30fc<\/h5>\n<ul>\n<li>\u5165\u9662\u3057\u305f\u3089\u3059\u3050\u306b\u8840\u6db2\u306e<span style=\"color: #ff0000;\"><strong>HCG-\u03b2 (\u30d9\u30fc\u30bf)<\/strong><span style=\"color: #333333;\">\u3068<\/span><strong>AFP<\/strong><\/span>\u306f\u5fc5\u305a\u8abf\u3079\u307e\u3059<\/li>\n<li>\u3068\u3066\u3082\u7cbe\u5bc6\u306a\u65b9\u6cd5\u3067\u6e2c\u5b9a\u3059\u308b\u3068<span style=\"color: #000080;\"><strong>\u3059\u3079\u3066\u306e\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067HCG\u306f\u967d\u6027<\/strong><\/span>\u306b\u306a\u308a\u307e\u3059<\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u9ac4\u6db2\u306ePLAP<\/strong><span style=\"color: #333333;\">\u3092<\/span><\/span>\u8abf\u3079\u307e\u3059\uff0c\u9ac4\u6db2HCG-beta\u306f\u3067\u304d\u308c\u3070\u6e2c\u5b9a\u3057\u305f\u65b9\u304c\u3044\u3044\u3067\u3059<\/li>\n<li>\u5c0f\u3055\u306a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u306f\uff0c\u901a\u5e38\u691c\u67fb\u306eHCG-beta\u306f\u967d\u6027\u306b\u306a\u308a\u307e\u305b\u3093\u304b\u3089\u8981\u6ce8\u610f<\/li>\n<li>\u9ac4\u6db2\u3068\u8840\u6e05\u3092\u691c\u4f53\u3068\u3057\u3066\uff0c\u8d85\u9ad8\u611f\u5ea6HCG-beta\u6e2c\u5b9a\uff0c<span style=\"color: #000080;\"><strong>PLAP<\/strong><\/span>\u6e2c\u5b9a\u3068\u3044\u3046\u691c\u67fb\u3092\u3059\u308b\u3068\u967d\u6027\u5024\u306b\u3067\u307e\u3059<\/li>\n<\/ul>\n<h5>\u624b\u8853<\/h5>\n<ul>\n<li>\u753b\u50cf\u3060\u3051\u3067\u306f\u9593\u9055\u3046\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u304b\u3089<strong><span style=\"color: #ff0000;\">\u751f\u691c\u8853<\/span><\/strong><span style=\"color: #333333;\">\uff08\u816b\u760d\u3092\u3061\u3087\u3063\u3068\u3060\u3051\u53d6\u308b\u624b\u8853\uff09\u3092\u3057\u307e\u3059<\/span><\/li>\n<li>\u306a\u308b\u3079\u304f\u958b\u982d\u624b\u8853\u3092\u3057\u306a\u3044\u3067<strong><span style=\"color: #333333;\"><a style=\"color: #333333;\" href=\"http:\/\/www.youtube.com\/watch?v=SN-4WnJMIIw&amp;feature=youtube_gdata_player\" target=\"_blank\" rel=\"noopener noreferrer\">\u5185\u8996\u93e1\u624b\u8853<\/a><\/span><\/strong>\uff0c<span style=\"color: #000080;\"><strong>\u7d4c\u8776\u5f62\u9aa8\u6d1e\u624b\u8853<\/strong><\/span>\uff0c\u5b9a\u4f4d\u8133\u624b\u8853\u3092\u9078\u3073\u307e\u3059<\/li>\n<li>\u624b\u8853\u304c\u5371\u967a\u306a\u5834\u5408\u306b\u306f<span style=\"color: #000080;\"><strong>\u751f\u691c\u8853\u3092\u3057\u306a\u3044\u3067\u753b\u50cf\u8a3a\u65ad\u3060\u3051\u3067\u6cbb\u7642<\/strong><\/span>\u306b\u5165\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u677e\u679c\u4f53\u306e\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u9589\u585e\u6027\u6c34\u982d\u75c7\u3092\u5408\u4f75\u3057\u3066\u3044\u308b\u6642\u306b\u306f\uff0c\u751f\u691c\u8853\u3068\u540c\u6642\u306b\uff0c\u7b2c\uff13\u8133\u5ba4\u958b\u7a93\u8853\u3092\u3059\u308c\u3070\u6539\u5584\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059<\/li>\n<li>\u3067\u3082\u5185\u8996\u93e1\u3092\u4f7f\u3046\u306e\u3067\u30ea\u30b9\u30af\u3082\u3042\u308a\u7121\u7406\u3092\u3057\u306a\u3044\u3053\u3068\u304c\u809d\u8981\u3067\u3059<\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u30921\u30b3\u30fc\u30b9\u3059\u308c\u3070\u6570\u65e5\u3067\u9589\u585e\u6027\u6c34\u982d\u75c7\u304c\u6539\u5584\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u306e\u3067\uff0c\u6c34\u982d\u75c7\u306b\u5bfe\u3057\u3066\u306f\uff0c\u307e\u305a\u306f\u30b7\u30e3\u30f3\u30c8\u3092\u3057\u306a\u3044\u3067\u5916\u30c9\u30ec\u30ca\u30fc\u30b8\u3067\u56de\u907f\u3059\u308b\u3068\u3044\u3046\u9078\u629e\u80a2\u304c\u6709\u529b\u3067\u3059<\/li>\n<\/ul>\n<h5>\u9ac4\u6db2\u7d30\u80de\u8a3a<\/h5>\n<ul>\n<li>\u9ac4\u6db2\u7d30\u80de\u8a3a\u306f\u5fc5\u8981\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u9ac4\u6db2\u7d30\u80de\u8a3a\u306f\u64ec\u967d\u6027\u304c\u591a\u3044\u306e\u3067\uff0c\u967d\u6027\u3068\u3044\u3046\u7d50\u679c\u3067\u3082\u5b89\u6613\u306b\u9ac4\u6db2\u64ad\u7a2e\u3068\u3057\u3066\u6cbb\u7642\u3092\u3057\u3066\u306f\u306a\u308a\u307e\u305b\u3093<\/li>\n<\/ul>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/CSFstudy-germinoma.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-9770 size-medium\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/CSFstudy-germinoma-300x281.jpg\" alt=\"\" width=\"300\" height=\"281\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/CSFstudy-germinoma-300x281.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/CSFstudy-germinoma-768x719.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/CSFstudy-germinoma-550x515.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/CSFstudy-germinoma.jpg 857w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\n\u3053\u308c\u306f1994\u5e74\u306e\u8133\u5ba4\u6db2\u7d30\u80de\u8a3a\u3067\uff0c\u5927\u578b\u306e\u6838\u5c0f\u4f53\u3092\u6709\u3059\u308b\u816b\u760d\u7d30\u80de\u304c\u3042\u308a\u307e\u3059<br \/>\n\u3057\u304b\u3057\uff0c<span style=\"color: #000080;\"><strong>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u9ac4\u6db2\u64ad\u7a2e\u306f\u5b9f\u969b\u306b\u306f\u307b\u3068\u3093\u3069\u7121\u3044<\/strong><\/span>\u3068\u3044\u3048\u308b\u304f\u3089\u3044\u73cd\u3057\u3044\u3082\u306e\u3067\u3059<br \/>\n\u591a\u304f\u306e\u5834\u5408\uff0cMRI\u3067\u64ad\u7a2e\u3068\u8aad\u5f71\u3055\u308c\u3066\u3082\uff0c\u8133\u5ba4\u58c1\u4e0a\u8863\u4e0b\u4f38\u5c55\u3092\u64ad\u7a2e\u3068\u8aad\u307f\u9593\u9055\u3048\u3066\u3044\u308b\u3060\u3051\u306a\u306e\u3067\u3059<\/p>\n<p>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u9ac4\u6db2\u64ad\u7a2e\u3068\u3044\u3046\u8a3a\u65ad\u306f\uff0c\u300c<strong><span style=\"color: #000080;\">\u8133\u5ba4\u5916\u306e\u8133\u810a\u9ac4\u8868\u9762\u306b\u7d50\u7bc0\u72b6\u306e\u816b\u760d<\/span><\/strong>\u300d\u304cMRI\u3067\u306f\u3063\u304d\u308a\u8a8d\u8b58\u3067\u304d\u305f\u6642\u306e\u307f\u3067\u3059\uff0c\u7d30\u80de\u8a3a\u3067\u306f\u6c7a\u307e\u308a\u307e\u305b\u3093<\/p>\n<h5>\u5185\u5206\u6ccc\u691c\u67fb<\/h5>\n<ul>\n<li>\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3057\u305f\u3089\uff0c\u4e0b\u5782\u4f53\u524d\u8449\u6a5f\u80fd\u3082\u8abf\u3079\u3066\u304a\u304d\u307e\u3059<\/li>\n<li>\u4f4e\u30ca\u30c8\u30ea\u30a6\u30e0\u8840\u75c7\u3067\u767a\u75c7\u3059\u308b\u4f8b\u3067\u306f\uff0c\u9593\u8133\u4e0b\u5782\u4f53\u6a5f\u80fd\u4f4e\u4e0b\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u4f4e\u8eab\u9577\u3067\u767a\u75c7\u3059\u308c\u3070\uff0c\u5185\u5206\u6ccc\u691c\u67fb\u306f\u8a73\u7d30\u306b\u306a\u3055\u308c\u3066\u3044\u308b\u306e\u304c\u901a\u5e38\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u816b\u760d\u304c\u4e0b\u5782\u4f53\u306b\u898b\u3048\u306a\u304f\u3066\u3082\uff0c\u4e0b\u5782\u4f53\u6a5f\u80fd\u304c\u4f4e\u4e0b\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u3042\u308b<\/strong><\/span>\u306e\u3067\u8abf\u3079\u3066\u304a\u304d\u307e\u3059<\/li>\n<li>\u677e\u679c\u4f53\u816b\u760d\u3060\u3051MRI\u3067\u307f\u3048\u3066\u3082\uff0c\u9593\u8133\u4e0b\u5782\u4f53\u6a5f\u80fd\u4f4e\u4e0b\u304c\u3042\u308a\u3048\u307e\u3059\uff0c\u753b\u50cf\u3067\u306f\u898b\u3048\u306a\u3044\u8996\u5e8a\u4e0b\u90e8\u6d78\u6f64\u3092\u751f\u3058\u3066\u3044\u308b\u304b\u3089\u3067\u3059<\/li>\n<li>\u7279\u306b<span style=\"color: #000080;\"><strong>\u96a0\u308c\u5c3f\u5d29\u75c7 occult DI<\/strong><\/span>\u304c\u3042\u308b\u304b\u3069\u3046\u304b\u898b\u6975\u3081\u3066\u304a\u304f\u3053\u3068\u304c\u5927\u5207\u3067\u3059<\/li>\n<li>\u30b3\u30fc\u30c8\u30ea\u30eb\uff08\u526f\u814e\u76ae\u8cea\u30db\u30eb\u30e2\u30f3\uff09\u3092\u6295\u4e0e\u3059\u308b\u3068\u96a0\u308c\u5c3f\u5d29\u75c7\u304c\u9855\u5728\u5316\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u624b\u8853\u524d\u306b\u9ad8\u5ea6\u306e\u4e0b\u5782\u4f53\u6a5f\u80fd\u4f4e\u4e0b\u304c\u3042\u3063\u3066\u3082\uff0c\u6cbb\u7642\u3067\u6539\u5584\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u816b\u760d\u304c\u6cbb\u3063\u3066\u304b\u3089\u3082\u4e0b\u5782\u4f53\u6a5f\u80fd\u304c\u3086\u3063\u304f\u308a\u6539\u5584\u3059\u308b\u304b\u3069\u3046\u304b\uff0c\u307e\u305f\u5185\u5206\u6ccc\u691c\u67fb\u3092\u7d9a\u3051\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<\/ul>\n<h5>\u8996\u529b\u3068\u8996\u91ce\u691c\u67fb<\/h5>\n<ul>\n<li>\u610f\u5916\u306b\u6c17\u3065\u304b\u308c\u306a\u3044\u306e\u3067\u3059\u304c\uff0c\u7279\u306b\u8996\u5e8a\u4e0b\u90e8\u3068\u4e0b\u5782\u4f53\u306e\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u306f\u8996\u529b\u3068\u8996\u91ce\u304c\u4f4e\u4e0b\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u307e\u3060\u3089\u306a\u8996\u91ce\u6b20\u640d\u306b\u306a\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomavision2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-15294 size-medium\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomavision2-284x300.jpg\" alt=\"\" width=\"284\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomavision2-284x300.jpg 284w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomavision2-550x581.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomavision2.jpg 626w\" sizes=\"auto, (max-width: 284px) 100vw, 284px\" \/><\/a><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-15295 size-medium\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomavision1-286x300.jpg\" alt=\"\" width=\"286\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomavision1-286x300.jpg 286w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomavision1-550x577.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomavision1.jpg 637w\" sizes=\"auto, (max-width: 286px) 100vw, 286px\" \/><\/p>\n<p>10\u6b73\u306e\u5973\u306e\u5b50\u304c\u8996\u529b\u8996\u91ce\u969c\u5bb3\u3068\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u8996\u529b\u304c\u3068\u3066\u3082\u4f4e\u304f\u3066\u4e21\u8033\u5074\u534a\u76f2\u3067\u3059\u304c\uff0c\u307e\u3060\u3089\u306a\u8996\u91ce\u6b20\u640d\u306b\u306a\u3063\u3066\u3044\u307e\u3059\u3002\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u8996\u4ea4\u53c9\u3092\u5727\u8feb\u3059\u308b\u306e\u3067\u306f\u306a\u304f\u3066\u8996\u4ea4\u53c9\u7d44\u7e54\u3092\u7834\u58ca\u6027\u306b\u6d78\u6f64\u3059\u308b\u304b\u3089\uff0c\u8996\u91ce\u969c\u5bb3\u304c\u6cbb\u3089\u306a\u3044\u3053\u3068\u304c\u3042\u308b\u306e\u3067\u6cbb\u7642\u3092\u6025\u304e\u307e\u3059\u3002<\/p>\n<hr \/>\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306b\u304a\u3059\u3059\u3081\u306e\u5316\u5b66\u7642\u6cd5\uff08\uff11\u30b3\u30fc\u30b9\u306b\u3064\u304d\uff09<\/h4>\n<h5><strong><span style=\"color: #ff0000;\">CARE\u5316\u5b66\u7642\u6cd5<\/span><\/strong>\uff08\u30b1\u30a2\u30fc\u3068\u547c\u3073\u307e\u3059\uff09<\/h5>\n<dl class=\"setumeiSub\">\n<dd>\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\uff08\u5546\u54c1\u540d\u30d1\u30e9\u30d7\u30e9\u30c1\u30f3\uff09\u3000\u3000\u3000450mg\/sq.m\u3000\uff11\u65e5\u306e\u307f<\/dd>\n<dd>\u30a8\u30c8\u30dd\u30b7\u30c9\uff08\u5546\u54c1\u540d\u30d9\u30d7\u30b7\u30c9\uff0c\u30e9\u30b9\u30c6\u30c3\u30c8\uff09\u3000150mg\/sq.m\u3000\uff11\u65e5\u76ee\u304b\u3089\uff13\u65e5\u76ee\u307e\u3067<\/dd>\n<dd>\u6700\u8fd1\uff0c<span style=\"color: #000080;\"><strong>CARE\u5316\u5b66\u7642\u6cd5\u306823.4\u30b0\u30ec\u30a4\u306e\u8133\u5ba4\u7167\u5c04\u3067\u6cbb\u7642\u3055\u308c\u305f\u60a3\u8005\u3055\u3093\u306e\u518d\u767a\u306e\u76f8\u8ac7\u3092\u53d7\u3051\u307e\u3059\u3002\u3053\u306e\u7d44\u307f\u5408\u308f\u305b\u306e\u6cbb\u7642\u5f37\u5ea6\u304c\u5f31\u3044\u3068\u3044\u3046\u6050\u308c\u304c\u3042\u308a\u307e\u3059<\/strong><\/span>\u3002\u5168\u56fd\u3067\u5171\u540c\u7814\u7a76\u304c\u306a\u3055\u308c\u3066\u305a\u3044\u3076\u3093\u7d4c\u3063\u3066\u3044\u308b\u306e\u3067\u3059\u304c\uff0craw data\u306e\u516c\u958b\u3068\u6b63\u5f0f\u306ainterium report\u304c\u51fa\u3055\u308c\u3066\u3044\u307e\u305b\u3093\u3002<\/dd>\n<\/dl>\n<h5><strong><span style=\"color: #ff0000;\">EP\u5316\u5b66\u7642\u6cd5<\/span><\/strong><\/h5>\n<dl class=\"setumeiSub\">\n<dd>\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff08\u5546\u54c1\u540d\u30e9\u30f3\u30c0\uff0c\u30d6\u30ea\u30d7\u30e9\u30c1\u30f3\uff09 20mg\/sq.m\u3000\uff11\u65e5\u76ee\u304b\u3089\uff15\u65e5\u76ee\u307e\u3067<\/dd>\n<dd>\u30a8\u30c8\u30dd\u30b7\u30c9\uff08\u5546\u54c1\u540d\u30d9\u30d7\u30b7\u30c9\uff0c\u30e9\u30b9\u30c6\u30c3\u30c8\uff09\u3000100mg\/sq.m\u3000\uff11\u65e5\u76ee\u304b\u3089\uff15\u65e5\u76ee\u307e\u3067<\/dd>\n<\/dl>\n<h5><span style=\"color: #ff0000;\">PE\u5316\u5b66\u7642\u6cd5<\/span><\/h5>\n<dl class=\"setumeiSub\">\n<dd>\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff08\u5546\u54c1\u540d\u30e9\u30f3\u30c0\uff0c\u30d6\u30ea\u30d7\u30e9\u30c1\u30f3\uff09 90mg\/sq.m\u3000\uff11\u65e5\u76ee<\/dd>\n<dd>\u30a8\u30c8\u30dd\u30b7\u30c9\uff08\u5546\u54c1\u540d\u30d9\u30d7\u30b7\u30c9\uff0c\u30e9\u30b9\u30c6\u30c3\u30c8\uff09\u3000150mg\/sq.m\u3000\uff11\u65e5\u76ee\u304b\u30893\u65e5\u76ee\u307e\u3067<\/dd>\n<\/dl>\n<h5><a title=\"ICE\u5316\u5b66\u7642\u6cd5\u4f7f\u3044\u65b9\" href=\"\/sawamura\/pediattumor\/icechemothr\/\"><strong><span style=\"color: #ff0000;\">ICE\u5316\u5b66\u7642\u6cd5<\/span><span style=\"color: #000080;\">\uff08\u30a2\u30a4\u30b9\u3068\u547c\u3073\u307e\u3059\uff09<br \/>\n\u6700\u3082\u78ba\u5b9f\u3067\u6709\u52b9\u6027\u304c\u9ad8\u3044\u5316\u5b66\u7642\u6cd5\u3067\u3059<\/span><\/strong><\/a><\/h5>\n<dl class=\"setumeiSub\">\n<dd>\u30a4\u30d5\u30a9\u30b9\u30d5\u30a1\u30df\u30c9\uff08\u5546\u54c1\u540d\u30a4\u30db\u30de\u30a4\u30c9\uff09\u3000\u3000\u3000900mg\/sq.m\u3000\uff11\u65e5\u76ee\u304b\u3089\uff15\u65e5\u76ee\u307e\u3067<\/dd>\n<dd>\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\uff08\u5546\u54c1\u540d\u30e9\u30f3\u30c0\uff0c\u30d6\u30ea\u30d7\u30e9\u30c1\u30f3\uff09 20mg\/sq.m\u3000\uff11\u65e5\u76ee\u304b\u3089\uff15\u65e5\u76ee\u307e\u3067<\/dd>\n<dd>\u30a8\u30c8\u30dd\u30b7\u30c9\uff08\u5546\u54c1\u540d\u30d9\u30d7\u30b7\u30c9\uff0c\u30e9\u30b9\u30c6\u30c3\u30c8\uff09\u3000 60mg\/sq.m\u3000\uff11\u65e5\u76ee\u304b\u3089\uff15\u65e5\u76ee\u307e\u3067<\/dd>\n<dd>\n<dl class=\"setumeiSub\">\n<dd>\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u306e\u4ee3\u308f\u308a\u306b\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3CBDCA \u304c\u4f7f\u7528\u3055\u308c\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u304c\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u306e\u65b9\u304c\u594f\u529f\u7387\u306f\u9ad8\u3044\u3067\u3059\u3002<\/dd>\n<\/dl>\n<\/dd>\n<\/dl>\n<ul>\n<li>\u5c0f\u5150\u79d1\u75c5\u68df\u3067\uff0c\u3053\u308c\u3089\u306e\u85ac\u5264\u3092\u70b9\u6ef4\u3067\u843d\u3068\u3057\u307e\u3059<\/li>\n<li>\u30b1\u30a2\u30fc\u306e\u65b9\u304c\u304a\u533b\u8005\u3055\u3093\uff08\u8133\u5916\u79d1\u533b\uff09\u306f\u697d\u306b\u3067\u304d\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\uff0c\u3057\u304b\u3057\uff0c\u3088\u308a<span style=\"color: #000080;\"><strong>\u5316\u5b66\u7642\u6cd5\u5f37\u5ea6\u304c\u9ad8\u3044\u306e\u306fICE\u5316\u5b66\u7642\u6cd5<\/strong><\/span>\u3067\u3059<\/li>\n<li>\u8840\u6db2\u816b\u760d\u3092\u6271\u3046\u5c0f\u5150\u79d1\u533b\u306b\u3068\u3063\u3066\u306f\uff0cICE\u5316\u5b66\u7642\u6cd5\u306f\u7c21\u5358\u306a\u3068\u3066\u3082\u8efd\u3044\u6cbb\u7642\u6cd5\u3068\u3082\u8a00\u3048\u307e\u3059<\/li>\n<li>\u5927\u304d\u306a\u3082\u306e\uff0c\u975e\u5e38\u306b\u5e83\u7bc4\u56f2\u306a\u3082\u306e\uff0c\u5927\u8133\u57fa\u5e95\u6838\u306e\u3082\u306e\uff0c\u64ad\u7a2e\u306a\u3069\u304c\u3042\u308b\u75c7\u4f8b\uff0c\u3042\u308b\u3044\u306f\u518d\u767a\u3067\u306f<a href=\"icechemo\/\" target=\"_blank\" rel=\"noopener noreferrer\"><strong><span style=\"color: #ff0000;\">ICE\u5316\u5b66\u7642\u6cd5<\/span><\/strong>\uff08\u30af\u30ea\u30c3\u30af\u3067\u5185\u5bb9\uff09<\/a>\u3092\u4f7f\u3063\u305f\u65b9\u304c\u3044\u3044\u3067\u3057\u3087\u3046<\/li>\n<li><strong><span style=\"color: #ff0000;\">\u5c3f\u5d29\u75c7\u306e\u3042\u308b\u4f8b\u3067\u306f\u30c7\u30b9\u30e2\u30d7\u30ec\u30c3\u30b7\u30f3<\/span><\/strong>\u3092\u4e2d\u65ad\u3057\u306a\u3044\u3067\u4f7f\u3044\u306a\u304c\u3089\u5316\u5b66\u7642\u6cd5\u3092\u3057\u307e\u3059<\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u4e2d\u306b\u30c7\u30b9\u30e2\u30d7\u30ec\u30c3\u30b7\u30f3\u3092\u4e2d\u6b62\u3059\u308b\u3068\u4f4e\u30ca\u30c8\u30ea\u30a6\u30e0\u8840\u75c7\u306b\u306a\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>1\u30b3\u30fc\u30b9\u306e\u5316\u5b66\u7642\u6cd5\u3067\u307b\u3068\u3093\u3069\u6d88\u5931\u3057\u307e\u3059\uff0c\u305d\u3046\u3067\u306a\u3044\u5834\u5408\u306f\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u306e\u7591\u3044\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u4e88\u5b9a\u306e\u5316\u5b66\u7642\u6cd5\u306f<strong><span style=\"color: #ff0000;\">\uff13\u30b3\u30fc\u30b9<\/span><\/strong>\u3067\u3059<\/li>\n<li>\u4e88\u5b9a\u306e\u5316\u5b66\u7642\u6cd5\u304c\u7d42\u308f\u3063\u305f\u3089\u3059\u3050\u306b\u5168\u8133\u5ba4\u306e\u7167\u5c04\u306b\u5165\u308c\u307e\u3059<\/li>\n<li>\u3082\u3057\u8133\u810a\u9ac4\u7167\u5c04\u3092\u4f7f\u3046\u6642\u306b\u306f\u6700\u5f8c\u306e\u5316\u5b66\u7642\u6cd5\u306e\u9aa8\u9ac4\u6291\u5236\u304c\u904e\u304e\u3066\u304b\u3089\u3057\u307e\u3059<\/li>\n<li>MTX\u30e1\u30bd\u30c8\u30ec\u30ad\u30bb\u30fc\u30c8\u306e\u9ac4\u8154\u5185\u6295\u4e0e\u306f\u3057\u3066\u306f\u3044\u3051\u307e\u305b\u3093\u3057\uff0c\u3059\u308b\u6839\u62e0\u306f\u5168\u304f\u3042\u308a\u307e\u305b\u3093<\/li>\n<\/ul>\n<h4><strong>ICE\u5316\u5b66\u7642\u6cd5\u6295\u4e0e\u958b\u59cb\u304b\u3089\u6570\u65e5\u3067\u5c0f\u3055\u304f\u306a\u308a\u307e\u3059<\/strong><\/h4>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/06a03656b4588b47d93556d988dcdd431.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6184\" title=\"germinomaa1\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/06a03656b4588b47d93556d988dcdd431-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/e313b6b1196f0d328e7ba9989298af0c.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6185\" title=\"germinomaa2\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/e313b6b1196f0d328e7ba9989298af0c-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/0cadd0a3598e8d2b33997b3e2a67bf16.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6186\" title=\"germinomaa3\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/0cadd0a3598e8d2b33997b3e2a67bf16-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/0cadd0a3598e8d2b33997b3e2a67bf16-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/0cadd0a3598e8d2b33997b3e2a67bf16-298x300.jpg 298w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/0cadd0a3598e8d2b33997b3e2a67bf16.jpg 340w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><\/p>\n<p>\u3053\u306e\u4f8b\u306f\u53e4\u3044\u306e\u3067\u7b2c\uff13\u8133\u5ba4\u958b\u7a93\u8853 ETV \u3092\u3057\u3066\u3044\u307e\u305b\u3093\u3002\u5de6\u306fICE\u5316\u5b66\u7642\u6cd5\u524d\u3002\u4e2d\u592e\u306f9\u65e5\u5f8c\u3002\u53f3\u306f25\u65e5\u5f8c\u3067\u3059\u3002\u9589\u585e\u6027\u6c34\u982d\u75c7\u304c\u3042\u3063\u3066\u30821\u9031\u9593\u304f\u3089\u3044\u3067\u4e2d\u8133\u6c34\u9053\u304c\u901a\u3063\u3066\u6c34\u982d\u75c7\u306f\u6539\u5584\u3057\u307e\u3059\u3002\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3042\u308c\u3070\uff0cICE\u5316\u5b66\u7642\u6cd51\u30b3\u30fc\u30b9\u3067\u304b\u306a\u308a\u7e2e\u5c0f\u3059\u308b\u306f\u305a\u3067\u3059\u3002\u3053\u306e\u3088\u3046\u306a\u9855\u8457\u306a\u52b9\u679c\u304c\u306a\u3044\u6642\u306b\u306f\uff0c\u9006\u306b\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u4ee5\u5916\u306e\u80da\u7d30\u80de\u816b\u760d\u304c\u6df7\u5728\u3057\u3066\u3044\u308b\u3068\u8003\u3048\u305f\u65b9\u304c\u3044\u3044\u3067\u3057\u3087\u3046\u3002\u591a\u304f\u306f\u5947\u5f62\u816b\u306e\u6df7\u5728\u3067\u3059\u3002<\/p>\n<h5><span style=\"color: #000080;\"><strong>\u5316\u5b66\u7642\u6cd5\u5f8c\u6b8b\u5b58\u816b\u760d\u306b\u5c40\u6240\u7167\u5c04\u3092\u8ffd\u52a0\u3057\u306a\u3044<\/strong><\/span><\/h5>\n<dl class=\"setumeiSub\">\n<dd>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u5316\u5b66\u7642\u6cd5\u306f\u3046\u307e\u304f\u884c\u3063\u3066\u3082\uff0c\u3068\u3066\u3082\u5c0f\u3055\u306a\u6b8b\u5b58\u816b\u760d\u306e\u3088\u3046\u306a\u3082\u306e\u304c\u6b8b\u308b\u3053\u3068\u304c\u3057\u3070\u3057\u306f\u3042\u308a\u307e\u3059 (nealy CR)\u3002\u3053\u308c\u306fgranulomatous reaction\u3068\u547c\u3070\u308c\u308b\u7622\u75d5\u69d8\u306e\u7d44\u7e54\u304c\u6b8b\u308b\u304b\u3089\u3067\u3059\u3002\u3067\u3059\u304b\u3089\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u6d88\u3048\u3066\u3044\u306a\u3044\u304b\u3089\u3068\u3044\u3063\u3066\uff0c\u5168\u8133\u5ba4\u7167\u5c04\u3084\u5168\u8133\u7167\u5c04\u306e\u5f8c\u306b\uff0c\u3055\u3089\u306b\u5c40\u6240\u7167\u5c04\u3092\u3059\u308b\u5fc5\u8981\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u307e\u305f\u3053\u306e\u6b8b\u6e23\u306e\u3088\u3046\u306a\u5c0f\u3055\u306a\u75c5\u5909\u304b\u3089\u518d\u767a\u3059\u308b\u3053\u3068\u306f\u3042\u308a\u307e\u305b\u3093\u3002<br \/>\n\u305f\u3060\u3057\uff0c\u5947\u5f62\u816b\u304c\u6df7\u3058\u3063\u3066\u3044\u308b\u5834\u5408\u306b\u306f\uff0c\u306f\u3063\u304d\u308a\u3057\u305f\u6b8b\u5b58\u816b\u760d\u304c\u6b8b\u308a\u307e\u3059\u304b\u3089\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u958b\u59cb\u524d\u306b\uff0c\u624b\u8853\u3092\u3057\u3066\u6b8b\u5b58\u816b\u760d\u3092\u6458\u51fa\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002\u75c5\u7406\u8a3a\u65ad\u3092\u6c7a\u5b9a\u3057\u3066\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u7dda\u91cf\u3068\u53ef\u5426\u306e\u6c7a\u5b9a\u3092\u3057\u307e\u3059\u306e\u3067\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u524d\u306a\u306e\u3067\u3059\u3002\u3053\u306e\u5224\u65ad\u306f\u6642\u3068\u3057\u3066\u96e3\u3057\u3044\u3082\u306e\u3067\u3059\u304c\uff0c\u3067\u304d\u307e\u3059\u3002<\/dd>\n<\/dl>\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u653e\u5c04\u7dda\u6cbb\u7642<\/h4>\n<ul>\n<li>\u5316\u5b66\u7642\u6cd5\u304c\u9032\u3080\u3068\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3042\u308c\u3070\u304b\u306a\u308a\u5c0f\u3055\u304f\u306a\u308a\u307e\u3059\u304b\u3089\uff0c\u305d\u308c\u304b\u3089\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u306e\u53cd\u5fdc\u6027\u304c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3060\u3068\u78ba\u5b9a\u3067\u304d\u3066\u304b\u3089\u884c\u3044\u307e\u3059\u3002<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u5316\u5b66\u7642\u6cd5\u304c\u7d42\u4e86\u3057\u3066\uff0c\u753b\u50cf\u5909\u5316\u3067\u307b\u3068\u3093\u3069\u306e\u816b\u760d\u304c\u6d88\u5931\u3057\u3066\u3044\u308b\u306e\u3092\u78ba\u8a8d\u3057\u3066\u304b\u3089\u958b\u59cb\u3059\u308b\u3079\u304d\u3067\u3059\u3002<\/li>\n<li>\u539f\u5247\u3068\u3057\u3066\u5168\u90e8\u306e\u8133\u5ba4\u3092\u30ab\u30d0\u30fc\u3067\u304d\u308b\u3088\u3046\u306a<span style=\"color: #000080;\"><strong style=\"color: #000080;\"><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"..\/braintumors\/radiation\/\">\u5168\u8133\u5ba4\u7167\u5c04<\/a><\/span>\u00a0WVI whole ventricle irradiation\u00a0<\/strong><\/span>\u3092\u3057\u307e\u3059<\/li>\n<li>\u8133\u5ba4\u4e0a\u8863\u304c\u3042\u308b\u90e8\u5206\u3059\u3079\u3066\u3068\u4e0b\u5782\u4f53\u3092\u30ab\u30d0\u30fc\u3057\u307e\u3059\uff0c\u7279\u306b\u5ef6\u9ac4\u4e0b\u7aef ovex\u3092\u5916\u3057\u3066\u306f\u306a\u308a\u307e\u305b\u3093<\/li>\n<li>\u6a19\u6e96\u7684\u306b\u7dda\u91cf\u306f<strong><span style=\"color: #ff0000;\">24\u30b0\u30ec\u30a4\u3068\u3044\u3046\u91cf\u309212\u56de\uff08\uff11\u56de\u7dda\u91cf2\u30b0\u30ec\u30a4\uff09<\/span><\/strong>\u306b\u5206\u3051\u308b\u304b<strong>\uff0c<span style=\"color: #ff0000;\">25.2\u30b0\u30ec\u30a4\u309214\u56de\uff081\u56de\u7dda\u91cf1.8\u30b0\u30ec\u30a4\uff09<\/span><\/strong>\u306b\u5206\u3051\u3066\u304b\u3051\u307e\u3059<\/li>\n<li>\u6700\u8fd1\u306f23.4\u30b0\u30ec\u30a4\/13\u5206\u5272\u3082\u8a66\u9a13\u3055\u308c\u3066\u3044\u307e\u3059\u304c\uff0c\u5b8c\u5168\u6cbb\u7652\u5272\u5408\u304c\u78ba\u5b9f\u306b\u9ad8\u3044\u304b\u3069\u3046\u304b\u306f\u307e\u3060\u8a3c\u660e\u3055\u308c\u3066\u3044\u307e\u305b\u3093\uff0c\u8133\u304c\u8106\u5f31\u306a7\u6b73\u4ee5\u4e0b\u306e\u5e74\u5c11\u5150\u3067\u306f\u691c\u8a0e\u3055\u308c\u308b\u3079\u304d\u7dda\u91cf\u3067\u3057\u3087\u3046<\/li>\n<li>18\u30b0\u30ec\u30a4\u3067\u6cbb\u308b\u3068\u3044\u3046\u6839\u62e0\u306f\u3042\u308a\u307e\u305b\u3093\uff0c\u884c\u3046\u3068\u304d\u306f\u8a66\u9a13\u3067\u3059<\/li>\n<li>\uff11\u9031\u9593\u306b\uff15\u56de\u304b\u3051\u308b\u306e\u304c\u901a\u5e38\u306e\u65b9\u6cd5\u3067\u3059<\/li>\n<\/ul>\n<h5><span style=\"color: #000080;\"><strong>\u4f8b\u5916\u306b\u6ce8\u610f<\/strong><\/span><\/h5>\n<ul>\n<li><strong><span style=\"color: #ff0000;\">\u9ac4\u6db2\u64ad\u7a2e\u3068\u810a\u9ac4\u64ad\u7a2e<\/span><\/strong>\u306a\u3069\u306e\u8ee2\u79fb\u304c\u3042\u308b\u4f8b\u3067\u306f\u5168\u8133\u810a\u9ac4\u7167\u5c04 craniospinal RT\u304c\u5fc5\u8981\u3067\u3059\uff08\u7dda\u91cf\u306f\u540c\u3058\uff09<\/li>\n<li><strong><span style=\"color: #ff0000;\">\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/span><\/strong>\u3067\u306f\u5168\u8133\u7167\u5c04 whole brain RT\u304c\u5fc5\u8981\u3067\u3059\uff08\u7dda\u91cf\u306f\u540c\u3058\uff09<\/li>\n<\/ul>\n<h5>\u653e\u5c04\u7dda\u304c\u5916\u308c\u3084\u3059\u3044\u90e8\u4f4d\u306f\u518d\u767a\u6e90\u3068\u306a\u308a\u307e\u3059<\/h5>\n<p>\u5074\u8133\u5ba4\u5148\u7aef\uff08\u524d\u89d2\uff0c\u5f8c\u89d2\uff0c\u5074\u982d\u89d2\uff0c\u9582\uff09\uff0c\u4e0b\u5782\u4f53\u3068\u5927\u8133\u57fa\u5e95\u6838\u306b\u653e\u5c04\u7dda\u304c\u5165\u3089\u306a\u3044\u3068\u305d\u306e\u90e8\u4f4d\u304b\u3089\u518d\u767a\u3057\u307e\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germsatouyuugo2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-15273\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germsatouyuugo2-300x289.jpg\" alt=\"\" width=\"300\" height=\"289\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germsatouyuugo2-300x289.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germsatouyuugo2-550x530.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germsatouyuugo2.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\n\u518d\u767a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u753b\u50cf\u3067\u3059\u3002\u5ef6\u9ac4\u80cc\u5074\u306e\u9582 ovex\u3068\u3044\u3046\u90e8\u4f4d\u306b\u518d\u767a\u3057\u3066\u3044\u307e\u3059\u3002<br \/>\n\u3053\u306e\u30d1\u30bf\u30fc\u30f3\u306f\u3068\u3066\u3082\u591a\u3044\u3067\u3059\u3002\u306a\u305c\u304b\u3068\u3044\u3046\u3068\uff0c\u5168\u8133\u5ba4\u7167\u5c04\u306e\u6642\u306b\uff0c\u7b2c\uff14\u8133\u5ba4\u4e0b\u7aef\u306eovex\u306e\u4e0a\u8863 ependyum \u3092\u7167\u5c04\u91ce\u306b\u5165\u308c\u306a\u3044\u653e\u5c04\u7dda\u6cbb\u7642\u533b\u306e\u5148\u751f\u304c\u3044\u308b\u304b\u3089\u3067\u3059\u3002\u653e\u5c04\u7dda\u79d1\u306e\u5148\u751f\u306b\u3082\u3061\u3087\u3063\u3068\u3057\u305f\u77e5\u8b58\u304c\u5fc5\u8981\u306a\u306e\u3067\u3059\u3002<br \/>\n\u3053\u308c\u306f\u518d\u6cbb\u7642\u3067\u816b\u760d\u304c\u6d88\u3048\u3066\u3082\u4e0d\u53ef\u9006\u7684\u306a\u91cd\u75c7\u306e\u5ef6\u9ac4\u969c\u5bb3\u3092\u6b8b\u3057\u3066\u3057\u307e\u3044\u307e\u3059\u3002<\/p>\n<h5><span style=\"color: #000080;\"><strong>\u521d\u671f\u6cbb\u7642\u3067\u306f\u5b9a\u4f4d\u7167\u5c04\u3092\u4f7f\u308f\u306a\u3044<\/strong><\/span><\/h5>\n<dl class=\"setumeiSub\">\n<dd>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u6d78\u6f64\u6027\u306e\u816b\u760d\uff08\u3057\u307f\u8fbc\u3093\u3067\u5e83\u304c\u308b\uff09\u3067\u3059\u304b\u3089\uff0c\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\uff0c\u30b5\u30a4\u30d0\u30fc\u30ca\u30a4\u30d5\u306a\u3069\u306e\u5b9a\u4f4d\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u4f7f\u3063\u3066\u6cbb\u7642\u3059\u308b\u3068\uff0c\u653e\u5c04\u7dda\u304c\u304b\u304b\u3063\u3066\u3044\u306a\u3044\u5834\u6240\u304b\u3089\u9ad8\u7387\u306b\u518d\u767a\u3057\u307e\u3059\u3002MRI\u3067\u898b\u3048\u306a\u3044\u8133\u5ba4\u58c1\u306b\u3082\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u7d30\u80de\u304c\u3044\u307e\u3059\u3002<\/dd>\n<\/dl>\n<h5><span style=\"color: #000080;\"><strong>\u5316\u5b66\u7642\u6cd5\u5f8c\u6b8b\u5b58\u816b\u760d\u306b\u5c40\u6240\u7167\u5c04\u3092\u8ffd\u52a0\u3057\u306a\u3044<\/strong><\/span><\/h5>\n<dl class=\"setumeiSub\">\n<dd>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u5316\u5b66\u7642\u6cd5\u306f\u3046\u307e\u304f\u884c\u3063\u3066\u3082\uff0c\u3068\u3066\u3082\u5c0f\u3055\u306a\u6b8b\u5b58\u816b\u760d\u306e\u3088\u3046\u306a\u3082\u306e\u304c\u6b8b\u308b\u3053\u3068\u304c\u3057\u3070\u3057\u306f\u3042\u308a\u307e\u3059 (nealy CR)\u3002\u3053\u308c\u306fgranulomatous reaction\u3068\u547c\u3070\u308c\u308b\u7622\u75d5\u69d8\u306e\u7d44\u7e54\u304c\u6b8b\u308b\u304b\u3089\u3067\u3059\u3002\u3067\u3059\u304b\u3089\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u6d88\u3048\u3066\u3044\u306a\u3044\u304b\u3089\u3068\u3044\u3063\u3066\uff0c\u5168\u8133\u5ba4\u7167\u5c04\u3084\u5168\u8133\u7167\u5c04\u306e\u5f8c\u306b\uff0c\u3055\u3089\u306b\u5c40\u6240\u7167\u5c04\u3092\u3059\u308b\u5fc5\u8981\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u307e\u305f\u3053\u306e\u6b8b\u6e23\u306e\u3088\u3046\u306a\u5c0f\u3055\u306a\u75c5\u5909\u304b\u3089\u518d\u767a\u3059\u308b\u3053\u3068\u306f\u3042\u308a\u307e\u305b\u3093\u3002<br \/>\n\u305f\u3060\u3057\uff0c\u5947\u5f62\u816b\u304c\u6df7\u3058\u3063\u3066\u3044\u308b\u5834\u5408\u306b\u306f\uff0c\u306f\u3063\u304d\u308a\u3057\u305f\u6b8b\u5b58\u816b\u760d\u304c\u6b8b\u308a\u307e\u3059\u304b\u3089\uff0c\u624b\u8853\u3092\u3057\u3066\u6b8b\u5b58\u816b\u760d\u3092\u6458\u51fa\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002\u3053\u306e\u5224\u65ad\u306f\u6642\u3068\u3057\u3066\u96e3\u3057\u3044\u3082\u306e\u3067\u3059\u304c\uff0c\u3067\u304d\u307e\u3059\u3002<\/dd>\n<\/dl>\n<h5><span style=\"color: #000080;\"><strong>IMRT\u3067\u6d77\u99ac\u3092\u907f\u3051\u308b\u3068\u5074\u982d\u89d2\u304b\u3089\u306e\u518d\u767a\u304c\u3042\u308b<\/strong><\/span><\/h5>\n<dl class=\"setumeiSub\">\n<dd>\u8a8d\u77e5\u6a5f\u80fd\u4f4e\u4e0b\u3092\u9632\u3050\u305f\u3081\u306b\u6d77\u99ac\u3092\u907f\u3051\u3066IMRT\u3067\u6cbb\u7642\u3092\u3057\u3088\u3046\u3068\u3044\u3046\u8a66\u307f\u304c\u3042\u308a\u307e\u3059\u3002\u305d\u3046\u3059\u308b\u3068\u5074\u8133\u5ba4\u5074\u982d\u89d2\u306e\u8133\u5ba4\u58c1\u306b\u4e0d\u5341\u5206\u306a\u7dda\u91cf\u3057\u304b\u5165\u308a\u307e\u305b\u3093\u3002\u5074\u982d\u89d2\u304b\u3089\u306e\u518d\u767a\u306e\u983b\u5ea6\u306f\u9ad8\u3044\u306e\u3067\u3059\u3002IMRT\u3067\u306f\uff0c\u5927\u8133\u57fa\u5e95\u6838\u304b\u3089\u306e\u518d\u767a\u4f8b\u3082\u3042\u308a\u307e\u3059\u3002\u8133\u5ba4\u4e0a\u8863\u3092\u3059\u3079\u3066\u30ab\u30d0\u30fc\u3059\u308b\u306e\u306f\u5927\u539f\u5247\u3067\u3059\u3057\uff0c\u5927\u8133\u57fa\u5e95\u6838\u306b\u3042\u308b\u7a0b\u5ea6\u306e\u7dda\u91cf\u304c\u5165\u308b\u5f93\u6765\u578b\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u307b\u3046\u304c\u3088\u3044\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093??<\/dd>\n<\/dl>\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u751f\u5b58\u7387<\/h4>\n<h2><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/germisuviv.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/germisuviv.png\" alt=\"\" width=\"499\" height=\"338\" \/><\/a><\/h2>\n<p>\u3053\u306e\u30b0\u30e9\u30d5\u306f\u79c1\u306e\u624b\u5143\u30671992\u5e74\u304b\u3089\u65b0\u305f\u306b\u6cbb\u7642\u3057\u305f58\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e2008\u5e74\u307e\u3067\u306e\u751f\u5b58\u5272\u5408\u3092\u8868\u3057\u3066\u3044\u307e\u3059\u3002\u4e0a\u306b\u66f8\u3044\u305f\u3088\u3046\u306a\u5316\u5b66\u7642\u6cd5\u3092\u5148\u306b\u3057\u3066\uff0c\u3042\u3068\u304b\u308924\u301c25.2\u30b0\u30ec\u30a4\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3059\u308b\u65b9\u6cd5\u3067\u3059\u3002\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u76f4\u63a5\u306e\u539f\u56e0\u3068\u306a\u3063\u30661\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u4ea1\u304f\u306a\u3063\u3066\u3044\u307e\u3059\u3002\u307e\u305f\uff0c10\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u518d\u767a\u3057\u307e\u3057\u305f\u3002\u3067\u3082\u518d\u767a\u6642\u306e\u6cbb\u7642\u304c\u3046\u307e\u304f\u884c\u3063\u3066\u3053\u306e\u7d50\u679c\u306b\u306a\u3063\u3066\u3044\u307e\u3059\u3002\u518d\u767a\u7387(17%)\u304c\u3068\u3066\u3082\u9ad8\u304b\u3063\u305f\u306e\u3067\u3059\u304c\uff0c\u305d\u308c\u306f\u521d\u671f\uff082000\u5e74\u4ee5\u524d\uff09\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u9818\u57df (field) \u3092\u7d5e\u308a\u3059\u304e\u305f(involved field irradiation)\u3053\u3068\u304c\u539f\u56e0\u3067\u3059\u3002\u5168\u8133\u5ba4\u4ee5\u4e0a\u306e\u7167\u5c04\u91ce\u3067\u306f\u518d\u767a\u306f\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093\u3002\u3053\u306e\u751f\u5b58\u7387\u306f\u4f8b\u5916\u7684\u3067\u3042\u308a\uff0c\u73fe\u5728\u306e\u6cbb\u7642\u6cd5\u3092\u7528\u3044\u3066\u3082<strong><span style=\"color: #ff0000;\">10\u5e74\u751f\u5b58\u5272\u5408\u306f90-95%\u304f\u3089\u3044<\/span><\/strong>\uff0c10-20\u4eba\u306b\u4e00\u4eba\u304f\u3089\u3044\u306e\u60a3\u8005\u3055\u3093\u306f\u6b7b\u4ea1\u3059\u308b\u3068\u8003\u3048\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u591a\u304f\u306e\u539f\u56e0\u306f\u521d\u671f\u6cbb\u7642\u306e\u30df\u30b9\u3084\u8996\u5e8a\u4e0b\u90e8\u4e0b\u5782\u4f53\u4e0d\u5168\u3067\u3059\u3002\u5b9f\u969b\u306b\u79c1\u306f2000\u5e74\u4ee5\u964d\u3067\u6cbb\u7642\u3057\u305f\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u60a3\u8005\u3055\u3093\u3067\u6b7b\u4ea1\u3057\u305f\u65b9\u3092\u307f\u305f\u3053\u3068\u304c\u3042\u308a\u307e\u305b\u3093\u3002\u6cbb\u7642\u306f\u9032\u6b69\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h5>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u65e5\u672c\u3067\u306e\u81e8\u5e8a\u7814\u7a76\u3000JCCG CNSGCT2021<br \/>\n\u521d\u767a\u4e2d\u67a2\u795e\u7d4c\u539f\u767a\u80da\u7d30\u80de\u816b\u760d\u306b\u5bfe\u3059\u308b\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13<\/h5>\n<p>\u4eac\u90fd\u5927\u5b66\u306e\u8352\u5ddd\u5148\u751f\u304c\u4e2d\u5fc3\u3068\u306a\u3063\u3066\u884c\u308f\u308c\u3066\u3044\u308b\u81e8\u5e8a\u7814\u7a76\u3067\u3059\u3002\u5316\u5b66\u7642\u6cd5\u306f\u3001CE\u7642\u6cd5\uff08carboplatin 560 mg\/m2 day1, etoposide 150 mg\/m2 day1-3\uff09\u3001PE\u7642\u6cd5\uff08cisplatin\u300090 mg\/m2 day1, etoposide 150 mg\/m2 day1-3\uff09\u306e\u4ea4\u4ee3\u7642\u6cd5\u3092\u8a084\u30b3\u30fc\u30b9\u5b9f\u65bd\u3059\u308b\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306f\u30011\u30b3\u30fc\u30b9\u76ee\u306e\u5316\u5b66\u7642\u6cd5\u958b\u59cb\u65e5\u304b\u30892\u30b3\u30fc\u30b9\u76ee\u306e\u5316\u5b66\u7642\u6cd5\u958b\u59cb\u65e5\u307e\u3067\u306b\u958b\u59cb\u3059\u308b\u3002\u75c5\u5de3\u306b\u5fdc\u3058\u3066\u5168\u8133\u7167\u5c04\u3082\u3057\u304f\u306f\u5168\u8133\u5ba4\u7167\u5c0423.4 Gy\/13\u56de\u3092\u5b9f\u65bd\u3059\u308b\u3002B1\u7fa4\u306f\uff0c\u7167\u5c04\u7dda\u91cf\u309218 Gy\/10\u56de\u307e\u3067\u843d\u3068\u3057\u307e\u3059\u3002\u5168\u8133\u5ba4\u7167\u5c0418\u30b0\u30ec\u30a4\u3067\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u6cbb\u308b\u304b\u3069\u3046\u304b\u3068\u3044\u3046\u3053\u3068\u3092\u307f\u308b\u304c\u305f\u3081\u306e\u8a66\u9a13\u3067\u3059\u3002<\/p>\n<\/div>\n<div class=\"setumei\">\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u518d\u767a\u306e\u306a\u3044\u751f\u5b58\u5272\u5408\uff08\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\uff09<\/h4>\n<h2><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/germpfs.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/germpfs.png\" alt=\"\" width=\"487\" height=\"331\" \/><\/a><\/h2>\n<p>\u524d\u306e\u30c7\u30fc\u30bf\u3067\u3001\u72ed\u3044\u7bc4\u56f2\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3067\u306f\u518d\u767a\u7387\u304c\u9ad8\u3044\u3068\u66f8\u304d\u307e\u3057\u305f\u3002\u3053\u306e\u30c7\u30fc\u30bf\u306f\u5168\u8133\u5ba4\u4ee5\u4e0a\u306e\u5e83\u3044\u9818\u57df\u306724\u301c25.2\u30b0\u30ec\u30a4\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u884c\u3063\u305f\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u60a3\u8005\u3055\u3093\u306e\u518d\u767a\u304c\u306a\u3044\u72b6\u614b\u3067\u306e\u7d4c\u904e\u3092\u793a\u3057\u307e\u3059\u3002<strong><span style=\"color: #ff0000;\">\u5168\u8133\u5ba4\u4ee5\u4e0a\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u7528\u3044\u308c\u3070\u518d\u767a\u3059\u308b\u78ba\u7387\u306f5%\u304f\u3089\u3044\u3068\u898b\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002<br \/>\n<\/span><\/strong><span style=\"color: #333333;\">\u3053\u306e\u30c7\u30fc\u30bf\u3092\u307e\u3068\u3081\u305f2009\u5e74\u4ee5\u964d\u304b\u30892020\u5e74\u307e\u3067\uff0c\u79c1\u306e\u624b\u5143\u306723\u4f8b\u306egerminoma\u3092\u6cbb\u7642\u3057\u307e\u3057\u305f\uff0c\u4e3b\u3068\u3057\u3066ICE\u5316\u5b66\u7642\u6cd53\u30b3\u30fc\u30b9\uff0c25.2\u30b0\u30ec\u30a414\u5206\u5272\u306e\u5168\u8133\u5ba4\u7167\u5c04\u3067\u3059\u30021\u4f8b (4%)\u3067\u6cbb\u76426\u5e74\u5f8c\u306b\u518d\u767a\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u3053\u306e\u4f8b\u306e\u521d\u671f\u6cbb\u7642\u3092\u8abf\u3079\u76f4\u3057\u305f\u3089\uff0c<span style=\"color: #000080;\"><strong>\u7b2c\uff14\u8133\u5ba4\u4e0b\u534a\u90e8 (ovex)\u306b\u653e\u5c04\u7dda\u304c\u5165\u3063\u3066\u3044\u307e\u305b\u3093\u3067\u3057\u305f<\/strong><\/span>\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u62c5\u5f53\u5148\u751f\u306b\u306f\u7167\u5c04\u306e\u524d\u306b\u5ff5\u3092\u62bc\u3057\u3066\u304a\u9858\u3044\u3057\u305f\u306e\u3067\u3059\u304c\uff0c\u805e\u3044\u3066\u3044\u305f\u3060\u3051\u306a\u304b\u3063\u305f\u305f\u3081\u3067\u3059\u3002\u3068\u3066\u3082\u6b8b\u5ff5\u3067\u3059! \u00a0\u304d\u3061\u3093\u3068\u6cbb\u7642\u3059\u308c\u3070\uff0c100\uff05\u6cbb\u308b\u816b\u760d\u3060\u3068\u4eca\u306f\u8003\u3048\u3066\u3044\u307e\u3059\u3002<\/span><\/p>\n<h4><strong>\u3082\u3057\u518d\u767a\u3057\u3066\u3057\u307e\u3063\u305f\u3089<\/strong><\/h4>\n<h5><span style=\"color: #ff0000;\">\u518d\u767a\u6cbb\u7642\u3067\u3082\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u306a\u3044\u3068\uff0c\u307e\u305f\u3059\u3050\u306b\u518d\u767a\u3057\u307e\u3059<\/span><\/h5>\n<h5>\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3067\u3082\u6cbb\u3057\u304d\u308c\u306a\u3044\u3053\u3068\u304c\u307b\u3068\u3093\u3069\u3067\u3059<\/h5>\n<ul>\n<li><strong><span style=\"color: #ff0000;\">\u307b\u3068\u3093\u3069\u306f\u7167\u5c04\u91ce\u5916\u518d\u767a\u3067\u3059<\/span><\/strong><\/li>\n<li><strong><span style=\"color: #ff0000;\">\u539f\u5247\u3068\u3057\u3066\uff0c\u4e0a\u306b\u66f8\u3044\u3066\u3042\u308b\u3088\u3046\u306a\u521d\u767a\u306e\u6642\u3068\u540c\u3058\u6cbb\u7642\u3092\u3057\u307e\u3059<\/span><\/strong><\/li>\n<li>\u307e\u305a\u5316\u5b66\u7642\u6cd5\u3092\u3057\u307e\u3059\uff08<strong><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/icechemo\/\">ICE\u5316\u5b66\u7642\u6cd5<\/a><\/span><\/strong>\u304c\u3044\u3044\u3067\u3057\u3087\u3046\uff09<\/li>\n<li>\u305d\u308c\u3067\u816b\u760d\u304c\u307b\u3068\u3093\u3069\u6d88\u3048\u305f\u3089\uff0c\u3042\u3068\uff12\u30b3\u30fc\u30b9\u8ffd\u52a0\u3057\u307e\u3059<\/li>\n<li>\u305d\u308c\u304b\u3089\u307e\u305f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3059\uff0824\u30b0\u30ec\u30a4\u309212\u56de\u304b25.2\u30b0\u30ec\u30a4\u309214\u56de\uff09<\/li>\n<li>\u521d\u56de\u6cbb\u7642\u3067\u306e\u653e\u5c04\u7dda\u91cf\u306b\u3088\u3063\u3066\u8ffd\u52a0\u7167\u5c04\u306e\u91cf\u304c25\u30b0\u30ec\u30a4\u307e\u3067\u4f7f\u3048\u306a\u3044\u6642\u306f18\u30b0\u30ec\u30a4\u3068\u304b20\u30b0\u30ec\u30a4\u304f\u3089\u3044\u306b\u843d\u3068\u3059\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u6700\u5f8c\u306e\u6cbb\u7642\u306b\u306a\u308b\u3067\u3057\u3087\u3046\u304b\u3089\uff0c\u53ef\u80fd\u3067\u3042\u308c\u3070\u7167\u5c04\u306e\u7bc4\u56f2\u306f\u3067\u304d\u308c\u3070\u5168\u90e8\u306e\u8133\u3068\u810a\u9ac4\u306b\u304b\u3051\u307e\u3059\uff0c\u77e5\u80fd\u4e88\u5f8c\u3092\u8003\u3048\u306a\u304c\u3089\u3082\u3067\u304d\u308b\u3060\u3051\u5e83\u304f<\/li>\n<li>\u65e9\u671f\u7167\u5c04\u91ce\u5916\u518d\u767a\u3042\u308b\u3044\u306f\u6975\u5c0f\u306e\u518d\u767a\u75c5\u5909\u3067\uff0c\u5e83\u7bc4\u56f2\u7167\u5c04\u3092\u7528\u3044\u308b\u3053\u3068\u306b\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u5834\u5408\u306f\uff0cmargin\u3092\u5e83\u3081\u306b\u53d6\u3063\u305f\u5c40\u6240\u7167\u5c04\u3092\u9078\u629e\u3057\u307e\u3059<\/li>\n<li><strong><span style=\"color: #ff0000;\">\u521d\u56de\u6cbb\u7642\u3067\u653e\u5c04\u7dda\u304c\u305f\u304f\u3055\u3093\u304b\u304b\u3063\u3066\u3044\u3066\uff0c\u8ffd\u52a0\u7167\u5c04\u304c\u3067\u304d\u306a\u3044\u6642\u306b\u306f\u3068\u3066\u3082\u56f0\u308a\u307e\u3059<\/span><\/strong><\/li>\n<li>\u305d\u306e\u3088\u3046\u306a\u5834\u5408\u306f\u6700\u521d\u304b\u3089\u672b\u68a2\u8840\u5e79\u7d30\u80de\u6551\u63f4\u3092\u4f7f\u3046\u5927\u91cf\u5316\u5b66\u7642\u6cd5\u3092\u8a08\u753b\u3057\u307e\u3059\u304c\uff0c\u6291\u3048\u304d\u308c\u306a\u3044\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u79c1\u304c\u7d4c\u9a13\u3057\u305f25\u4f8b\u306e\u518d\u767a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u7121\u5897\u60aa5\u5e74\u751f\u5b58\u5272\u5408\u306f70%\u3067\u3057\u305f<\/li>\n<li>\u521d\u56de\u6cbb\u7642\u3067\u4f4e\u7dda\u91cf\u7167\u5c04\u304c\u4f7f\u308f\u308c\u3066\u3044\u305f\u518d\u767a\u4f8b\u3067\u306f\uff0c\u518d\u7167\u5c04\u304c\u5fdc\u7528\u3067\u304d\u308b\u306e\u3067\u518d\u767a\u6cbb\u7642\u306b\u5931\u6557\u3059\u308b\u3053\u3068\u306f\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f<\/li>\n<\/ul>\n<h5>\u3053\u3053\u304b\u3089\u4e0b\u306f\u96e3\u3057\u3044<\/h5>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlsmall-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-11937\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlsmall-1-240x300.jpg\" alt=\"\" width=\"240\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlsmall-1-240x300.jpg 240w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlsmall-1-479x600.jpg 479w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/owlsmall-1.jpg 591w\" sizes=\"auto, (max-width: 240px) 100vw, 240px\" \/><\/a><\/p>\n<h4><strong><span style=\"color: #ff0000;\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306b\u306f\u8133\u5ba4\u3092\u5168\u90e8\u542b\u3080\u304b\u305d\u308c\u4ee5\u4e0a\u306e\u7167\u5c04\u91ce\u304c\u5fc5\u8981<\/span><\/strong><\/h4>\n<p align=\"left\">Calaminus G: SIOP CNS GCT 96: final report of outcome of a prospective, multinational nonrandomized trial for children and adults with intracranial germinoma, comparing craniospinal irradiation alone with chemotherapy followed by focal primary site irradiation for patients with localized disease. Neuro Oncol, 2013<br \/>\n2013\u5e74\u306e\u5831\u544a\u3067\u3059\u3002190\u4f8b\u306e\u60a3\u8005\u3055\u3093\u304c\u8133\u810a\u9ac4\u7167\u5c04\u306e\u307f\u306e\u6cbb\u7642\u3092\u53d7\u3051\uff0c65\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c2\u30b3\u30fc\u30b9\u306e\u5316\u5b66\u7642\u6cd5 (CBDCA\/VP-16 alternating with VP-16\/IFO)\u3068\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u30025\u5e74\u306e\u6642\u70b9\u306eEFS\u3068OS\u306f\u6709\u610f\u5dee\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u304c\uff0cPFS\u306f0.97\u30680.88 (P&lt;0.04)\u3067\u5dee\u304c\u8a8d\u3081\u3089\u308c\u307e\u3057\u305f\u3002\u5316\u5b66\u7642\u6cd5\u3068\u5c40\u6240\u7167\u5c04\u3067\u6cbb\u7642\u3055\u308c\u305f65\u4eba\u306e\u3046\u30617\u4eba\u3067\u518d\u767a\u304c\u3042\u3063\u3066\u6210\u7e3e\u304c\u60aa\u304b\u3063\u305f\u306e\u3067\u3059\u304c\uff0c\u305d\u306e\u5185\u306e6\u4eba\u306f\u7167\u5c04\u91ce\u5916\u304b\u3064\u8133\u5ba4\u5185\u3067\u306e\u518d\u767a\u3067\u3057\u305f\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0c\u7167\u5c04\u91ce\u306b\u8133\u5ba4\u3092\u542b\u3080\u3079\u304d\u3067\u3042\u308b\u3068\u8ff0\u3079\u3066\u3044\u307e\u3059\u3002\u8133\u810a\u9ac4\u7167\u5c04\u3092\u53d7\u3051\u305f125\u4f8b\u4e2d 4\u4f8b (3%) \u3067\u518d\u767a\u304c\u751f\u3058\u3066\u3044\u307e\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300d<strong><span style=\"color: #ff0000;\">2013\u5e74\u306b\u306a\u3063\u3066\uff0c\u4f55\u3092\u4eca\u3055\u3089\uff01<\/span><\/strong>\u3068\u3044\u3046\u8ad6\u6587\u3067\u3059\u3002\u305d\u3082\u305d\u3082\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u8133\u5ba4\u58c1\u5168\u4f53\u3092\u4fb5\u3059\u816b\u760d\u306a\u306e\u3067\u3059\u3002\u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u4eba\u3005\u3082\u3088\u3046\u3084\u304f\u306e\u3053\u3068\u3067\u305d\u308c\u306b\u6c17\u3065\u3044\u305f\u306e\u304b\u3082\u3002\u65e5\u672c\u306e\u5c0f\u5150\u79d1\u533b\u306e\u4e00\u90e8\u5206\u306f\u306f\u307e\u3060\u6c17\u3065\u3044\u3066\u3044\u307e\u305b\u3093\u3002<br \/>\n\u3053\u306e\u5831\u544a\u3067\u306f\uff0c\u8133\u810a\u9ac4\u7167\u5c04\u3067\u6cbb\u7642\u3055\u308c\u305f\u5834\u5408\uff0cCSI 24Gy\/15fr \u3068 boost 16Gy\/10fr\u304c\u539f\u767a\u5de3\u306b\u5165\u3063\u3066\u3044\u307e\u3059\u3002\u795e\u7d4c\u4e0b\u5782\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3060\u3068<span style=\"color: #000080;\"><strong>\u8996\u5e8a\u4e0b\u90e8\u4e0b\u5782\u4f53\u304c40\u30b0\u30ec\u30a4\u3082\u88ab\u7206<\/strong><\/span>\u3057\u3066\u3044\u307e\u3059\u3002\u305d\u306e\u7dda\u91cf\u304c\u5165\u308b\u3068\u8996\u5e8a\u4e0b\u90e8\u4e0b\u5782\u4f53\u969c\u5bb3\uff0c\u8a8d\u77e5\u6a5f\u80fd\u4f4e\u4e0b\uff0c\u30a6\u30a3\u30ea\u30b9\u52d5\u8108\u8f2a\u9589\u585e\u75c7\uff0c\uff12\u6b21\u816b\u760d\u304c\u3067\u304d\u308b\u304b\u3089\u7dda\u91cf\u3092\u843d\u3068\u305d\u3046\u3068\u3044\u3046\u306e\u304c20\u5e74\u524d\u304b\u3089\u306e\u65e5\u672c\u3067\u306e\u30b3\u30f3\u30bb\u30f3\u30b5\u30b9\u3067\u3059\u3002<\/p>\n<h4>\u767a\u751f\u3059\u308b\u5e74\u9f62<\/h4>\n<p>germinoma\u306f\u4e2d\u67a2\u795e\u7d4c\u7cfb\u539f\u767a\u80da\u7d30\u80de\u816b\u760d\u306e\uff13\u5206\u306e\uff12\u5f37\u3092\u5360\u3081\u308b\u983b\u5ea6\u306e\u9ad8\u3044\u816b\u760d\u3067\u3059\u3002\u56f3\uff12\u306b\u898b\u3089\u308c\u308b\u3088\u3046\u306b15\u6b73\u3092\u30d4\u30fc\u30af\u3068\u3057\u3066\u5c0f\u5150\u671f\u304b\u3089\u601d\u6625\u671f\u306b\u591a\u3044\u3082\u306e\u3067\u3059\u3002\u6ce8\u76ee\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u306e\u306f10\u6b73\u4ee5\u4e0b\u306e\u5c0f\u5150\u306b\u3082\u7a00\u3067\u306f\u306a\u3044\u3053\u3068\u3067\u3059\u3002\u540c\u69d8\u306e\u6cbb\u7642\u3092\u5168\u5e74\u9f62\u5c64\u306b\u884c\u3063\u305f\u5834\u5408\uff0c10\u6b73\u4ee5\u4e0b\u306e\u5e74\u9f62\u5c64\u306b\u5bfe\u3057\u3066\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u3088\u308b\u9045\u767a\u6027\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\u306f\u3088\u308a\u5927\u304d\u3044\u3068\u8003\u3048\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002<\/p>\n<p class=\"imgCenter\"><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct1.gif\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct1.gif\" alt=\"\" width=\"440\" height=\"293\" \/><\/a><\/p>\n<p class=\"centering\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u5e74\u9f62\u5225\u767a\u751f\u983b\u5ea6<\/p>\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u80da\u816b\uff09\u306eMRI\u8a3a\u65ad<\/h4>\n<p>germinoma\u306eMRI\u6240\u898b\u306f\uff0c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u50cf\u5f37T1\u5f37\u8abf\u753b\u50cf\u3067\u5f37\u304f\u5897\u5f37\u3055\u308c\u308b\u3053\u3068\u3067\u3059\u3002\u3057\u304b\u3057\uff0c\u56a2\u80de\u6027\u5909\u5316\u3092\u4f34\u3046\u3053\u3068\u3082\u5c11\u306a\u304f\u306a\u3044\u3057\uff0c\u5927\u304d\u306a\u591a\u623f\u6027\u306e\u816b\u760d\u3068\u306a\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002MRI\u4e0a\u3067\u306f\u4e00\u898b\u5883\u754c\u660e\u77ad\u306b\u898b\u3048\u307e\u3059\u304c\uff0c\u5b9f\u969b\u306b\u306f\u753b\u50cf\u3067\u307f\u3048\u306a\u304f\u3068\u3082\u304b\u306a\u308a\u5e83\u7bc4\u306b\u5468\u56f2\u3078\u6d78\u6f64\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u591a\u3044\u306e\u3067\u9650\u5c40\u6027\u816b\u760d\u3068\u306f\u8003\u3048\u3066\u306f\u3044\u3051\u307e\u305b\u3093\u3002\u305d\u308c\u304c\u624b\u8853\u6458\u51fa\u3060\u3051\u3042\u308b\u3044\u306f\u30ac\u30f3\u30de\u30ca\u30a4\u30d5\u306a\u3069\u306e\u5b9a\u4f4d\u7167\u5c04\u3067\u6cbb\u3089\u306a\u3044\u7406\u7531\u3067\u3059\u3002<\/p>\n<p>germinoma\u304c\u597d\u3093\u3067\u767a\u751f\u3057\u6d78\u6f64\u3059\u308b\u90e8\u4f4d\u306f\uff0c\u677e\u679c\u4f53\uff0c\u8996\u5e8a\u4e0b\u90e8\uff0c\u4e0b\u5782\u4f53\u67c4\uff0c\u4e0b\u5782\u4f53\u5f8c\u8449\uff0c\u4e0b\u5782\u4f53\u524d\u8449\uff0c\u8996\u5e8a\uff0c\u7d42\u677f\uff0c\u7b2c\uff13\u8133\u5ba4\u58c1\uff0c\u5074\u8133\u5ba4\u58c1\u306e\u7279\u306b\u524d\u89d2\uff0c\u524d\u4ea4\u9023\uff0c\u5927\u8133\u57fa\u5e95\u6838\uff0c\u8133\u6881\u819d\u90e8\uff0c\u4e2d\u8133\u8996\u84cb\uff0c\u7b2c\uff14\u8133\u5ba4\u58c1 (obex)\uff0c<span style=\"color: #000080;\"><strong>\u6d77\u7dbf\u9759\u8108\u6d1e\uff0c\u8776\u5f62\u9aa8\u6d1e\u659c\u53f0<\/strong><\/span>\u306a\u3069\u3067\u3059\u3002\u3053\u308c\u3089\u306f\u76f4\u63a5\u6d78\u6f64\u3067\u3042\u308a\uff0c\u64ad\u7a2e\u3042\u308b\u3044\u306f\u8ee2\u79fb\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<p>\u6642\u306b\u8133\u5ba4\u4e0a\u8863\u306b\u6cbf\u3063\u3066\u8133\u5ba4\u58c1\u3078\u5e83\u7bc4\u306b\u6d78\u6f64\u3059\u308b\u7279\u5fb4\u304c\u3042\u308a\u307e\u3059\u3002\u3053\u306e<span style=\"color: #000080;\"><strong>\u8133\u5ba4\u4e0a\u8863\u4e0b\u6d78\u6f64 subependymal infiltration<\/strong><\/span> \u306f\uff0c\u521d\u671f\u306b\u306f\u9ad8\u89e3\u50cf\u5ea6 3-tesla MRI\u3067\u3082\u63cf\u51fa\u3067\u304d\u307e\u305b\u3093\u304c\uff0c\u9032\u884c\u3059\u308b\u3068\u8133\u5ba4\u58c1\u306b\u7d50\u7bc0\u72b6\u306e\u591a\u767a\u75c5\u5909\u3068\u3057\u3066\u63cf\u51fa\u3055\u308c\u3066\u304d\u307e\u3059\u3002<\/p>\n<p>\u4e00\u65b9\uff0c\u810a\u67f1\u7ba1\u5185\u306b\u8a8d\u3081\u3089\u308c\u308b\u75c5\u5909\u306f\u9ac4\u6db2\u64ad\u7a2e\u3067\u3042\u308a\uff0c\u4e0a\u8863\u4e0b\u6d78\u6f64 subependymal infiltration \u3068\u9ac4\u6db2\u64ad\u7a2e CSF dissemination\/seeding \u3092\u6df7\u540c\u3057\u3066\u306f\u3044\u3051\u307e\u305b\u3093\u3002\u8a3a\u65ad\u6642\u306b\u306f\u810a\u9ac4\u306eMRI\u3082\u5fc5\u305a\u64ae\u5f71\u3057\u307e\u3059\u3002\u3067\u3082\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e<span style=\"color: #000080;\"><strong>\u9ac4\u6db2\u64ad\u7a2e\u3068\u3044\u3046\u306e\u306f\uff0c\u5b9f\u969b\u306b\u306f\u307b\u3068\u3093\u3069\u7121\u3044<\/strong><\/span>\u3068\u3044\u3048\u308b\u304f\u3089\u3044\u983b\u5ea6\u306e\u4f4e\u3044\u3082\u306e\u3067\u3059\u3002<\/p>\n<p>germinoma\u306e\u753b\u50cf\u8a3a\u65ad\u3067\u6ce8\u610f\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u3082\u306e\u306b\uff0c<strong><span style=\"color: #ff0000;\">occult (neurohypophyseal) germinoma<\/span><\/strong>\u3068\u547c\u3070\u308c\u308b\u3082\u306e\u3067\u3059\u3002\u4e00\u3064\u306f\uff0c\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3059\u308b\u5c0f\u5150\u4f8b\u306b\u307f\u3089\u308c\u308b\u3082\u306e\u3067\u3042\u308a\uff0c\u767a\u75c7\u6642\u306bMRI\u3092\u64ae\u50cf\u3057\u3066\u3082\u816b\u760d\u9670\u5f71\u304c\u6349\u3048\u3089\u308c\u307e\u305b\u3093\u3002\u3053\u306e\u5834\u5408\u306b\u306f\uff0c\u7a81\u767a\u6027\u5c3f\u5d29\u75c7\u3068\u8a3a\u65ad\u3055\u308c\u3066\u6cbb\u7642\u3092\u53d7\u3051\u308b\u3053\u3068\u304c\u591a\u3044\u306e\u3067\u3059\u304c\uff0cMRI\u3092\u53cd\u5fa9\u3059\u308b\u3046\u3061\u306b\u767a\u75c7\u304b\u3089\u6570\u30f6\u6708\u3042\u308b\u3044\u306f\u6570\u5e74\u3092\u7d4c\u3066\u795e\u7d4c\u4e0b\u5782\u4f53\u306b\u816b\u7624\u304c\u51fa\u73fe\u3057\u307e\u3059\u3002\u521d\u767a\u6642\u306eMRI\u3092\u3088\u304f\u89b3\u5bdf\u3059\u308b\u3068\u5f8c\u8449\u306ebrightness (ADH) \u304c\u6d88\u5931\u3057\u3066\u3044\u305f\u308a\uff0c\u4e0b\u5782\u4f53\u67c4\u304c\u816b\u5927\u3057\u3066\u3044\u305f\u308a\u3059\u308b\u521d\u671f\u50cf\u3092\u898b\u9003\u3057\u3066\u3044\u308b\u5834\u5408\u304c\u591a\u3044\u3067\u3057\u3087\u3046\u3002MRI\u3067\u677e\u679c\u4f53\u306e\u5358\u767agerminoma\u3068\u8a3a\u65ad\u3055\u308c\u305f\u4f8b\u3067\uff0c\u4e0b\u5782\u4f53\u6a5f\u80fd\u3092\u691c\u67fb\u3057\u3066\u307f\u308b\u3068GHD\u304c\u3042\u3063\u305f\u308amasked DI\u3092\u8a8d\u3081\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u3053\u306e\u5834\u5408\u306b\u306focult germinoma\u304c\u4f75\u5b58\u3057\u3066\u3044\u307e\u3059\u3002\u3068\u3066\u3082\u91cd\u8981\u306a\u6240\u898b\u3068\u3057\u3066\uff0c<strong><span style=\"color: #ff0000;\">CT\u691c\u67fb\u3092\u3059\u308b\u3068\u75c5\u5909\u304c\u6d88\u3048\u3066\u3057\u307e\u3046<\/span><\/strong>\u3053\u3068\u3067\u3059\u3002CT\u691c\u67fb\u306e\u5f8c\u3067\u306f\u4e0b\u5782\u4f53\u306f\u840e\u7e2e\u50cf\u3068\u306a\u308a\u7d4c\u904e\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u3053\u308c\u306fgerminoma\u304c\u653e\u5c04\u7dda\u611f\u53d7\u6027\u304c\u9ad8\u3044\u305f\u3081\u306b\u4e00\u5ea6\u306eCT\u691c\u67fb\u3067\u4f7f\u7528\u3059\u308b\u30ac\u30f3\u30de\u7dda\u91cf\u3060\u3051\u3067\u816b\u760d\u6d88\u5931\u304c\u751f\u3058\u308b\u305f\u3081\u3067\u3059\u3002\u3067\u3082\u307e\u305f\u6570\u5e74\u5f8c\u306b\u518d\u767a\u3057\u307e\u3059\u3002<\/p>\n<p>\u3082\u3046\u4e00\u3064\u306f\uff0c\u9ad8\u6b21\u8133\u6a5f\u80fd\u969c\u5bb3\u3084\u7de9\u5f90\u9032\u884c\u6027\u306e\u7247\u9ebb\u75fa\u3067\u767a\u75c7\u3059\u308b\u5c0f\u5150\u306e<strong><span style=\"color: #ff0000;\">\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de basal ganglia germinoma<\/span><\/strong>\u3067\u3059\u3002\u3053\u306e\u816b\u760d\u3082\u816b\u7624\u9670\u5f71\u304c\u5168\u304f\u898b\u3048\u305a\uff0c\u5927\u8133\u534a\u7403\u306e\u59d4\u7e2e\u50cf\u306e\u307f\u304c\u753b\u50cf\u4e0a\u306e\u6240\u898b\u3067\u3042\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u3053\u306e\u5927\u8133\u57fa\u5e95\u6838germinoma\u306e\u753b\u50cf\u6240\u898b\u306f\u7279\u6709\u306a\u3082\u306e\u3067\u3059\u3002CT\/MRI\u30ac\u30a4\u30c9\u5b9a\u4f4d\u7684\u751f\u691c\u8853\u306b\u3088\u308agerminoma\u306e\u78ba\u5b9a\u75c5\u7406\u8a3a\u65ad\u3092\u3064\u3051\u308b\u3053\u3068\u306f\u3067\u304d\u307e\u3059\u304c\uff0c\u5927\u8133\u57fa\u5e95\u6838germinoma\u306f\u51fa\u8840\u3057\u3084\u3059\u304f\u3066\u8133\u5185\u8840\u816b\u3068\u3044\u3046\u5408\u4f75\u75c7\u3092\u751f\u3058\u308b\u3053\u3068\u304c\u7a00\u306a\u3089\u305a\u3042\u308b\u306e\u3067\uff0cT2\/FLAIR\u753b\u50cf\u3067\u5185\u5305\u306b\u9650\u5c40\u3059\u308b\u3088\u3046\u306a\u5c0f\u3055\u306a\u75c5\u5909\u306e\u307f\u306e\u5834\u5408\u306f\u751f\u691c\u8853\u306f\u907f\u3051\u305f\u65b9\u304c\u3088\u3044\u3067\u3059\u3002\u30e1\u30c1\u30aa\u30cb\u30f3PET\u3067\u9ad8\u96c6\u7a4d\u304c\u8a8d\u3081\u3089\u308c\uff0c\u3053\u306e\u691c\u67fb\u306f\u8a3a\u65ad\u7684\u4fa1\u5024\u304c\u9ad8\u3044\u3068\u3044\u3048\u307e\u3059\u3002\u8840\u6e05\u9ac4\u6db2\u306eHCG\u5024\u304c\u3054\u304f\u5fae\u91cf\u306b\u967d\u6027\u5024\u3068\u306a\u308a\u307e\u3059\u3002<\/p>\n<hr \/>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-13041\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt2-300x298.jpg\" alt=\"\" width=\"300\" height=\"298\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt2-300x298.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt2-768x762.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt2-550x545.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt2-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt2.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-13042\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt1-300x276.jpg\" alt=\"\" width=\"300\" height=\"276\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt1-300x276.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt1-768x707.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt1-550x507.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomakt1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<p class=\"centering\" style=\"text-align: left;\">\u5c3f\u5d29\u75c7\u306b\u3066\u767a\u75c7\u3057\u305f\uff12\u5e74\u5f8c\u306b\u3088\u3046\u3084\u304f\u5c0f\u3055\u306aneurohypophyseal germinoma\u3092\u767a\u898b\u3055\u308c\u305f\uff19\u6b73\u5973\u5150\u4f8b\u3067\u3059\u3002\u8853\u524d\u306eT1\u5f37\u8abf\u753b\u50cf\u3067\u306f\u4e0b\u5782\u4f53\u5f8c\u8449\u306ebrightness\u304c\u6d88\u5931\u3057\uff0c\u4e0b\u5782\u4f53\u67c4\u304c\u816b\u5927\u3057\u3066\u3044\u307e\u3059\uff08\u5de6\u5074\uff09\u3002\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u3067\u816b\u760d\u90e8\u5206\u304c\u5897\u5f37\u3055\u308c\u307e\u3059\u304c\u524d\u8449\u3088\u308a\u306f\u4f4e\u4fe1\u53f7\u3068\u306a\u3063\u3066\u3044\u307e\u3059\uff08\u53f3\u5074\uff09\u3002\u7d4c\u8776\u5f62\u9aa8\u6d1e\u751f\u691c\u8853\u3067\u78ba\u5b9a\u8a3a\u65ad\u3092\u5f97\u305f\u5f8c\u306b\uff0c\u30b7\u30b9\u30d7\u30e9\u30c1\u30f3\u3068\u30a8\u30c8\u30dd\u30b7\u30c9\u3092\uff11\u30b3\u30fc\u30b9\u6295\u4e0e\u3057\u305f\u3068\u3053\u308d\u816b\u760d\u306f\u5b8c\u5168\u6d88\u5931\u3057\u307e\u3057\u305f\u30023\u30b3\u30fc\u30b9\u5f8c\u306b24Gy12\u5206\u5272\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u518d\u767a\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u6b8b\u3063\u3066\u3044\u305f\u4e0b\u5782\u4f53\u524d\u8449\u6a5f\u80fd\u306f\u6cbb\u7642\u5f8c\u306b\u5c11\u3057\u6539\u5584\u3057\u307e\u3057\u305f\u3002\u751f\u691c\u8853\u3067\u306f\uff0c\u30c8\u30eb\u30b3\u978d\u5e95\u3092\u958b\u3051\u3066\u4e0b\u5782\u4f53\u5f8c\u8449\u306e\u4e0b\u90e8\u3092\u76ee\u6a19\u306b\u3057\u3066\u5c0f\u3055\u306a\u7d44\u7e54\u63a1\u53d6\u3092\u3057\u307e\u3059\u3002GHD\u304c\u3042\u3063\u3066\u3082\u524d\u8449\u306b\u306fmass\u3068\u3057\u3066\u306e\u816b\u760d\u304c\u7121\u3044\u3068\u8003\u3048\u305f\u65b9\u304c\u3044\u3044\u3067\u3057\u3087\u3046\u3002<\/p>\n<h4><span style=\"color: #000080;\"><strong>bifocal tumor<br \/>\n<\/strong><\/span><span style=\"color: #000080;\"><strong>\u677e\u679c\u4f53\u3068\u795e\u7d4c\u4e0b\u5782\u4f53\u540c\u6642\u767a\u751f<br \/>\nsynchronous tumor, tandem lesion<\/strong><\/span><\/h4>\n<ul>\n<li>\u540c\u6642\u3068\u3044\u3063\u3066\u3082\u8133\u5ba4\u4e0a\u8863\u3067\u3064\u306a\u304c\u3063\u3066\u3044\u307e\u3059\u304b\u3089\uff0c\u3069\u3061\u3089\u304b\u304c\u6d78\u6f64\u75c5\u5de3\u3067\u7d44\u7e54\u74b0\u5883\u7684\u306b\u5897\u5927\u3057\u3084\u3059\u304b\u3063\u305f\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093<\/li>\n<li>\u7d44\u7e54\u578b\u306f\uff0c\u307b\u3068\u3093\u3069\u304cgerminoma\u3067\u3059\uff0c\u6975\u3081\u3066\u7a00\u306b\u5947\u5f62\u816b\u304c\u6df7\u5728\u3057\u307e\u3059<\/li>\n<li>\u3067\u3082\uff0cHCG\u304c\u6975\u7aef\u306b\u9ad8\u3051\u308c\u3070\u7d68\u6bdb\u764c\uff0cAFP\u304c\u6975\u7aef\u306b\u9ad8\u3051\u308c\u3070\u5375\u9ec4\u56a2\u7a2e\u304c\u6df7\u3058\u3063\u3066\u3044\u307e\u3059<\/li>\n<li>bifocal tumor \u306b\uff0c\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3059\u308b\uff0cHCG\u03b2\u304c5mIU\/ml\u3092\u8d85\u3048\u306a\u3044\uff0cAFP\u304c\u6b63\u5e38\u7bc4\u56f2\uff0c\u5947\u5f62\u816b\u3092\u793a\u5506\u3059\u308b\u753b\u50cf\u6240\u898b\u304c\u306a\u3044\uff0c\u3068\u3044\u3046\u9805\u76ee\u3092\u52a0\u3048\u308b\u3068\u307e\u305a\u9593\u9055\u3044\u306a\u304fgerminoma\u3067\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089<span style=\"color: #000080;\"><strong>\u3053\u306e\u6761\u4ef6\u3092\u6e80\u305f\u305b\u3070\u751f\u691c\u624b\u8853\u306f\u5fc5\u8981\u306a\u3044<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u3082\u3061\u308d\u3093\uff0c\u4e16\u306e\u4e2d\u306b\u306f\u4f8b\u5916\u3082\u3042\u308a\u307e\u3059\u304c\uff0c\u751f\u691c\u8853\u3068\u3044\u3063\u3066\u3082\u5168\u3066\u306e\u816b\u760d\u90e8\u5206\u3092\u898b\u308b\u308f\u3051\u3067\u306f\u306a\u3044\u306e\u3067\uff0c\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u306e\u6975\u3081\u3066\u4f4e\u3044\u53ef\u80fd\u6027\u306f\uff0c\u751f\u691c\u3092\u3057\u3066\u3082\u3057\u306a\u304f\u3066\u3082\u5b8c\u5168\u6392\u9664\u3067\u304d\u306a\u3044\u304b\u3089\u540c\u3058\u306a\u306e\u3067\u3059<\/li>\n<li>\u9f3b\u8154\u304b\u3089\u306e\u30c8\u30eb\u30b3\u978d\u5185\u816b\u760d\u306e\u751f\u691c\u8853\u306f\uff0c30\u5206\u304f\u3089\u3044\u3067\u6e08\u3080\u3057\uff0c\u306a\u3093\u306e\u4fb5\u8972\u3082\u306a\u3044\u306e\u3067\uff0c\u751f\u691c\u3059\u308b\u3068\u3044\u3046\u8003\u3048\u3082\u3042\u308a\u307e\u3059\uff08\u305d\u3046\u3057\u3066\u3044\u307e\u3059\uff09<\/li>\n<\/ul>\n<hr \/>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17054\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihih11-300x291.jpg\" alt=\"\" width=\"300\" height=\"291\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihih11-300x291.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihih11-550x534.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihih11-768x745.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaihih11.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><br \/>\n\u8840\u6e05HCG\u304c2.1mIU\/ml\uff0c\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3057\u305f\u601d\u6625\u671f\u7537\u5150\u3067\u3059\u3002\u77f3\u7070\u5316\u306f\u3042\u308a\u307e\u305b\u3093\u3057\uff0c\u8102\u80aa\u7d44\u7e54\u306a\u3069\u3082\u6df7\u5728\u3057\u307e\u305b\u3093\u3002\u751f\u691c\u8853\u3092\u3057\u306a\u304f\u3066\u3082germinoma\u3068\u8a3a\u65ad\u3067\u304d\u307e\u3059\u3002\u3067\u3082\u7c21\u5358\u306a\u306e\u3067\uff0c\u7d4c\u9f3b\u7684\u306a\u751f\u691c\u8853\u3092\u884c\u3063\u305f\u65b9\u304c\u3044\u3044\u3067\u3059\u3002<\/p>\n<hr \/>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodsag.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17688\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodsag-300x294.jpg\" alt=\"\" width=\"300\" height=\"294\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodsag-300x294.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodsag-550x539.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodsag-768x753.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodsag.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodciss.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17689\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodciss-300x289.jpg\" alt=\"\" width=\"300\" height=\"289\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodciss-300x289.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodciss-550x530.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodciss-768x740.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodciss.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u3053\u306e\u4f8b\u306f18\u6b73\uff0cHCG 0.1mIU\/ml\uff0c\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u795e\u7d4c\u4e0b\u5782\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306a\u306e\u3067\uff0c\u4e0b\u5782\u4f53\u524d\u8449\u306e\u307f\u304c\u6b8b\u3063\u3066\u5f8c\u8449\u304b\u3089\u8996\u5e8a\u4e0b\u90e8\u304c\u816b\u760d\u5316\u3057\u3066\u3044\u307e\u3059\u3002\u3088\u304f\u3088\u304f\u898b\u308b\u3068\u677e\u679c\u4f53\u306b\u3082\u3054\u304f\u5c0f\u3055\u306a\u816b\u760d\u304c\u3042\u308a\u307e\u3059\u3002\u53f3\u306eCISS\u753b\u50cf\u3067\u677e\u679c\u4f53\u306e\u816b\u760d\u5316\u304c\u660e\u77ad\u3067\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodice1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17690\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodice1-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodice1-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodice1-550x549.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodice1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodice1-768x766.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaodice1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\n\u7d4c\u9f3b\u751f\u691c\u8853\u3067\u4e0b\u5782\u4f53\u5f8c\u8449\u90e8\u5206\u304cgerminoma\u3068\u3044\u3046\u3053\u3068\u3092\u78ba\u8a8d\u3057\u3066\u304b\u3089ICE (IFO\/CDDP\/VP-16)\u30921\u30b3\u30fc\u30b9\u52a0\u3048\u3066\uff13\u9031\u9593\u5f8c\u306e\u753b\u50cf\u3067\u3059\u3002\u816b\u760d\u306f\u7070\u767d\u9686\u8d77\u306e\u90e8\u5206\u3092\u6b8b\u3057\u3066\u307b\u307c\u6d88\u5931\u3057\u3066\u3044\u307e\u3059\u3002\u677e\u679c\u4f53\u90e8\u306e\u816b\u760d\u3082\u6d88\u3048\u3066\u3044\u307e\u3059\u3002\u5178\u578b\u7684\u306agerminoma\u306e\u5316\u5b66\u7642\u6cd5\u53cd\u5fdc\u6027\u3092\u793a\u3057\u3066\u3044\u307e\u3059\u3002\u4e0b\u5782\u4f53\u524d\u8449\u6a5f\u80fd\u306f\u6b63\u5e38\uff0c\u5c3f\u5d29\u75c7\u3082\u5c11\u3057\u826f\u304f\u306a\u308a\u307e\u3057\u305f\u3002<\/p>\n<hr \/>\n<h3><a href=\"http:\/\/www.youtube.com\/watch?v=SN-4WnJMIIw&amp;feature=youtube_gdata_player\" target=\"_blank\" rel=\"noopener noreferrer\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u5185\u8996\u93e1\u751f\u691c\u8853\u306e\u30d3\u30c7\u30aa (endoscopic biopsy of germinoma)\u3000\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u52d5\u753b\u304c\u898b\u3048\u307e\u3059\uff083\u520646\u79d2\uff09<\/a><\/h3>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germiendo.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-15257\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germiendo-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><br \/>\nPeroperative view during endoscopic surgery in a boy with neurohypophyseal and pineal germinoma. There are numerous tiny nodules on the wall of right lateral ventricle.<\/p>\n<p>These lesions are neither tumor CSF seeding nor dissemination. Germinoma cells always invades into subependymal glial tissue and spread to the whole ventricular system including the ovex. This has been called as subependymal infiltration (extension) of germinoma. Third ventriculostomy at the tuber cinereum in front of the mammillary bodies and tumor biopsy at the pineal lesion were shown.<\/p>\n<h4><span style=\"color: #000080;\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306b\u751f\u691c\u8853\u3092\u3057\u306a\u3044\u3068\u3044\u3046\u9078\u629e\u80a2\u306f\u3042\u308b\u304b\uff1f<\/span><\/h4>\n<h5>\u7b54\u3048\uff1a\u3042\u308a\u307e\u3059<\/h5>\n<\/div>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-19876\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais2-300x285.jpg\" alt=\"\" width=\"300\" height=\"285\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais2-300x285.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais2-550x523.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais2-768x730.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais2.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-19877\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais1-300x290.jpg\" alt=\"\" width=\"300\" height=\"290\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais1-300x290.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais1-550x531.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais1-768x742.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais3-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-19880\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais3-1-300x294.jpg\" alt=\"\" width=\"300\" height=\"294\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais3-1-300x294.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais3-1-550x540.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais3-1-768x754.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais3-1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-19879\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais4-300x286.jpg\" alt=\"\" width=\"300\" height=\"286\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais4-300x286.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais4-550x523.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais4-768x731.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais4.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u8efd\u5ea6\u306e\u8907\u8996\u306e\u307f\u3067\u767a\u75c7\u3057\u305f20\u4ee3\u524d\u534a\u7537\u6027\u3067\u3059\u3002\u53f3\u4e0a\u306e\u3088\u3046\u306b\u677e\u679c\u4f53\u816b\u760d\u306e\u524d\u306b\u5272\u308c\u76ee\u304c\u5165\u308b\u3088\u3046\u306b\u7b2c\uff13\u8133\u5ba4\u304c\u3042\u308a\uff0c\u4e21\u5074\u8996\u5e8a\u306b\u6d78\u6f64\u3059\u308b\u305f\u3081\u306b\u8efd\u5ea6\u306e\u8996\u5e8a\u6d6e\u816b\u304c\u3042\u308a\uff0c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u3067\u5f37\u304f\u5897\u5f37\u3055\u308c\u4e00\u90e8\u306b\u306e\u3046\u80de\u304c\u3042\u308a\u307e\u3059\u3002\u3053\u308c\u3060\u3051\u3067\u3082geriminoma\u306b\u304b\u306a\u308a\u7279\u6709\u306e\u6240\u898b\u3067\u3059\u3002\u3055\u3089\u306b\uff0c\u7070\u767d\u9686\u8d77\uff08\u77e2\u5370\uff09\u306e\u3068\u3053\u308d\u306b\u5c0f\u3055\u306a\u795e\u7d4c\u4e0b\u5782\u4f53germinoma\u816b\u760d\u304c\u3042\u308a\u307e\u3059 (bifocal tumor)\u3002HCG\u306f\u6e2c\u5b9a\u9650\u754c\u4ee5\u4e0b\uff0cAFP 2.5\u3067\uff0c\u6c34\u982d\u75c7\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u5168\u3066\u306e\u81e8\u5e8a\u6240\u898b\u304cgerminoma\u3067\u3042\u308b\u3053\u3068\u3092\u793a\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais7.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-19881\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais7-300x289.jpg\" alt=\"\" width=\"300\" height=\"289\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais7-300x289.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais7-550x529.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais7-768x739.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomais7.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/04\/germinomais6.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20465\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/04\/germinomais6-300x281.jpg\" alt=\"\" width=\"300\" height=\"281\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/04\/germinomais6-300x281.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/04\/germinomais6-550x514.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/04\/germinomais6-768x718.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2016\/04\/germinomais6.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u751f\u691c\u75c5\u7406\u8a3a\u65ad\u3092\u3057\u306a\u3044\u3067ICE\u5316\u5b66\u7642\u6cd5\u30921\u30b3\u30fc\u30b9\u7d42\u3048\u305f\u5f8c\u306e\u753b\u50cf\u3067\u3059\u3002\u816b\u760d\u306f\u6d88\u5931\u3057\u3066\u3044\u307e\u3059\u3002\u3053\u308c\u3067germinoma\u3067\u3042\u308b\u3053\u3068\u304c\u78ba\u8a8d\u3067\u304d\u305f\u306e\u3067\uff0cICE\u5316\u5b66\u7642\u6cd5\u30922\u30b3\u30fc\u30b9\u8ffd\u52a0\u3057\u3066\uff0c25.2\u30b0\u30ec\u30a4\u306e\u5168\u8133\u5ba4\u7167\u5c04\u3092\u3057\u3066\u6cbb\u7642\u3092\u7d42\u4e86\u3057\u307e\u3057\u305f\u3002<\/p>\n<hr \/>\n<h3><span style=\"color: #000080;\">\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/span><\/h3>\n<ul>\n<li>\u3080\u305a\u304b\u3057\u3044\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3059<\/li>\n<li>\u7537\u5150\u306b\u591a\u3044\u3067\u3059<\/li>\n<li>\u75c7\u72b6\u304c\u308f\u304b\u308a\u306b\u304f\u3044\u306e\u304c\u7279\u9577\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u3086\u3063\u304f\u308a\uff08\u6570\u30f6\u6708\u304b\u30892\u5e74\u304f\u3089\u3044\uff09\u7247\u65b9\u306e\u624b\u8db3\u306e\u52d5\u304d\u304c\u60aa\u304f\u306a\u308b<\/strong><\/span>\uff08\u7de9\u5f90\u9032\u884c\u6027\u7247\u9ebb\u75fa\uff09<\/li>\n<li>\u3086\u3063\u304f\u308a\u6027\u683c\u5909\u5316\u304c\u751f\u3058\u308b\u305f\u3081\uff0c<strong><span style=\"color: #000080;\">\u7279\u306b\u591a\u52d5\u75c7\uff0c\u81ea\u9589\u75c7\uff0cAD\/HD\uff0c\u6ce8\u610f\u6b20\u9665\u969c\u5bb3\u3068\u8a3a\u65ad<\/span><\/strong>\u3092\u53d7\u3051\u308b\u5b50\u3069\u3082\u305f\u3061\u306f\u591a\u3044\u3067\u3059<\/li>\n<li>MRI\u3067\u8133\u816b\u760d\u3089\u3057\u304f\u898b\u3048\u306a\u3044\u3068\u8a00\u308f\u308c\u307e\u3059<\/li>\n<li>\u8996\u5e8a\u4e0b\u90e8\u4e0b\u5782\u4f53\u306b\u96a0\u308c\u305f\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de occult germinoma \u3092\u5408\u4f75\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u8996\u5e8a\u4e0b\u90e8\u4e0b\u5782\u4f53\u306b\u96a0\u308c\u305f\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u3042\u308b\u5834\u5408\u306b\u306f\uff0c\u4f4e\u8eab\u9577\u3084\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3057\u3066\u304b\u3089\uff0c\u6570\u5e74\u304b\u304b\u3063\u3066\u9ebb\u75fa\u3084\u6ce8\u610f\u6b20\u9665\u969c\u5bb3\u306a\u3069\u3067\u767a\u75c7\u3057\u307e\u3059<\/li>\n<\/ul>\n<h4>MRI\u306e\u7279\u5fb4\u306f\uff12\u3064\u306e\u30bf\u30a4\u30d7\u304c\u3042\u308a\u307e\u3059<\/h4>\n<h5>1.\u3000\u5927\u8133\u57fa\u5e95\u6838\u306b\u816b\u760d\u3068\u3057\u3066\u306e\u584a\u3092\u4f5c\u3063\u3066\u5927\u304d\u304f\u306a\u308b\u3082\u306e<\/h5>\n<ul>\n<li>\u306f\u3063\u304d\u308a\u3057\u305f\u816b\u760d\u304c\u3042\u308a\uff0c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u307e\u3059<\/li>\n<li>\u5927\u304d\u3055\u306e\u5272\u306bmass effect\u304c\u5c11\u306a\u3044\u304b\u3082\u3057\u308c\u307e\u305b\u3093<\/li>\n<li>\u816b\u760d\u5468\u56f2\u6d6e\u816b\u3082\u898b\u3089\u308c\u307e\u3059<\/li>\n<li>\u60aa\u6027\u795e\u7d4c\u81a0\u816b\uff08\u9000\u5f62\u6210\u6027\u4e4f\u7a81\u8d77\u81a0\u816b\u3084\u81a0\u82bd\u816b\uff09\u306e\u3088\u3046\u306b\u898b\u3048\u307e\u3059<\/li>\n<\/ul>\n<h5>2.\u3000\u816b\u760d\u304c\u96a0\u308c\u3066\u3057\u307e\u3063\u3066\u307b\u3068\u3093\u3069\u898b\u3048\u306a\u3044\u3082\u306e<br \/>\n\u30aa\u30ab\u30eb\u30c8\u30fb\u30bf\u30a4\u30d7 occult type<\/h5>\n<ul>\n<li>\u304a\u5316\u3051\u306e\u3088\u3046\u306a\u816b\u760d\u3067\u898b\u3048\u307e\u305b\u3093<\/li>\n<li>\u795e\u7d4c\u4e0b\u5782\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3082\u30aa\u30ab\u30eb\u30c8\u30fb\u30bf\u30a4\u30d7\u306f\u3042\u308a\u307e\u3059\u306e\u3067\u540c\u3058\u3088\u3046\u306a\u3082\u306e\u3067\u3059<\/li>\n<li>1980\u5e74\u4ee3\u3067\u306f\uff0c<span style=\"color: #000080;\"><strong>\u539f\u56e0\u4e0d\u660e\u306e\u5927\u8133\u534a\u7403\u840e\u7e2e<\/strong><\/span>\u306f\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3042\u308b\u3068\u8a00\u308f\u308c\u3066\u3044\u307e\u3057\u305f<\/li>\n<li>\u7247\u5074\u306e\u5927\u8133\u57fa\u5e95\u6838\u3092\u4e2d\u5fc3\u306b\u8133\u840e\u7e2e\u3060\u3051\u304c\u307f\u3048\u308b\u3068\u3044\u3046\u3082\u306e\u3067\u3059<\/li>\n<li>\u73fe\u5728\u306f\u305d\u3053\u307e\u3067\u9032\u884c\u3059\u308b\u4f8b\u304c\u306a\u304f\uff0c\u534a\u7403\u840e\u7e2e\u306b\u81f3\u308b\u524d\u306b\u767a\u898b\u3055\u308c\u307e\u3059<\/li>\n<li>MRI\u3067\u3088\u304f\u898b\u3048\u306a\u3044\uff0c\u306f\u3063\u304d\u308a\u3057\u306a\u3044\uff0c\u3068\u8a00\u308f\u308c\u308b\u306e\u304c\u9006\u306b\u7279\u9577\u3068\u3082\u8a00\u3048\u307e\u3059<\/li>\n<li>\u30ec\u30f3\u30ba\u6838\uff0c\u5185\u5305\u3042\u305f\u308a\u306b\uff0cT2\/FLAIR\u3067\u30dc\u30c3\u3068\u3057\u305f\u5f71\u304c\u307f\u3048\u307e\u3059<\/li>\n<li>\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u307e\u305b\u3093<\/li>\n<\/ul>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaht2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-9187 size-medium\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaht2-297x300.jpg\" alt=\"germinomaht2\" width=\"297\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaht2-297x300.jpg 297w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaht2-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaht2.jpg 472w\" sizes=\"auto, (max-width: 297px) 100vw, 297px\" \/><\/a><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-9186 size-medium\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaht1-297x300.jpg\" alt=\"germinomaht1\" width=\"297\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaht1-297x300.jpg 297w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaht1-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaht1.jpg 472w\" sizes=\"auto, (max-width: 297px) 100vw, 297px\" \/><\/p>\n<p>10\u4ee3\u306e\u7537\u5150\u3067\uff0c\u975e\u5e38\u306b\u3086\u3063\u304f\u308a1\u5e74\u304f\u3089\u3044\u304b\u3051\u3066\u5de6\u7247\u9ebb\u75fa\u304c\u9032\u884c\u3057\u307e\u3057\u305f\uff0c\u75d9\u6027\u7247\u9ebb\u75fa\u3067\u3059\u3002\u843d\u3061\u7740\u304d\u306e\u306a\u3044\u6027\u683c\u3067\u3082\u3042\u308a\u307e\u3057\u305f\u3002\u8840\u6e05HCG-beta 0.1\u3067\u967d\u6027\u3067\u3057\u305f\u3002\u3053\u306e\u75c5\u5909\u306f\u5185\u5305\u5f8c\u811a\u306e\u5c0f\u3055\u306a\u3082\u306e\u3067\u3059\u304b\u3089\uff0c\u5b9a\u4f4d\u751f\u691c\u8853\u3067\u3055\u3048\u3082\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u306e\u3067\u884c\u3044\u307e\u305b\u3093\u3002\u51fa\u8840\u306e\u30ea\u30b9\u30af\u3068\u3044\u3046\u308f\u3051\u3067\u306f\u306a\u304f\uff0c\u7d44\u7e54\u63a1\u53d6\u3067\u5185\u5305\u9ad8\u811a\u306ecompact\u306a\u767d\u8cea\u3092\u640d\u50b7\u3057\u3066\u75c7\u72b6\u3092\u60aa\u304f\u3059\u308b\u304b\u3089\u3067\u3059\u3002\u3054\u4e21\u89aa\u3068\u3088\u304f\u8a71\u3057\u5408\u3063\u3066\u75c5\u7406\u8a3a\u65ad\u306a\u3057\u3067\u6cbb\u7642\u3092\u958b\u59cb\u3057\u307e\u3059\u3002ICE\u5316\u5b66\u7642\u6cd54\u30b3\u30fc\u30b9\u3068\u5168\u8133\u7167\u5c0425.2Gy\/14fr \u3067\u6cbb\u7642\u3057\u307e\u3057\u305f\u3002ICE\u5316\u5b66\u7642\u6cd5\u958b\u59cb\u5f8c\u304b\u3089\u306f\u7247\u9ebb\u75fa\u306e\u60aa\u5316\u50be\u5411\u304c\u505c\u6b62\u3057\u3066\uff0c\u75c7\u72b6\u304c\u6539\u5584\u50be\u5411\u306b\u5411\u304b\u3044\u307e\u3057\u305f\u3002\u3084\u304c\u3066\uff0c\u8d70\u308c\u308b\u3088\u3046\u306b\u3082\u306a\u308a\u307e\u3057\u305f\u3002<\/p>\n<h4>\u610f\u5916\u306b\u5371\u306a\u3044\u751f\u691c\u8853<\/h4>\n<p>\u6fa4\u6751\u81ea\u8eab\u306e\u7d4c\u9a13\u3067\u3059\uff0c\u5b9a\u4f4d\u8133\u624b\u8853\u3067\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3092\u751f\u691c\u3057\u3066\uff0c2\u4f8b\u3067\u8133\u51fa\u8840\u3092\u751f\u3058\u307e\u3057\u305f\uff0c1\u4f8b\u3067\u306f\u5de6\u306e\u5927\u8133\u57fa\u5e95\u6838\u51fa\u8840\u3067\u958b\u982d\u624b\u8853\u3092\u8981\u3057\uff0c\u5931\u8a9e\u3068\u7247\u9ebb\u75fa\u3092\u751f\u3058\u307e\u3057\u305f\uff08\u3067\u3082\u4eca\u306f\u5143\u6c17\u3067\u3059\u3051\u3069\uff09\u3002\u305d\u306e\u5f8c\uff0c\u5b66\u4f1a\u306a\u3069\u3067\u3044\u308d\u3044\u308d\u306a\u8133\u5916\u79d1\u533b\u306b\u805e\u3044\u3066\u56de\u3063\u305f\u306e\u3067\u3059\u304c\uff0c\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u751f\u691c\u8853\u3067\u8133\u51fa\u8840\u3092\u7d4c\u9a13\u3057\u305f\u8133\u5916\u79d1\u533b\u306f\u591a\u6570\u3044\u307e\u3057\u305f\u3002\u3053\u306e\u60c5\u5831\u306f\uff0c\u304a\u305d\u3089\u304f\u5b66\u4f1a\u767a\u8868\u3084\u8ad6\u6587\u306b\u73fe\u308c\u308b\u3053\u3068\u306f\u306a\u3044\u3068\u8003\u3048\u307e\u3059\u306e\u3067\uff0c\u53c2\u8003\u306b\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/p>\n<h4>PET\u691c\u67fb<\/h4>\n<ul>\n<li>MRI\u3067\u307f\u3048\u306a\u3044\u3088\u3046\u306a\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c <strong><span style=\"color: #ff0000;\">Met-PET\u00a0\u30e1\u30c1\u30aa\u30cb\u30f3\u30da\u30c3\u30c8<\/span><\/strong>\u3067\u53d6\u308a\u8fbc\u307f\u304c\u307f\u3089\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u75c5\u5909\u306e\u4e2d\u5fc3\u90e8\u3060\u3051\u304c\u308f\u305a\u304b\u306bMet uptake\u304c\u4e0a\u6607\u3057\u3066\uff0c\u307c\u30fc\u3063\u3068\u5149\u3063\u305f\u3088\u3046\u306a\u753b\u50cf\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u91cd\u8981\u306a\u88dc\u52a9\u8a3a\u65ad\u3068\u306a\u308a\u307e\u3059<\/li>\n<\/ul>\n<p>Sudo A1, Shiga T, Okajima M, Takano K, Terae S, Sawamura Y, Ohnishi A, Nagashima K, Saitoh S: High uptake on 11C-methionine positron emission tomographic scan of basal ganglia germinoma with cerebral hemiatrophy. AJNR Am J Neuroradiol 24:1909-1911, 2003<\/p>\n<h4>\u75c5\u72b6\u306e\u9032\u884c<\/h4>\n<p>\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\uff0c\u6027\u683c\u5909\u5316\uff08\u591a\u52d5\u75c7\uff0c\u5b66\u7fd2\u969c\u5bb3\uff0c\u81ea\u9589\u75c7\uff09\u3067\u767a\u75c7\u3059\u308b\u3068\u304b\u306a\u308a\u60aa\u5316\u3059\u308b\u307e\u3067\u6c17\u3065\u304b\u308c\u307e\u305b\u3093\u3002\u7247\u9ebb\u75fa\u3067\u767a\u75c7\u3057\u3066\u3082\u305d\u3046\u3067\u3059\u3002\u75c7\u72b6\u304c\u9032\u884c\u3057\u3059\u304e\u308b\u3068\u6cbb\u7642\u3057\u3066\u3082\u5143\u306b\u623b\u308a\u307e\u305b\u3093\u3002\u7cbe\u795e\u75c7\u72b6\u3082\u7247\u9ebb\u75fa\u3082\u6b8b\u3063\u305f\u307e\u307e\u3067\uff0c\u7cbe\u795e\u8eab\u4f53\u306e\u969c\u5bb3\u5150\u3068\u3057\u3066\u751f\u304d\u6b8b\u3063\u3066\u3044\u304b\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u3067\u3059\u304b\u3089\uff0c<span style=\"color: #ff0000;\"><strong>\u75c5\u7406\u78ba\u5b9a\u8a3a\u65ad\u304c\u3067\u304d\u306a\u3044\u5834\u5408\u3067\u3082\u6cbb\u7642\u3092\u958b\u59cb\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/strong><\/span>\u3002<\/p>\n<h4>\u6cbb\u7642\u306e\u9806\u5e8f<\/h4>\n<ul>\n<li>\u6cbb\u7642\u306e\u8003\u3048\u65b9\u306f\uff0c\u4e00\u822c\u7684\u306a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3088\u308a\u6cbb\u308a\u306b\u304f\u3044\u3057\u518d\u767a\u4f8b\u304c\u591a\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059<\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u306f\uff0cICE (CDDP, VP-16, IFO)\u5316\u5b66\u7642\u6cd5\u30924\u30b3\u30fc\u30b9\u3057\u307e\u3059<\/li>\n<li>\u5316\u5b66\u7642\u6cd5\u3092\u7d42\u3048\u3066\u304b\u3089<span style=\"color: #333333;\">\u5168\u8133\u7167\u5c04<\/span>\u3092\u3057\u307e\u3059<\/li>\n<\/ul>\n<h4>\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u653e\u5c04\u7dda\u6cbb\u7642<\/h4>\n<ul>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\uff0c\u6a19\u6e96\u7684\u306a\u5168\u8133\u5ba4\u7167\u5c04 whole ventricle irradiation WVI\u3067\u306f\u30ab\u30d0\u30fc\u3057\u5207\u308c\u307e\u305b\u3093<\/li>\n<li>\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u521d\u767a\u6642\u3068\u53cd\u5bfe\u5074\u306e\u8133\u306b\u518d\u767a\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\u4e0b\u5782\u4f53\u3092\u542b\u3081\u305f<span style=\"color: #000080;\"><strong>\u5168\u8133\u7167\u5c04<\/strong><\/span> whole brain irradiation WBI\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u7dda\u91cf\u306f25.2\u30b0\u30ec\u30a4\u309214\u5206\u5272\u306a\u3089\u78ba\u5b9f\u3067\u3057\u3087\u3046<\/li>\n<li>7\u6b73\u4ee5\u4e0b\u306e\u5c0f\u3055\u3044\u5b50\u306b\u306f\u8a8d\u77e5\u6a5f\u80fd\u3092\u5b88\u308b\u305f\u3081\u306b23.4\u30b0\u30ec\u30a413\u5206\u5272\u3082\u9078\u629e\u80a2\u3067\u3059<\/li>\n<\/ul>\n<h4>\u60aa\u6027\u795e\u7d4c\u81a0\u816b\u3068\u9593\u9055\u3048\u305d\u3046\u306a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/h4>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm11.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6574\" title=\"germinomanm1\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm11-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm21.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6575\" title=\"germinomanm2\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm21-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm33.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6576\" title=\"germinomanm3\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm33-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6232\" title=\"germinomanm4\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm4-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6235\" title=\"germinomanm5\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm5-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm6.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6236\" title=\"germinomanm6\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm6-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><\/p>\n<p>14\u6b73\u3067\u53f3\u306e\u7247\u9ebb\u75fa\u3068\u5b66\u529b\u306e\u4f4e\u4e0b\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u9020\u5f71\u304c\u307e\u3060\u3089\u3067\u6700\u521d\u306f\u81a0\u82bd\u816b\u304b\u306a\uff1f\u3068\u601d\u3044\u307e\u3057\u305f\u304c\uff0cmass effect\u304c\u8efd\u3044\u3053\u3068\u304c\u89e3\u308a\u307e\u3059\u3002geminoma\u3068\u3057\u3066\u306f\u73cd\u3057\u3044\u306e\u3067\u3059\u304cperifocal edema\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm7.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6237\" title=\"germinomanm7\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm7-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm8.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-6238\" title=\"germinomanm8\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomanm8-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><\/p>\n<p>\u5b9a\u4f4d\u751f\u691c\u8853\u3067\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u3092\u3057\u3066\u5316\u5b66\u7642\u6cd5\u3092\u52a0\u3048\u305f\u5f8c\u306e\u753b\u50cf\u3067\u3059\u3002germinoma\u306e\u304a\u7d04\u675f\u3069\u304a\u308a\uff0c\u5316\u5b66\u7642\u6cd5\u3067\u304d\u308c\u3044\u306b\u6d88\u5931\u3057\u307e\u3059\u3002\u3061\u3087\u3063\u3068\u3057\u305f\u5c0f\u3055\u306a\u5897\u5f37\u3055\u308c\u308b\u90e8\u5206\u304c\u6b8b\u308b\u306e\u3067\u3059\u304c\u3053\u308c\u306fstromal reaction (gliofibrosis)\u3092\u307f\u3066\u3044\u308b\u306e\u3067\uff0c\u6b8b\u5b58\u816b\u760d\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u4f59\u5206\u306a\u8ffd\u52a0\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u306a\u3044\u3088\u3046\u306b\u6c17\u3092\u3064\u3051\u307e\u3059\u3002<\/p>\n<h4>\u5c40\u6240\u7167\u5c04\u3067\u518d\u767a\u3057\u3066\u518d\u7167\u5c04\u3057\u305f\u4f8b\uff1a\u5de6\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/h4>\n<p>9\u6b73\u3067\u77e5\u7684\u6a5f\u80fd\u306e\u4f4e\u4e0b\u3068\u5f90\u3005\u306b\u9032\u884c\u3059\u308b\u53f3\u7247\u9ebb\u75fa\uff0c\u5931\u8a9e\u75c7\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002MRI\u3067\u306f\u5de6\u5927\u8133\u534a\u7403\u840e\u7e2e\u306e\u6240\u898b\u3060\u3051\u3067\uff0c11\u6b73\u307e\u3067\u8a3a\u65ad\u304c\u3064\u304b\u305a\u306b\u6765\u9662\u3057\u307e\u3057\u305f\u3002\u5f53\u6642\u306e\u65b9\u91dd\u3067\u5316\u5b66\u7642\u6cd5\u3068\u5de6\u5927\u8133\u57fa\u5e95\u6838\u306b\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u764224\u30b0\u30ec\u30a4\u304c\u306a\u3055\u308c\u307e\u3057\u305f\u304c\uff0c4\u5e74\u5f8c\u306b\u5de6\u5074\u982d\u8449\u306b\u518d\u767a\u3057\u3066\u5316\u5b66\u7642\u6cd5\u3068\u8133\u810a\u9ac4\u7167\u5c0424\u30b0\u30ec\u30a4\u306e\u518d\u7167\u5c04\u3092\u884c\u306a\u3063\u305f\u4f8b\u3067\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-14522\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-1-289x300.jpg\" alt=\"\" width=\"289\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-1-289x300.jpg 289w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-1-768x796.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-1-550x570.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-1.jpg 850w\" sizes=\"auto, (max-width: 289px) 100vw, 289px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-14523\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-2-295x300.jpg\" alt=\"\" width=\"295\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-2-295x300.jpg 295w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-2-768x781.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-2-550x559.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2014\/10\/germinomaot-2.jpg 850w\" sizes=\"auto, (max-width: 295px) 100vw, 295px\" \/><\/a><\/p>\n<p>\u518d\u767a\u6cbb\u7642\u304b\u308917\u5e74\u5f8c\u306eMRI\u3067\u3059\u3002\u5de6\u5927\u8133\u57fa\u5e95\u6838\u306e\u840e\u7e2e\u3068\u9ad8\u5ea6\u306e\u5168\u8133\u840e\u7e2e\u304c\u8a8d\u3081\u3089\u308c\u307b\u307c\u5bdd\u305f\u304d\u308a\u306e\u751f\u6d3b\u3067\u3059\u3002\u3053\u306e\u4f8b\u3067\u306f\uff0c\u521d\u767a\u6642\u306b\u816b\u760d\u584a\u5f62\u6210\u304c\u306a\u304f\u8a3a\u65ad\u304c\u9045\u308c\u305f\u3053\u3068\uff0c\u521d\u56de\u6cbb\u7642\u3067\u816b\u760d\u306e\u3042\u308b\u90e8\u4f4d\u3068\u305d\u306e\u5468\u8fba\u3060\u3051\u306e\u5c40\u6240\u7167\u5c04\u304c\u7528\u3044\u3089\u308c\u305f\u3053\u3068\u304c\u8aa4\u308a\u3067\u3057\u305f\u3002<br \/>\n\u6b63\u78ba\u306a\u65e9\u671f\u8a3a\u65ad\u3068\u521d\u56de\u6cbb\u7642\u3067\u306e\u5168\u8133\u4f4e\u7dda\u91cf\u7167\u5c04\u3092\u3057\u3066\u3044\u308c\u3070\uff0c\u826f\u3044\u72b6\u614b\u3067\u6cbb\u7652\u3057\u305f\u3082\u306e\u3067\u3057\u3087\u3046\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-medium wp-image-21980\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/cherrybl-300x201.jpg\" alt=\"\" width=\"300\" height=\"201\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/cherrybl-300x201.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/cherrybl-550x369.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/cherrybl-768x515.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/cherrybl.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<hr \/>\n<div class=\"setumei\">\n<h1 class=\"setumei\"><a title=\"\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u75c5\u7406\" href=\"\/sawamura\/pathocase\/germinom\/\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u80da\u816b\uff09\u306e\u75c5\u7406<br \/>\n\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u3082\u3063\u3068\u305f\u304f\u3055\u3093\u898b\u3048\u307e\u3059\uff09<\/a><\/h1>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomahashi.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-6585\" title=\"germinomahashi\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomahashi-297x300.jpg\" alt=\"\" width=\"297\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomahashi-297x300.jpg 297w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomahashi-550x555.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomahashi.jpg 709w\" sizes=\"auto, (max-width: 297px) 100vw, 297px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaty1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-6586\" title=\"germinomaty1\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaty1-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaty1-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaty1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaty1-550x550.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaty1.jpg 624w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u75c5\u7406\u8a3a\u65ad\u306f\u56f0\u96e3\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u5de6\u5074\u306e\u5199\u771f\u306e\u3088\u3046\u306b\uff0c\u591a\u304f\u306e\u5834\u5408\u306bHE\u67d3\u8272\u3067two-cell pattern\u3068\u547c\u3070\u308c\u308b\uff0c \u5927\u578b\u306e\u816b\u760d\u7d30\u80de\u3068\u5c0f\u578b\u306e\u30ea\u30f3\u30d1\u7403\u6d78\u6f64\u306e\u7279\u5fb4\u7684\u306a\u75c5\u7406\u50cf\u3067\u8a3a\u65ad\u304c\u3064\u304d\u307e\u3059\u3002\u5927\u578b\u306e\u816b\u760d\u7d30\u80de\u306f\u6955\u5186\u5f62\u306e\u5927\u304d\u306a\u6838\u306b\u5927\u304d\u306a\u6838\u5c0f\u4f53\u304c\u7279\u5fb4\u3067\u3059\u3002<\/p>\n<h4 class=\"setumei\">\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\uff08\u80da\u816b\uff09\u306e\u6cbb\u7642\u306e\u6b74\u53f2<\/h4>\n<p>1990\u5e74\u4ee3\u307e\u3067germinoma\u306b\u5bfe\u3057\u3066\u306f\uff0c\u62e1\u5927\u5c40\u6240\uff0c\u5168\u8133\u5ba4\u3042\u308b\u3044\u306f\u5168\u8133\u810a\u9ac4\u3092\u542b\u3080\u5e83\u7bc4\u56f2\u306a\u9818\u57df\u306b\uff0c45\uff5e55Gy\u307b\u3069\u306e\u9ad8\u7dda\u91cf\u3092\u7528\u3044\u308b\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u884c\u308f\u308c\u307e\u3057\u305f\u300210\u5e74\u751f\u5b58\u5272\u5408\u306f90%\u7a0b\u5ea6\u3068\u6e80\u8db3\u3059\u3079\u304d\u7d50\u679c\u306f\u5f97\u3089\u308c\u3066\u3044\u307e\u3057\u305f\u304c\uff0c\u9577\u671f\u751f\u5b58\u4f8b\u306b\u304a\u3044\u3066\uff0c\u7cbe\u795e\u767a\u9054\u9045\u6ede\uff0c\u8a8d\u77e5\u6a5f\u80fd\uff08\u77e5\u80fd\uff09\u4f4e\u4e0b\uff0c\u9593\u8133\u4e0b\u5782\u4f53\u6a5f\u80fd\u4f4e\u4e0b\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\u3002\u3053\u308c\u3089\u306f\u6cbb\u7642\u5f8c20\u5e74\u3092\u7d4c\u3066\u304b\u3089\u751f\u3058\u308b\u3053\u3068\u3082\u3042\u308b\u306e\u3067\u3059\u3002 1990\u5e74\u521d\u982d\u307e\u3067\u306e\u79c1\u306e\u7d4c\u9a13\u3067\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u305f\u9577\u671f\u751f\u5b5885\u75c7\u4f8b\uff08\u89b3\u5bdf\u671f\u9593\u4e2d\u592e\u502488\u30f5\u6708\uff09\u306e\u3046\u3061\uff0c58\u540d\u304c\u4e0b\u5782\u4f53\u30db\u30eb\u30e2\u30f3\u306e\u88dc\u5145\u3092\u53d7\u3051\u3066\u304a\u308a\uff0c26\u540d\u304c\u65e5\u5e38\u751f\u6d3b\u306b\u652f\u63f4\u3092\u8981\u3057\uff0c\u7d50\u5a5a\u3092\u3057\u3066\u5b50\u4f9b\u3092\u8a2d\u3051\u308b\u3053\u3068\u306e\u3067\u304d\u305f\u306e\u306f\u305f\u3060\uff11\u540d\u306e\u307f\u3067\u3057\u305f (Sawamura Y, et al. Eur J Cancer: 1998)\u3002<\/p>\n<p>germinoma\u306e\u9577\u671f\u751f\u5b58\u8005\u3067\uff0c\u81ea\u7acb\u3057\u3066\u307e\u3068\u3082\u306a\u793e\u4f1a\u751f\u6d3b\u3092\u9001\u308c\u3066\u3044\u308b\u60a3\u8005\u3055\u3093\u304c\u307b\u3093\u3068\u3046\u306b\u5c11\u306a\u3044\u3053\u3068\u3092\u3053\u306e\u6642\u671f\u306b\u75db\u611f\u3057\u307e\u3057\u305f\u3002<\/p>\n<p>\u305d\u306e\u305f\u30811990\u5e74\u4ee3\u534a\u3070\u304b\u3089\u306f\uff0c\u6cbb\u7642\u5f8c\u306e\u60a3\u5150\u306e\u751f\u5b58\u306e\u8cea\u3092\u5411\u4e0a\u3055\u305b\u308b\u305f\u3081\u306b\uff0c\u5316\u5b66\u7642\u6cd5\u3092\u4f75\u7528\u3057\u3066\u7167\u5c04\u7dda\u91cf\u3092\u6e1b\u5c11\u305b\u3057\u3081\u308b\u52aa\u529b\u3092\u884c\u3044\u307e\u3057\u305f\u3002germinoma\u306f\uff0cCARE, EP, ICE\u5316\u5b66\u7642\u6cd5\u306a\u3069\u3078\u306e\u611f\u53d7\u6027\u304c\u975e\u5e38\u306b\u9ad8\u304f\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\u816b\u760d\u306f\u4f8b\u5916\u306a\u304f\u307b\u307c\u5b8c\u5168\u306bMRI\u753b\u50cf\u4e0a\u3067\u6d88\u5931\u3057\u307e\u3059 (Sawamura Y, et al. J Neurosurg: 1997, 1998)\u3002 \u5316\u5b66\u7642\u6cd5\u3092\u59cb\u3081\u308b\u6642\u70b9\u3067\uff0c\u6c34\u982d\u75c7\u3092\u7ba1\u7406\u3059\u308b\u305f\u3081\u306e\u8133\u5ba4\u30c9\u30ec\u30ca\u30fc\u30b8\u3092\u7559\u7f6e\u3059\u308c\u3070\uff11\u9031\u9593\u7a0b\u5ea6\u3067\u6c34\u982d\u75c7\u306f\u6539\u5584\u3059\u308b\u306e\u3067\uff0cV-P\u30b7\u30e3\u30f3\u30c8\u8853\u3084\u30ea\u30b9\u30af\u3092\u4fb5\u3057\u3066\u307e\u3067\u306e\u7b2c\uff13\u8133\u5ba4\u958b\u7a93\u8853\u306e\u5fc5\u7528\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct3.gif\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct3.gif\" alt=\"\" width=\"470\" height=\"159\" \/><\/a><\/p>\n<p>2000\u5e74\u9803\u306e\u4f8b\u3067\u3059\u3002\u9589\u585e\u6027\u6c34\u982d\u75c7\u3092\u4f75\u767a\u3059\u308b\u677e\u679c\u4f53\u90e8germinoma\uff1a\u5de6\u306eMRI\u306f\u767a\u75c7\u6642\u306e\u3082\u306e\u3067\u3059\u3002\u5b9a\u4f4d\u7684\u751f\u691c\u8853\u3067\u78ba\u5b9a\u8a3a\u65ad\u3057\u3066\u8133\u5ba4\u30c9\u30ec\u30ca\u30fc\u30b8\u3092\u7559\u7f6e\u3057\u307e\u3057\u305f\u3002\uff11\u30b3\u30fc\u30b9\u306eICE\u5316\u5b66\u7642\u6cd5\u76f4\u5f8c\uff0c<span style=\"color: #000080;\"><strong>\u751f\u691c\u8853\u304b\u3089\uff16\u65e5\u76ee\u306eMRI\uff08\u4e2d\u592e\uff09\u3067\u306f\u816b\u760d\u306f\u307b\u307c\u6d88\u5931<\/strong><\/span>\u3057\uff0c\u6c34\u982d\u75c7\u306f\u6539\u5584\u3057\u305f\u306e\u3067\u30c9\u30ec\u30ca\u30fc\u30b8\u3092\u629c\u53bb\u3057\u307e\u3057\u305f\u3002\uff14\u30b3\u30fc\u30b9\u306e\u5316\u5b66\u7642\u6cd5\u5f8c\uff08\u53f3\u5074\uff09\u306b24Gy\u306e\u5168\u8133\u5ba4\u7167\u5c04\u3092\u52a0\u3048\u307e\u3057\u305f\u3002<\/p>\n<p>\u5316\u5b66\u7642\u6cd5\u5358\u72ec\u6cbb\u7642\u3067\u306f\u518d\u767a\u304c\u304b\u306a\u308a\u9ad8\u983b\u5ea6 (40%\u4ee5\u4e0a) \u306b\u751f\u3058\u308b\u306e\u3067\uff0c\u6700\u4f4e\u3067\u308223\uff5e25Gy\u7a0b\u5ea6\u306e\u4f4e\u7dda\u91cf\u653e\u5c04\u7dda\u7167\u5c04\u3092\u52a0\u3048\u308b\u3053\u3068\u304c\u5fc5\u9808\u3068\u306a\u308a\u307e\u3059\u3002<\/p>\n<p>1992\u5e74\u304b\u3089\u306f\uff0c\u5316\u5b66\u7642\u6cd5\u3092\u884c\u306a\u3063\u305f\u5f8c\u306b24Gy\/12\u5206\u5272\u306e\u816b\u760d\u62e1\u5927\u5c40\u6240\u306b\u5bfe\u3059\u308b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u7528\u3044\u3066\u3044\u307e\u3057\u305f\u304c\uff0c40\u4f8b\u3092\u6cbb\u7642\u3057\u305f\u6642\u70b9\u306720%\u7a0b\u306e\u518d\u767a\u306b\u906d\u9047\u3057\u307e\u3057\u305f\u3002\u518d\u767a\u4f8b\u306e\u5206\u6790\u3067\u306f\uff0c\u7167\u5c04\u91ce\u304c\u72ed\u304b\u3063\u305f\u305f\u3081\u7167\u5c04\u91ce\u5916\u518d\u767a\u3092\u62db\u3044\u305f\u3053\u3068\u304c\u660e\u3089\u304b\u3068\u306a\u308a\uff0c1998\u5e74\u304b\u3089\u306f\u5168\u8133\u5ba4\u9818\u57df\uff0825.2Gy\/14\u5206\u5272\uff09\u306b\u7167\u5c04\u91ce\u3092\u62e1\u5927\u3057\u307e\u3057\u305f\u3002\u307e\u305f\uff0c\u3068\u3066\u3082\u7a00\u306a\u306e\u3067\u3059\u304c\u8a3a\u65ad\u6642\u3088\u308a\u9ac4\u8154\u5185\u64ad\u7a2e\u3092\u5448\u3059\u308b\u75c7\u4f8b\u3067\u306f\u540c\u3058\u7dda\u91cf\u3067\u306e\u5168\u8133\u810a\u9ac4\u7167\u5c04\u3092\uff0c\u5927\u8133\u57fa\u5e95\u6838germinoma\u3067\u306f\u5168\u8133\u7167\u5c04\u3092\u7528\u3044\u307e\u3057\u305f\u3002\u3053\u306e\u6cbb\u7642\u6cd5\u3092\u958b\u59cb\u3057\u3066\u304b\u3089\u306f\uff0c\u300c\u518d\u767a\u3068\u3044\u3046\u61f8\u5ff5\u304c\u307b\u3068\u3093\u3069\u306a\u3044\u300d\u3068\u60a3\u8005\u3055\u3093\u306b\u8aac\u660e\u3067\u304d\u308b\u304f\u3089\u3044\u306b\u6cbb\u7642\u6210\u7e3e\u306f\u5411\u4e0a\u3057\u307e\u3057\u305f\u3002<\/p>\n<p>2022\u5e74\u57fa\u672c\u7684\u306b\uff0cICE\u5316\u5b66\u7642\u6cd53\u30b3\u30fc\u30b9\u3067\u816b\u760d\u304c\u307b\u307c\u6d88\u5931\u3057\u305f\u3053\u3068\u3092\u78ba\u8a8d\u3057\u3066\u304b\u3089\uff0c\u5168\u8133\u5ba4 25.2Gy\/14\u5206\u5272\uff0c8\u6b73\u4ee5\u4e0b\u306e\u4f4e\u5e74\u9f62\u5c64\u306b\u306f23.4Gy\/13\u5206\u5272\u3092\u4f7f\u7528\u3057\u3066\u3044\u307e\u3059\u3002\u3067\u308223.4Gy\u3067\u306e\u591a\u6570\u4f8b\u306e\u7d4c\u9a13\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<hr \/>\n<h4>germinoma\u306e\u751f\u5b58\u5272\u5408<\/h4>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct4.gif\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/gct4.gif\" alt=\"\" width=\"469\" height=\"277\" \/><\/a><\/p>\n<p class=\"centering\" style=\"text-align: left;\">\u53e4\u3044\u30c7\u30fc\u30bf\u3067\u3059\uff0c\u65e5\u672c\u8133\u816b\u760d\u7d71\u8a08\u306b1991\u5e74\u304b\u30891996\u5e74\u306e\u9593\u306b\u767b\u9332\u3055\u308c\u305fgerminoma458\u75c7\u4f8b\u306e\u7d2f\u7a4d\u751f\u5b58\u66f2\u7dda\u3067\uff0c10\u5e74\u751f\u5b58\u5272\u5408\u306f\u3055\u3089\u306b\u4f4e\u4e0b\u3057\u3066\u884c\u304d\u307e\u3059\u3002<\/p>\n<p>\u5b8c\u5168\u6cbb\u7652\u304c\u671f\u5f85\u3067\u304d\u308b\u5c0f\u5150\u60aa\u6027\u8133\u816b\u760d\u306e\u4ee3\u8868\u683c\u3068\u3055\u308c\u307e\u3059\u3002\u3057\u304b\u3057\u306a\u304c\u3089\uff0c\u816b\u760d\u304c\u6cbb\u7652\u3057\u3066\u3082\u5f8c\u907a\u75c7\u3092\u6b8b\u3055\u305a\u793e\u4f1a\u5fa9\u5e30\u3067\u304d\u308b\u60a3\u5150\u306f\u73fe\u5b9f\u306b\u306f\u591a\u304f\u306f\u3042\u308a\u307e\u305b\u3093 \u3002\u8fc5\u901f\u306a\u8a3a\u65ad\u3068\u6700\u4f4e\u4fb5\u8972\u5ea6\u304b\u3064\u5fc5\u7528\u5341\u5206\u306a\u6cbb\u7642\u306b\u3088\u3063\u3066\uff0c\u795e\u7d4c\u8131\u843d\u75c7\u72b6\u3084\u4e0b\u5782\u4f53\u6a5f\u80fd\u4e0d\u5168\u306e\u9032\u884c\u3092\u5c11\u3057\u3067\u3082\u304f\u3044\u6b62\u3081\u308b\u3053\u3068\u304c\u6c42\u3081\u3089\u308c\u307e\u3059\u3002\u307e\u305f\uff0c\u4e0a\u8a18\u306e\u751f\u5b58\u5272\u5408\u66f2\u7dda\u306f\u767b\u9332\u3055\u308c\u9577\u671f\u8ffd\u8de1\u3055\u308c\u305f\u3082\u306e\u3067\u3042\u308b\u306e\u3067\uff0c\u767b\u9332\u3055\u308c\u306a\u3044\u4f8b\u3084\u8ffd\u8de1\u304c\u3055\u308c\u3066\u306a\u3044\u4f8b\u3092\u9451\u307f\u308c\u3070\u5b9f\u969b\u306e10\u5e74\u751f\u5b58\u5272\u5408\u306f\u3053\u308c\u3088\u308a\u78ba\u5b9f\u306b\u4f4e\u3044\u306e\u3067\u3057\u3087\u3046\u3057\uff0c\u307e\u305f\u518d\u767a\u5272\u5408\u306f\u304b\u306a\u308a\u9ad8\u3044\u3082\u306e\u3068\u63a8\u5b9a\u3055\u308c\u307e\u3059\u30022000\u5e74\u4ee5\u964d\u306e\u8a3a\u65ad\u3068\u6cbb\u7642\u6280\u8853\u306e\u9032\u6b69\u3092\u8003\u3048\u3042\u308f\u305b\u3066\u308210\u5e74\u751f\u5b58\u5272\u5408\u306f\u304a\u305d\u3089\u304f90%\u307b\u3069\u3067\u3042\u308d\u3046\u3068\u8003\u3048\u3066\u3044\u307e\u3059\u3002\u3082\u3061\u308d\u3093\u6b63\u78ba\u306a\u30c7\u30fc\u30bf\u306f\u3069\u3053\u306b\u3082\u3042\u308a\u307e\u305b\u3093\u3002\u305d\u308c\u3092\u5f97\u308b\u306b\u306f\u81e8\u5e8a\u8a66\u9a13\u3092\u958b\u59cb\u3057\u3066\u304b\u308915\u5e74\u3068\u3044\u3046\u6b73\u6708\u3092\u8981\u3059\u308b\u304b\u3089\u3067\u3059\u3002\u65e5\u672c\u306b\u304a\u3044\u3066\u306e2021\u5e74\u6642\u70b9\u3067\u6cbb\u7642\u3055\u308c\u308bgerminoma\u306e\u63a8\u5b9a\uff15\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f95%\u7a0b\u5ea6\u3067\u3057\u3087\u3046\u3002<\/p>\n<h4>\u518d\u767a\u307e\u3067\u306e\u671f\u9593\u3068\u7d4c\u904e\u89b3\u5bdf\u306e\u5fc5\u8981\u6027<\/h4>\n<p>\u518d\u767a\u306f\u3069\u306e\u304f\u3089\u3044\u306e\u671f\u9593\u3067\u751f\u3058\u308b\u304b\uff0c\u3068\u3044\u3046\u554f\u3044\u306b\u660e\u78ba\u306a\u89e3\u7b54\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u3067\u3082\uff0c\u591a\u304f\u306e\u5834\u5408\u306f\uff15\u5e74\u4ee5\u5185\u3068\u8003\u3048\u3066\u3088\u3044\u3067\u3059\u3002\u3057\u304b\u3057\u306a\u304c\u3089\uff0c\u4ee5\u4e0b\u306e\u30b0\u30e9\u30d5\u306b\u793a\u3059\u3088\u3046\u306b\uff0c\u6fa4\u6751\u304c\u7d4c\u9a13\u3057\u305f25\u4f8b\u306e\u518d\u767agerminoma\u306e\u521d\u671f\u6cbb\u7642\u304b\u3089\u518d\u767a\u307e\u3067\u306e\u671f\u9593\u3092\u307f\u308b\u3068\uff0c\uff13\u5272\u7a0b\u5ea6\u306e\u518d\u767a\u306f\uff15\u5e74\u4ee5\u964d\u306b\u751f\u3058\u3066\u3044\u307e\u3057\u305f\u3002\u521d\u671f\u6cbb\u7642\u304b\u308910\u5e74\u4ee5\u4e0a\u305f\u3063\u3066\u304b\u3089\u306e\u518d\u767a\u4f8b\u3082\u3042\u308a\u307e\u3059\u3002germinoma\u306e\u6cbb\u7642\u5f8c\u306e\u5916\u6765\u7d4c\u904e\u89b3\u5bdf\u306f\uff0c2\u6b21\u816b\u760d\u306e\u767a\u751f\u3078\u306e\u8b66\u6212\u3082\u542b\u3081\u306610\u5e74\u4ee5\u4e0a\u3092\u8981\u3059\u308b\u3053\u3068\u304c\u660e\u3089\u304b\u3067\u3059\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/germirecur.png\"><img loading=\"lazy\" decoding=\"async\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/07\/gct\/germirecur.png\" alt=\"\" width=\"459\" height=\"311\" \/><\/a><\/p>\n<h4 class=\"setumei\"><strong>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u8c46\u77e5\u8b58\uff08\u751f\u691c\u8853\u306e\u3042\u308c\u3053\u308c\uff09<\/strong><\/h4>\n<p>\u751f\u691c\u8853\u306e\u524d\u306b<strong><span style=\"color: #ff0000;\">CT scan \u3084\u8133\u8840\u7ba1\u64ae\u5f71 DSA \u3092\u3057\u3066\u306f\u3044\u3051\u307e\u305b\u3093<\/span><\/strong>\u3002\u308f\u305a\u304b\u306a\u653e\u5c04\u7dda\u88ab\u66dd\u3067\uff0c\u816b\u760d\u7d30\u80de\u304c\u6d88\u5931\u3057\u3066\u3057\u307e\u3063\u3066\u30ea\u30f3\u30d1\u7403\u6d78\u6f64\u306e\u307f\u306e\u75c5\u7406\u6240\u898b\u3068\u306a\u308abiopsy failure\u306b\u306a\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002\u4e0b\u5782\u4f53\u5185\u306e\u5c0f\u3055\u306a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3060\u3068CT\u64ae\u5f71\uff11\u56de\u3060\u3051\u3067\u3082\u6d88\u5931\u3057\u3066\u3057\u307e\u3046\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u7d50\u679c\u7684\u306b\u751f\u691c\u8853\u304c\u7121\u99c4\u306b\u306a\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u5927\u304d\u306a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3082\uff0c\u6cbb\u7642\u958b\u59cb\u524d\u306bMRI\u4e0a\u3067\u7e2e\u5c0f\u3057\u3066\u30d3\u30c3\u30af\u30ea\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n<\/div>\n<div class=\"setumei\">\n<hr \/>\n<h4><span style=\"color: #000080;\"><strong>\u8853\u524dCT\u3067\u5c0f\u3055\u304f\u306a\u3063\u3066\u751f\u691c\u8853\u304c\u4e0d\u6210\u529f\u306b\u306a\u3063\u305f\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/strong><\/span><\/h4>\n<\/div>\n<ul>\n<li>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\uff0c<span style=\"color: #000080;\"><strong>\u653e\u5c04\u7dda\u611f\u53d7\u6027\u304c\u6975\u3081\u3066\u9ad8\u3044<\/strong><\/span>\u816b\u760d\u3067\u3059<\/li>\n<li>\u307b\u3093\u306e\u5c11\u3057\u306eX\u7dda\u88ab\u66dd\u3067\u5c0f\u3055\u304f\u306a\u3063\u305f\u308a\u6d88\u3048\u3066\u3057\u307e\u3063\u305f\u308a\u3057\u307e\u3059<\/li>\n<li>18\u30b0\u30ec\u30a4\u304f\u3089\u3044\u306e\u5c40\u6240\u653e\u5c04\u7dda\u3060\u3051\u3067\u6d88\u5931\u3057\u3066\u5b8c\u5168\u6cbb\u7652\u3057\u305f\u4f8b\u306a\u3069\u3082\u77e5\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li><strong><span style=\"color: #000080;\">CT\u691c\u67fb\u3060\u3051\u3067\u6d88\u5931<\/span><\/strong>\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u3082\u3061\u308d\u3093\u30ab\u30c6\u30fc\u30c6\u30eb\u3092\u7528\u3044\u308b<span style=\"color: #000080;\"><strong>\u8840\u7ba1\u64ae\u5f71 DSA\u3067\u3082\u6d88\u3048\u308b<\/strong><\/span>\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3092\u7591\u3063\u305f\u5834\u5408\u306b\u306f<strong><span style=\"color: #000080;\">X\u7dda\u3092\u7528\u3044\u308b\u691c\u67fb\u3092\u884c\u3044\u307e\u305b\u3093<\/span><\/strong><\/li>\n<\/ul>\n<p>\u4e0b\u306b\u304a\u898b\u305b\u3059\u308b\u306e\u306f\u5b9f\u4f8b\u3067\u3059\u300211\u6b73\u3067\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\uff0c\u521d\u6f6e\u304c\u767a\u6765\u305b\u305a\uff0c18\u6b73\u3067\u4f4e\u8eab\u9577\u3092\u6307\u6458\u3055\u308c\u4e0b\u5782\u4f53\u6a5f\u80fd\u4e0d\u5168\u3068MRI\u306b\u3066LCH\u3092\u7591\u308f\u308c\u307e\u3057\u305f\u3002HCG\u306f\u6e2c\u5b9a\u9650\u754c\u5024\u4ee5\u4e0b\u3067\u7d4c\u904e\u3057\u307e\u3057\u305f\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-13083\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie1-293x300.jpg\" alt=\"\" width=\"293\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie1-293x300.jpg 293w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie1-768x787.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie1-550x564.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie1.jpg 850w\" sizes=\"auto, (max-width: 293px) 100vw, 293px\" \/>\u5de6\u5074\u306eMRI\u306f21\u6b73\u6642\u306e\u3082\u306e\u3067\u3059\u3002\u767a\u75c7\u5f8c10\u5e74\u304c\u7d4c\u904e\u3057\u3066\u3044\u307e\u3057\u305f\u3002<br \/>\n\u816b\u760d\u6027\u75c5\u5909\u304c\u5897\u5927\u3057\u305f\u305f\u3081\u306b\uff0c\u7d4c\u8776\u5f62\u9aa8\u6d1e\u624b\u8853 TSS \u3067\u751f\u691c\u8853\u3092\u8a08\u753b\u3057\u307e\u3057\u305f\u3002\u7d4c\u9f3b\u624b\u8853\u3067\u3057\u305f\u306e\u3067\uff0c\u53d7\u3051\u6301\u3061\u306e\u82e5\u3044\u5148\u751f\u304c\uff0c\u5165\u9662\u5f8c\u306b3D\u3084\u3089thin slice\u3084\u3089\u6fc3\u539a\u306aCT\u691c\u67fb\u3092\uff12\u5ea6\u884c\u3044\u307e\u3057\u305f\u3002<br \/>\n\u4e88\u5b9a\u3069\u304a\u308a\u751f\u691c\u3057\u305f\u306e\u3067\u3059\u304c\uff0c\u5927\u5b66\u75c5\u9662\u75c5\u7406\u90e8\u304b\u3089\u5e30\u3063\u3066\u304d\u305f\u8fd4\u4e8b\u306f\u300c\u514d\u75ab\u67d3\u8272\u3092\u542b\u3081\u3066\u816b\u760d\u7d30\u80de\u306f\u306a\u304f\uff0c\u5c0f\u578b\u30ea\u30f3\u30d1\u7403\u3092\u4e2d\u5fc3\u3068\u3057\u305f\u591a\u5f69\u306a\u708e\u75c7\u7d30\u80de\u6d78\u6f64\u3092\u8a8d\u3081\u308b\u3053\u3068\u304b\u3089lymphocytic hypophysitis\u306e\u53ef\u80fd\u6027\u306f\u8003\u3048\u3089\u308c\u307e\u3059\u300d\u3068\u3044\u3046\u8fd4\u4e8b\u3067\u3057\u305f\u3002<\/p>\n<p>\u79c1\u306f\uff0c\u751f\u691c\u8853\u304c\u7d42\u308f\u3063\u3066\u304b\u3089\u521d\u3081\u3066\uff0c\u624b\u8853\u524d\u306bCT\u691c\u67fb\u304c\u7e70\u308a\u8fd4\u3055\u308c\u305f\u3053\u3068\u3092\u77e5\u308a\u307e\u3057\u305f\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-13085\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie2-296x300.jpg\" alt=\"\" width=\"296\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie2-296x300.jpg 296w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie2-768x779.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie2-550x558.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie2.jpg 850w\" sizes=\"auto, (max-width: 296px) 100vw, 296px\" \/><\/a><br \/>\n\u300c\u751f\u691c\u300d\u8853\u76f4\u5f8c\u306eMRI\u3067\u3059\u3002\u816b\u760d\u304c\u304b\u306a\u308a\u7e2e\u5c0f\u3057\u3066\u3044\u307e\u3059\u3002\u624b\u8853\u3067\u306f\u30c8\u30eb\u30b3\u978d\u5e95\u90e8\u306e\u816b\u760d\u3092\u3054\u304f\u308f\u305a\u304b\u306b\u6458\u51fa\u3057\u305f\u3060\u3051\u306a\u306e\u3067\uff0c\u624b\u8853\u524d\u306e\u982d\u84cbCT\uff0c\u80f8\u90e8\u5199\u771f\u306a\u3069\u306eX\u7dda\u88ab\u66dd\u306b\u3088\u3063\u3066\u816b\u760d\u7d30\u80de\u304c\u6d88\u5931\u3057\u3066\u3057\u307e\u3063\u305f\u3068\u8003\u3048\u3089\u308c\u307e\u3059\u3002<\/p>\n<p>\u307e\u305f\u7d4c\u904e\u89b3\u5bdf\u3092\u7d9a\u3051\u307e\u3057\u305f\u3002\u60a3\u8005\u3055\u3093\u306f\u90e8\u5206\u7684\u6c4e\u4e0b\u5782\u4f53\u6a5f\u80fd\u4f4e\u4e0b\u75c7\u304c\u3042\u3063\u305f\u3082\u306e\u306e\u30db\u30eb\u30e2\u30f3\u88dc\u5145\u3067\u5143\u6c17\u306b\u66ae\u3089\u3057\u3066\u3044\u307e\u3057\u305f\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-13087\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie3-291x300.jpg\" alt=\"\" width=\"291\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie3-291x300.jpg 291w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie3-768x791.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie3-550x567.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaie3.jpg 850w\" sizes=\"auto, (max-width: 291px) 100vw, 291px\" \/><br \/>\n\u305d\u306e2\u5e74\u5f8c24\u6b73\u306e\u6642\u306eMRI\u3067\u3059\u3002\u767a\u75c7\u5f8c13\u5e74\u3002<br \/>\n\u30c8\u30eb\u30b3\u978d\u5185\u90e8\u306e\u816b\u760d\u306f\u307b\u307c\u6d88\u5931\u3057\u3066\u3057\u307e\u3063\u3066\uff0c\u8996\u5e8a\u4e0b\u90e8\u304b\u3089\u7b2c\uff13\u8133\u5ba4\u306b\u6025\u6fc0\u306b\u816b\u760d\u5897\u5927\u3057\u307e\u3057\u305f\u3002\u4ed5\u65b9\u304c\u306a\u3044\u306e\u3067\uff0c\u958b\u982d\u624b\u8853\u3067\u3059\u3050\u306b\u751f\u691c\u8853\u3092\u3057\u307e\u3057\u305f\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaiepatho.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-13088\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaiepatho-300x228.jpg\" alt=\"\" width=\"300\" height=\"228\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaiepatho-300x228.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaiepatho-768x583.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaiepatho-550x417.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/germinomaiepatho.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><br \/>\n\u75c5\u7406\u6240\u898b\u3067\u3059\u3002\u5178\u578b\u7684\u306a germinoma \u3067\u3057\u305f\u3002\u6cbb\u7642\u306f\uff0cICE (IFO\/CDDP\/VP-16)\u5316\u5b66\u7642\u6cd5\u30923\u30b3\u30fc\u30b9\u306e\u5f8c\u3067\u5168\u8133\u5ba4\u7167\u5c04 25.2Gy\/14\u5206\u5272\u3092\u52a0\u3048\u307e\u3057\u305f\u3002\u6cbb\u7642\u5f8c8\u5e74\u307b\u3069\u7d4c\u3061\u307e\u3059\u304c\uff0c\u5e78\u3044\u60a3\u8005\u3055\u3093\u306f\u5143\u6c17\u3067\u3054\u304f\u666e\u901a\u306e\u793e\u4f1a\u751f\u6d3b\u304c\u3067\u304d\u3066\u3044\u307e\u3059\u3002<\/p>\n<div class=\"setumei\">\n<hr \/>\n<h4><span style=\"color: #000080;\"><strong>\u795e\u7d4c\u4e0b\u5782\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de neurohypophyseal germinoma<\/strong><\/span><\/h4>\n<p><strong><span style=\"color: #ff0000;\">\u795e\u7d4c\u4e0b\u5782\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de neurohypophyseal germinoma<\/span><\/strong> : \u795e\u7d4c\u4e0b\u5782\u4f53\u304b\u3089\u767a\u751f\u3057\u307e\u3059\u3002\u5927\u304d\u306a\u816b\u760d\u306f\u7d4c\u8776\u5f62\u9aa8\u6d1e\u624b\u8853 transsphenoidal surgery\u3067\u751f\u691c\u3059\u308b\u3053\u3068\u306b\u306a\u3093\u3089\u554f\u984c\u3082\u96e3\u70b9\u3082\u3042\u308a\u307e\u305b\u3093\u3002\u4e00\u65b9\uff0c\u304b\u306a\u308a\u5c0f\u3055\u306a\u3082\u306e\u3067\u3042\u3063\u3066\u3082transsphenoidal surgery\u306b\u3088\u308b\u751f\u691c\u304c\u9069\u5207\u3067\u3059\u3002\u5f8c\u8449\u304c\u816b\u760d\u5316\u3059\u308b\u306e\u3067\u30c8\u30eb\u30b3\u978d\u5e95\u9762\u3092\u958b\u3051\u3066\u978d\u80cc\u306e\u65b9\u5411\u3078\u5411\u304b\u3063\u3066\u751f\u691c\u8853\u3092\u884c\u3044\u307e\u3059\u3002\u975e\u5e38\u306b\u5c0f\u3055\u306a\u816b\u760d\u7247\u3057\u304b\u63a1\u53d6\u3067\u304d\u306a\u3044\u306e\u3067\uff0c\u30d0\u30a4\u30aa\u30d7\u30b7\u30fc\u9257\u5b50\u306f\u7d30\u304f\u92ed\u3044\u3082\u306e\u304c\u306a\u3044\u3068\u3053\u306e\u624b\u8853\u306f\u3067\u304d\u307e\u305b\u3093\u3002\u75c5\u6b74\u306e\u9577\u3044\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u7dda\u7dad\u7d50\u5408\u7d44\u7e54\u3092\u542b\u3093\u3067\u975e\u5e38\u306b\u786c\u3044\u3053\u3068\u304c\u3042\u308b\u306e\u3067\uff0c\u305d\u3093\u306a\u6642\u306f\u5f15\u3063\u3071\u3063\u3066\u3061\u304e\u308b\u3053\u3068\u304c\u3067\u304d\u306a\u3044\u305f\u3081\u306b\u30cf\u30b5\u30df\u3067\u5207\u308a\u53d6\u308a\u307e\u3059\u3002<\/p>\n<p>\u4e0b\u5782\u4f53\u67c4\u306e\u307f\u304c\u816b\u308c\u3066\u3044\u308b\u3088\u3046\u306a\u4e00\u898b\u30c8\u30eb\u30b3\u978d\u5185\u306b\u816b\u760d\u304c\u306a\u3044\u3088\u3046\u306a\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3082\u5f8c\u8449\u5185\u306b\u816b\u760d\u306f\u898b\u3064\u304b\u308b\u3057\u8a3c\u660e\u3067\u304d\u307e\u3059\u3002\u7406\u7531\u306f\uff0c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304c\u767a\u751f\u3059\u308b\u3068\u4e0b\u5782\u4f53\u7d44\u7e54\u306f\u4fb5\u3055\u308c\u3066\u840e\u7e2e\u3057\uff0c\u305d\u306e\u5bb9\u7a4d\u5206\u306e\u816b\u760d\u304c\u4e0b\u5782\u4f53\u5185\u306b\u5b58\u5728\u3059\u308b\u304b\u3089\u3067\uff0c\u6cbb\u7642\u3092\u7d42\u3048\u308c\u3070\u4e0b\u5782\u4f53\u306e\u59d4\u7e2e\u50cf\u304c\u89b3\u5bdf\u3067\u304d\u307e\u3059\u3002LCH\u3068\u306e\u9451\u5225\u306e\u305f\u3081\u306b\uff0c\u958b\u982d\u8853\u3067\u4e0b\u5782\u4f53\u67c4\u3092\u90e8\u5206\u7684\u306b\u5207\u308a\u53d6\u308b\u3088\u3046\u306a\u751f\u691c\u8853\u3092\u884c\u3048\u3070\uff0c\u4e0b\u5782\u4f53\u6a5f\u80fd\u3092\u4f4e\u4e0b\u3055\u305b\u308b\u53ef\u80fd\u6027\u304c\u5927\u304d\u3044\u304c\u5927\u304d\u3044\u306e\u3067\u884c\u3044\u307e\u305b\u3093\u3002\u307e\u305f\u958b\u982d\u8853\u3067\uff0c\u978d\u9694\u819c\u3092\u5207\u958b\u3057\u3066\u524d\u8449\u3092\u640d\u50b7\u3057\u306a\u3044\u3067\u5f8c\u8449\u90e8\u5206\u306e\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u7d44\u7e54\u3092\u6458\u51fa\u3059\u308b\u3068\u3044\u3046\u3068\u306f\u3067\u304d\u307e\u305b\u3093\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-15261\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomatm-296x300.jpg\" alt=\"\" width=\"296\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomatm-296x300.jpg 296w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomatm-550x558.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomatm.jpg 709w\" sizes=\"auto, (max-width: 296px) 100vw, 296px\" \/><br \/>\n2000\u5e74\u306b\u767a\u75c7\u3057\u305f\u5973\u306e\u5b50\u3067\u3059\uff0c4\u6b73\u306e\u6642\u306b\u591c\u9593\u306e\u6c34\u5206\u6442\u53d6\u3068\u591c\u5c3f\u30025\u6b73\u306e\u6642\u306b\u3055\u3089\u306b\u98f2\u6c34\u91cf\u304c\u5897\u3048\u3066\uff0c1\u65e5\u6392\u5c3f\u56de\u657018\u56de\u3068\u3044\u3046\u75c7\u72b6\u304c\u3042\u308a\u307e\u3057\u305f\u30026\u6b73\u3067\u3088\u3046\u3084\u304f\uff0c\u5c3f\u5d29\u75c7\u3068\u4f4e\u8eab\u9577 105cm (-1.47SD)\u3068\u8a3a\u65ad\u3055\u308c\uff0cMRI\u3067\u4e0b\u5782\u4f53\u67c4\u306e\u816b\u5927\u304c\u767a\u898b\u3055\u308c\u307e\u3057\u305f\u3002<br \/>\n\u4f4e\u5e74\u9f62\u3060\u3063\u305f\u306e\u3067CDDP\/VP-16\u5316\u5b66\u7642\u6cd54\u30b3\u30fc\u30b9\u3068\u5168\u8133\u5ba4\u7167\u5c0423.4Gy\/13\u5206\u5272\u3067\u6cbb\u7642\u3057\u307e\u3057\u305f\u3002<br \/>\n\u6cbb\u7642\u5f8c\u306fGHD\u306f\u6539\u5584\u3057\u3066\u5c3f\u5d29\u75c7\u3060\u3051\uff0c20\u6b73\u3092\u3059\u304e\u3066\u3068\u3066\u3082\u5143\u6c17\u306b\u66ae\u3089\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<p>LCH\u306fhit-and-run\u3067\uff0c\u4e00\u6c17\u306b\u75c7\u72b6\u304c\u60aa\u304f\u306a\u308a\u307e\u3059\u3002\u307e\u305f\u540c\u3058\u795e\u7d4c\u4e0b\u5782\u4f53\u306b\u4f55\u5ea6\u3082\u75c5\u5909\u306f\u51fa\u307e\u305b\u3093\u3002\u3086\u3063\u304f\u308a\u75c7\u72b6\u304c\u9032\u884c\u3059\u308b\u306e\u304cgerminoma\u3067\u3059\u3002<\/p>\n<hr \/>\n<h5><span style=\"color: #000080;\"><a style=\"color: #000080;\" title=\"5\u6b73\u6642\u306b\u4f4e\u8eab\u9577\u3068\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3057\u305fgerminoma\" href=\"\/sawamura\/pediattumor\/germinomadwarfism\/\"><strong>\u5e7c\u5150\u671f\u306b\u4f4e\u8eab\u9577\u3067\u767a\u75c7\u3059\u308b\u4f8b\u304c\u3042\u308b\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\u3067\u898b\u308c\u307e\u3059\uff09<\/strong><\/a><\/span><\/h5>\n<\/div>\n<div class=\"setumei\">\n<h4><span style=\"color: #000080;\"><strong>\u677e\u679c\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de pineal germinoma<\/strong><\/span><\/h4>\n<p>\u677e\u679c\u4f53\u5b9f\u8cea\u304b\u3089\u767a\u751f\u3057\u307e\u3059\u3002\u4e2d\u8133\u6c34\u9053\u9589\u585e\u306b\u3088\u308b\u6c34\u982d\u75c7\u3067\u767a\u75c7\u3059\u308b\u3053\u3068\u304c\u591a\u3044\u306e\u3067\uff0c\u8fd1\u5e74\u3067\u306f\u795e\u7d4c\u5185\u8996\u93e1\u306b\u3088\u308b\u7b2c3\u8133\u5ba4\u958b\u7a93\u8853\u3068\u751f\u691c\u8853\u304c\u884c\u308f\u308c\u308b\u3053\u3068\u304c\u5727\u5012\u7684\u306b\u591a\u3044\u3067\u3059\u3002<a href=\"http:\/\/www.youtube.com\/watch?v=SN-4WnJMIIw&amp;feature=youtube_gdata_player\">\u5b9f\u4f8b\u3092\u30d3\u30c7\u30aa\u306b\u63d0\u793a\u3059\u308b\u306e\u3067\u53c2\u7167\u3057\u3066\u304f\u3060\u3055\u3044 (click here)\u3002<\/a>\u5c0f\u3055\u306a\u3082\u306e\u3067\u306f\u677e\u679c\u4f53\u90e8\u3092\u5185\u8996\u93e1\u3067\u89b3\u5bdf\u3057\u3066\u3082\u5909\u8272\u3057\u305f\u816b\u760d\u3089\u3057\u304d\u3082\u306e\u304c\u898b\u3048\u306a\u3044\u3053\u3068\u304c\u3042\u308a\uff0c\u624b\u7db1\u4ea4\u9023\u3068\u5f8c\u4ea4\u9023\u306e\u767d\u8cea\u304c\u307f\u3048pineal recess\u3089\u3057\u3044\u3068\u3053\u308d\u304c\u898b\u3048\u308b\u3060\u3051\u3068\u3044\u3046\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u304c\uff0c\u9686\u8d77\u306e\u72b6\u614b\u3092\u89b3\u5bdf\u3057\u3066\u6a19\u672c\u63a1\u53d6\u3057\u307e\u3059\u3002\u751f\u691c\u9257\u5b50\u3067\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u7d44\u7e54\u7247\u3092\u63a1\u53d6\u3059\u308b\u3068\u308f\u305a\u304b\u306a\u51fa\u8840\u304c\u751f\u3058\u308b\u306e\u304c\u5e38\u3067\u3042\u308b\u306e\u3067\uff0c\u8133\u5ba4\u5185\u6d17\u6d44\u3092\u5341\u5206\u3067\u304d\u308b\u3088\u3046\u306b\u3057\u3066\u304a\u304d\u307e\u3059\u3002\u591a\u304f\u306e\u5834\u5408\u306f\u6b62\u8840\u64cd\u4f5c\u306a\u3069\u305b\u305a\u3068\u3082\u81ea\u7136\u306b\u6b62\u8840\u3057\u307e\u3059\u304c\uff0c\u9ac4\u6db2\u304c\u6df7\u6fc1\u3057\u3066\u89b3\u5bdf\u304c\u56f0\u96e3\u306b\u306a\u3089\u306a\u3044\u3088\u3046\u306b\u6ce8\u610f\u3057\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093\u3002\u5185\u8996\u93e1\u89b3\u5bdf\u4e0b\u3067\uff0c\u5375\u9ec4\u306e\u3046\u816b\u3084\u7d68\u6bdb\u4e0a\u76ae\u764c\u306a\u3069\u306e\u767a\u9054\u3057\u305f\u816b\u760d\u8840\u7ba1\u304c\u898b\u3048\u308b\u3088\u3046\u306a\u3089\u3070\uff0c\u7121\u7406\u3057\u3066\u751f\u691c\u3092\u9042\u884c\u3057\u306a\u3044\u65b9\u304c\u826f\u3044\u3067\u3057\u3087\u3046\u3002\u308f\u305a\u304b\u3067\u3082\u816b\u760d\u5185\u306e\u52d5\u9759\u8108\u30b7\u30e3\u30f3\u30c8 (red veins\u304c\u3042\u308b) \u3092\u640d\u50b7\u3059\u308c\u3070\u6b62\u8840\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u306a\u3044\u304b\u3089\u3067\u3059\u3002\u677e\u679c\u4f53\u816b\u760d\u306e\u751f\u691c\u8853\u3067\u306f\u5b66\u4f1a\u767a\u8868\u3067\u306f\u77e5\u308b\u3053\u3068\u304c\u3067\u304d\u306a\u3044\u591a\u304f\u306e\u5408\u4f75\u75c7\u304c\u8d77\u3053\u3063\u3066\u3044\u308b\u306e\u3082\u4e8b\u5b9f\u3067\u3059\u3057\uff0c\u5185\u8996\u93e1\u624b\u8853\u306e\u8853\u524d\u306b\u3082\u958b\u982d\u3088\u308a\u30ea\u30b9\u30af\u304c\u4f4e\u3044\u3068\u306f\u8aac\u660e\u3057\u306a\u3044\u65b9\u304c\u826f\u3044\u3067\u3057\u3087\u3046\u3002<\/p>\n<h4><span style=\"color: #000080;\"><strong>\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de basal ganglia germinoma<\/strong><\/span><\/h4>\n<p>\u5927\u8133\u57fa\u5e95\u6838\u304a\u305d\u3089\u304f\u8996\u5e8a\u4e0b\u90e8\u304b\u3089\u767a\u751f\u3057\u307e\u3059\u3002\u7247\u9ebb\u75fa\uff0c\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\uff0c\u6027\u683c\u5909\u5316\u30fb\u591a\u52d5\u304c\u6570\u30f6\u6708\u304b\u3089\u6570\u5e74\u306b\u308f\u305f\u3063\u3066\u9032\u884c\u3057\u3066\u3082\uff0cMRI\u3067\u816b\u760d\u304c\u6349\u3048\u3089\u308c\u306a\u3044\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002CT\/MRI\u30ac\u30a4\u30c9\u5b9a\u4f4d\u8133\u751f\u691c\u8853\u304c\u9069\u5207\u3067\u3059\u304c\uff0c\u751f\u691c\u90e8\u3067\u306e\u8133\u51fa\u8840\u306e\u5408\u4f75\u75c7\u306e\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002\u751f\u691c\u6642\u306e\u8133\u51fa\u8840\u306e\u30ea\u30b9\u30af\u306f\u6c7a\u3057\u3066\u4f4e\u3044\u78ba\u7387\u3067\u306f\u306a\u3044\u3057\uff0c\u5927\u8133\u57fa\u5e95\u6838\u51fa\u8840\u306e\u305f\u3081\u306b\u9ad8\u6b21\u8133\u6a5f\u80fd\u969c\u5bb3\u3092\u60aa\u5316\u3055\u305b\u308b\u3053\u3068\u304c\u3042\u308b\u306e\u3067\uff0c\u30e1\u30c1\u30aa\u30cb\u30f3\u30da\u30c3\u30c8\u3067\u306euptake\u304c\u9ad8\u3044\u306a\u3069\u3092\u508d\u8a3c\u306b\u753b\u50cf\u8a3a\u65ad\u306e\u307f\u3067\u6cbb\u7642\u958b\u59cb\u3059\u308b\u3053\u3068\u3082\u3057\u3070\u3057\u3070\u3067\u3059\u3002<\/p>\n<h5><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" title=\"\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\" href=\"\/sawamura\/pediattumor\/basalganggerminoma\/\">\u5927\u8133\u57fa\u5e95\u6838\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u75c7\u4f8b\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/strong><\/span><\/h5>\n<hr \/>\n<h4><span style=\"color: #000080;\"><strong><a style=\"color: #000080;\" href=\"\/sawamura\/pediattumor\/germcelltumors\/advancedgerminoma\/\">\u9032\u884c\u3057\u3066\u64ad\u7a2e\u3092\u4f34\u3063\u305f\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de advanced case\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/strong><\/span><\/h4>\n<hr \/>\n<h4><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/pediattumor\/germcelltumors\/geminomadeepfrontal\/ \u200e\"><span style=\"color: #000080;\"><strong>\u524d\u982d\u8449\u6df1\u90e8\u767d\u8cea\u6d78\u6f64\u30fb\u8133\u5ba4\u58c1\u3060\u3051\u306e\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/strong><\/span>\uff08\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af\uff09<\/a><\/h4>\n<hr \/>\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3068\u9593\u9055\u3048\u3084\u3059\u3044\u4e0b\u5782\u4f53\u5f8c\u8449\u708e neurophypophysitis<\/h4>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-13071\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj1-292x300.jpg\" alt=\"\" width=\"292\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj1-292x300.jpg 292w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj1-550x565.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj1.jpg 683w\" sizes=\"auto, (max-width: 292px) 100vw, 292px\" \/><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-13072\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj2-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj2-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj2-550x550.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj2-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2019\/04\/neurohypophisitiskj2.jpg 729w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>40\u4ee3\u5973\u6027\u304c\u591a\u98f2\u591a\u5c3f\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u4e0b\u5782\u4f53\u3068\u4e0b\u5782\u4f53\u67c4\u306e\u816b\u5927\u304c\u307f\u3089\u308c\u307e\u3059\u3002\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3068\u306e\u9055\u3044\u306f\uff0c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u304c\u5747\u4e00\u3067\uff0c\u4e0b\u5782\u4f53\u5f8c\u8449\u5168\u4f53\u304c\u524d\u8449\u3068\u540c\u7a0b\u5ea6\u307e\u3067\u5897\u5f37\u3055\u308c\u308b\u3053\u3068\u3067\u3059\u3002\u3082\u3061\u308d\u3093\u5e74\u9f62\u3082\u9055\u3044\u307e\u3059\u304c\uff0clymphocytic neurohypophysitis\u306f\u82e5\u5e74\u5973\u6027\u306b\u597d\u767a\u3059\u308b\u306e\u3067\uff0c10\u221220\u4ee3\u3060\u3068\u9451\u5225\u304c\u96e3\u3057\u3044\u3067\u3057\u3087\u3046\u3002\u3053\u306e\u60a3\u8005\u3055\u3093\u306f\u751f\u691c\u5f8c\u306b\u30b9\u30c6\u30ed\u30a4\u30c9\u6cbb\u7642\u3092\u884c\u3063\u3066\u8efd\u5ea6\u306e\u5c3f\u5d29\u75c7\u3092\u6b8b\u3057\u305f\u306e\u307f\u3067\u3059\u3002\u7121\u6cbb\u7642\u3067\u3082\u81ea\u7136\u5bdb\u89e3\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3068\u9593\u9055\u3048\u3084\u3059\u3044\u4e0b\u5782\u4f53\u5f8c\u8449\u708e neurophypophysitis<\/h4>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-18085\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa1-298x300.jpg\" alt=\"\" width=\"298\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa1-298x300.jpg 298w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa1-550x554.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa1-768x774.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa1-1525x1536.jpg 1525w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa1.jpg 1651w\" sizes=\"auto, (max-width: 298px) 100vw, 298px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-18086\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa2-291x300.jpg\" alt=\"\" width=\"291\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa2-291x300.jpg 291w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa2-550x567.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa2-768x792.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa2-1490x1536.jpg 1490w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa2.jpg 1566w\" sizes=\"auto, (max-width: 291px) 100vw, 291px\" \/><\/a><\/p>\n<\/div>\n<p>18\u6b73\u7537\u6027\u304c\u6025\u306b\u591a\u98f2\u306b\u306a\u308a\u307e\u3057\u305f\uff0c\u304b\u306a\u308a\u9ad8\u5ea6\u306e\u5c3f\u5d29\u75c7\u3067\u3057\u305f\u3002\u767a\u75c7\u5f8c2\u30f6\u6708\u306eMRI\u3067\u3059\u3002\u5de6\u5074\u306eT1\u5f37\u8abf\u753b\u50cf\u3067\u306f\u4e0b\u5782\u4f53\u5f8c\u8449\u306e\u9ad8\u4fe1\u53f7\uff08\u6297\u5229\u5c3f\u30db\u30eb\u30e2\u30f3\uff09\u304c\u6d88\u5931\u3057\u3066\u3044\u307e\u3059\u3002\u53f3\u5074\u306e\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3067\u306f\u4e0b\u5782\u4f53\u67c4\u304c\u592a\u304f\u306a\u3063\u3066\u3044\u3066\u4e0b\u5782\u4f53\u5168\u4f53\u304c\u5897\u5f37\u3055\u308c\uff0c\u677e\u679c\u4f53\u306b\u306e\u3046\u80de\u304c\u307f\u3089\u308c\u307e\u3059\u3002\u816b\u760d\u30de\u30fc\u30ab\u30fc\u306f\u9670\u6027\u3002\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3092\u7591\u3044\u7d4c\u9f3b\u751f\u691c\u8853\u3092\u884c\u3044\u307e\u3057\u305f\u3002<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-18087\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa3-300x293.jpg\" alt=\"\" width=\"300\" height=\"293\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa3-300x293.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/pituigranusa3.jpg 523w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/>\u75c5\u7406\u8a3a\u65ad\u306e\u7d50\u679c\u306f\uff0c\u30ea\u30f3\u30d1\u7403\uff0c\u5f62\u8cea\u7d30\u80de\u6d78\u6f64\u3068\u8089\u82bd\u816b\u760d\u7d44\u7e54\u304c\u3042\u308b\u306e\u307f\u3067\u3057\u305f\u3002\u6162\u6027\u4e0b\u5782\u4f53\u708e\u306e\u6240\u898b\u3067\u3059\u3002\u5185\u5206\u6ccc\u5185\u79d1\u3067\u30d7\u30ec\u30c9\u30cb\u30be\u30ed\u30f3\u6295\u4e0e\u304c\u884c\u308f\u308c\u307e\u3057\u305f\u3002<br \/>\n\u5c3f\u5d29\u75c7\u306f\u5c11\u3057\u6539\u5584\u3057\u3066\uff0c\u6cbb\u7642\u5f8c\uff14\u5e74\u306eMRI\u3067\u306f\u4e0b\u5782\u4f53\u5f8c\u8449\u306b\u9ad8\u4fe1\u53f7\u304c\u8a8d\u3081\u3089\u308c\u3066\u3044\u307e\u3059\u3002\u677e\u679c\u4f53\u306e\u3046\u80de\u306f\u305d\u306e\u307e\u307e\u3067\u3059\u3002<br \/>\n\u3053\u306e\u4f8b\u306f\uff0c\u80da\u7d30\u80de\u816b\u760d\u3068\u81e8\u5e8a\u7684\u306b\u306f\u533a\u5225\u3067\u304d\u307e\u305b\u3093\u3002\u5c3f\u5d29\u75c7\u306e\u767a\u75c7\u6a5f\u8ee2\u304c\u6025\u6fc0\u3060\u3063\u305f\u306e\u304c\u552f\u4e00\u306e\u4e0b\u5782\u4f53\u708e\u306e\u7279\u5fb4\u3067\u3057\u305f\u3002\u751f\u691c\u8853\u304c\u552f\u4e00\u306e\u9451\u5225\u65b9\u6cd5\u3067\u3059\u3002<\/p>\n<div class=\"setumei\">\n<hr \/>\n<h4>\u5de8\u5927\u306a\u524d\u982d\u5e95\u90e8\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de<\/h4>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17057\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash1-300x292.jpg\" alt=\"\" width=\"300\" height=\"292\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash1-300x292.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash1-550x535.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash1-768x747.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash1.jpg 1476w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17059\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash2-300x298.jpg\" alt=\"\" width=\"300\" height=\"298\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash2-300x298.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash2-550x546.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash2-768x763.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomash2.jpg 1476w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u5c11\u5e74\u306e\u3082\u306e\u3067\u3059\u3002\u6570\u5e74\u306e\u7d4c\u904e\u306e\u3086\u3063\u304f\u308a\u3057\u305f\u8a8d\u77e5\u6a5f\u80fd\u4f4e\u4e0b\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\u3002\u5b66\u696d\u304c\u4e0d\u632f\u3067\u3057\u305f\u304c\u6c17\u3065\u304b\u308c\u305a\u5897\u5927\u3057\u305f\u3082\u306e\u3067\u3059\u3002\u521d\u8a3a\u6642\u306b\u306f\uff0c\u8a8d\u77e5\u6a5f\u80fd\u969c\u5bb3\uff0c\u5c3f\u5d29\u75c7\uff0c\u6c4e\u4e0b\u5782\u4f53\u6a5f\u80fd\u4f4e\u4e0b\u75c7\uff0c\u9ad8\u5ea6\u306e\u4e21\u5074\u8996\u529b\u4f4e\u4e0b\u3067\u3057\u305f\u3002\u3053\u3093\u306a\u3082\u306e\u3067\u3082ICE\u5316\u5b66\u7642\u6cd51\u30b3\u30fc\u30b9\u3067\u307b\u3068\u3093\u3069\u6d88\u5931\u3057\u307e\u3059\uff08\u53f3\u5074\u306e\u753b\u50cf\u306f2\u30b3\u30fc\u30b9\u5f8c\u304b\u3064\u653e\u5c04\u7dda\u6cbb\u7642\u524d\u306eMRI\uff09\u3002\u3067\u3059\u304b\u3089\uff0c\u7121\u7406\u3057\u3066\u958b\u982d\u6458\u51fa\u8853\u3092\u3057\u306a\u3044\u3002<\/p>\n<\/div>\n<hr \/>\n<h4>germinoma\u306e\u8996\u5e8a\u6d78\u6f64\uff1a\u30df\u30c3\u30ad\u30fc\u30de\u30a6\u30b9\u306e\u8033<\/h4>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17061\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-1-300x293.jpg\" alt=\"\" width=\"300\" height=\"293\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-1-300x293.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-1-550x537.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-1-768x750.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17062\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-2-300x283.jpg\" alt=\"\" width=\"300\" height=\"283\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-2-300x283.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-2-550x520.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-2-768x726.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-2.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/mouseears.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-17063\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/mouseears-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-17064\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-3-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-3-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-3-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-3-550x550.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-3-768x768.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomasy-3.jpg 850w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/>\u677e\u679c\u4f53\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306f\u4e21\u5074\u8996\u5e8a\u306b\u6d78\u6f64\u3057\u3066\u8996\u5e8a\u6d6e\u816b\u3092\u751f\u3058\u307e\u3059\u3002\u771f\u3093\u4e2d\u306b\u7b2c\uff13\u8133\u5ba4\u5f8c\u534a\u90e8\u306e\u5272\u308c\u76ee\u304c\u6b8b\u3063\u3066\u3044\u308b\u306e\u304c\u7279\u5fb4\u7684\u306a\u6240\u898b\u3067\u3059\u3002\u30df\u30c3\u30ad\u30fc\u30de\u30a6\u30b9\u306e\u8033\u307f\u305f\u3044\u306b\u306a\u308a\u307e\u3059\u3002\u304b\u306a\u308a\u7279\u7570\u7684\u306a\u6240\u898b\u3067\u3042\u308a\u8a3a\u65ad\u306b\u6709\u7528\u3067\u3059\u3002\u53f3\u4e0b\u306f\u6cbb\u7642\u5f8c\u3067\u3059\u3002<\/p>\n<hr \/>\n<h4>germinoma\u306e\u518d\u767a\u306e\u4e0d\u601d\u8b70<\/h4>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaum1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17106\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaum1-300x298.jpg\" alt=\"\" width=\"300\" height=\"298\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaum1-300x298.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaum1-550x546.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaum1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaum1-768x763.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaum1.jpg 1095w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17107\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaum2-300x295.jpg\" alt=\"\" width=\"300\" height=\"295\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaum2-300x295.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomaum2.jpg 551w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<p>1996\u5e74\uff0c18\u6b73\u7537\u6027\u304c\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3057\u307e\u3057\u305f\uff08\u5de6MRI\uff09\u3002bifocal tumor\u3067\uff0c\u677e\u679c\u4f53\u816b\u760d\u3060\u3051\u3092\u6458\u51fa\u3057\u3066\u4e88\u60f3\u3069\u304a\u308agerminoma\u306e\u75c5\u7406\u8a3a\u65ad\u3067\u3057\u305f\u3002ICE\u5316\u5b66\u7642\u6cd54\u30b3\u30fc\u30b9\u884c\u3063\u3066\uff0ctumor bed\u306b24Gy\/12fr\u306e\u62e1\u5927\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3057\u305f\u3002\u5f53\u6642\u306f\u5168\u8133\u5ba4\u7167\u5c04\u3092\u884c\u3063\u3066\u3044\u306a\u304b\u3063\u305f\u6642\u671f\u3067\u3059\u300210\u5e74\u5f8c\u306e2006\u5e74\u306bHCG\u304c\u308f\u305a\u304b\u306b\u4e0a\u6607\u3057\uff0c\u8133\u6881\u819d\u90e8\u5185\u90e8\u306b\u518d\u767a\u3092\u751f\u3058\u307e\u3057\u305f\u3002\u7167\u5c04\u91ce\u5916\u518d\u767a\u3067\u3059\u3002\u958b\u982d\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u305f\u3089\u786c\u3044\u816b\u760d\u3067\uff0c\u6210\u719f\u5947\u5f62\u816b\u3068germinoma\u306e\u6df7\u5408\u6027\u80da\u7d30\u80de\u816b\u760d\u3068\u306a\u3063\u3066\u3044\u307e\u3057\u305f\u3002\u305d\u306e\u5f8c\u306b\uff0cCARE 3\u30b3\u30fc\u30b9\u3068\u8133\u810a\u9ac4\u7167\u5c0419.2Gy\/12fr\u3068\u5c40\u62405.4Gy\/1fr\u306e\u7167\u5c04\u3092\u52a0\u3048\u307e\u3057\u305f\u3002\u305d\u306e\u5f8c\uff0c17\u5e74\u518d\u767a\u306a\u304f\u793e\u4f1a\u4eba\u3068\u3057\u3066\u7d50\u5a5a\uff0c\u304a\u5b50\u3055\u3093\u304c\u3044\u3066\u666e\u901a\u306b\u66ae\u3089\u3057\u3066\u3044\u307e\u3059\u3002<br \/>\n\u3053\u306e\u4f8b\u304c\uff0c<span style=\"color: #000080;\"><strong>metachronous germ cell tumor<\/strong><\/span>\u3067\u3042\u3063\u305f\u306e\u304b\u3069\u3046\u304b\u306f\u4e0d\u660e\u3067\u3059\u3002germinoma\u306f\u5c11\u306a\u304f\u3068\u308210\u5e74\u4ee5\u4e0a\u306e\u7d4c\u904e\u89b3\u5bdf\u304c\u5fc5\u8981\u3060\u3068\u3044\u3046\u3053\u3068\u3092\u793a\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u5c3f\u5d29\u75c7\u306f\u6cbb\u7642\u3067\u6cbb\u308b\u306e\u304b\uff1f<\/h4>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomany1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20628\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomany1-300x285.jpg\" alt=\"\" width=\"300\" height=\"285\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomany1-300x285.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomany1-550x522.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomany1.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20626\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomany2-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomany2-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomany2-550x552.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomany2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/germinomany2.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<p>14\u6b73\u304f\u3089\u3044\u304b\u3089\u30c8\u30a4\u30ec\u306e\u56de\u6570\u304c\u5897\u3048\uff0c\u4e2d\u5b66\u751f\u306e\u6642\u306b\u591c\u5c3f\u3092\u3059\u308b\u3088\u3046\u306b\u306a\u308a\u307e\u3057\u305f\u3002\u751f\u7406\u304c\u306a\u3044\u306e\u3067\u5a66\u4eba\u79d1\u3092\u53d7\u8a3a\u3057\u307e\u3057\u305f\u3002\u5b50\u5bae\u3068\u81a3\u306e\u767a\u9054\u3082\u60aa\u304f\uff0c\u539f\u767a\u6027\u4f4e\u30b4\u30ca\u30c9\u30c8\u30ed\u30d4\u30f3\u6027\u7121\u6708\u7d4c\u3068\u8a3a\u65ad\u3055\u308c\u3066MRI\u3092\u3057\u3066\u767a\u898b\u3055\u308c\u307e\u3057\u305f\u3002\u91cd\u75c7GHD\u304c\u3042\u308a\u307e\u3057\u305f\u304c\u305d\u308c\u307b\u3069\u4f4e\u8eab\u9577\u3067\u306f\u306a\u304f\uff0c\u9aa8\u7aef\u7dda\u672a\u9589\u9396\u3067\u3057\u305f\u3002\u79c1\u306e\u3068\u3053\u308d\u3092\u53d7\u8a3a\u3057\u305f\u306e\u304c19\u6b73\u3067\u3057\u305f\u3002\u75c5\u6b74\u304b\u3089\u306f\uff0c5\u5e74\u306e\u7d4c\u904e\u3067\u304b\u306a\u308a\u3086\u3063\u304f\u308a\u4e0b\u5782\u4f53\u4e0d\u5168\u304c\u9032\u884c\u3057\u305f\u3068\u3044\u3046\u3053\u3068\u304c\u308f\u304b\u308a\u307e\u3059\u3002\u8996\u5e8a\u4e0b\u90e8\u306b\u4e2d\u5fc3\u304c\u3042\u308a\u4e0b\u5782\u4f53\u67c4\u3082\u4fb5\u3059\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u3059\u304c\uff0c\u4e0b\u5782\u4f53\u306f\u8457\u3057\u304f\u840e\u7e2e\u3057\u3066\u3044\u307e\u3059\u3002<br \/>\n\u958b\u982d\u624b\u8853\u306b\u3088\u308b\u751f\u691c\u8853\u3092\u9078\u629e\u3057\u3066\u75c5\u7406\u8a3a\u65ad\u3092\u78ba\u5b9a\u3057\u307e\u3057\u305f\u3002\u8853\u5f8c\u306bICE\u5316\u5b66\u7642\u6cd53\u30b3\u30fc\u30b9\u3068\u5168\u8133\u5ba4\u7167\u5c0425.2\u30b0\u30ec\u30a414\u5206\u5272\u3067\u6cbb\u7642\u3057\u307e\u3057\u305f\u3002\u305d\u306e\u5f8c\uff0c\u7121\u4e8b\u306b\u5927\u5b66\u3092\u5352\u696d\u3057\u3066\u793e\u4f1a\u4eba\u3068\u3057\u3066\u50cd\u3044\u3066\u3044\u307e\u3059\u3002\u9a5a\u304f\u3053\u3068\u306b\uff0c\u6297\u5229\u5c3f\u30db\u30eb\u30e2\u30f3\uff08\u30c7\u30b9\u30e2\u30d7\u30ec\u30c3\u30b7\u30f3\uff09\u3092\u4f7f\u7528\u3057\u3066\u3044\u307e\u305b\u3093\u3002GHD\u306f\u3084\u3084\u6539\u5584\u3057\u3066\u7121\u75c7\u72b6\uff0c\u526f\u814e\u76ae\u8cea\u30db\u30eb\u30e2\u30f3\u3068\u7532\u72b6\u817a\u30db\u30eb\u30e2\u30f3\u306e\u88dc\u5145\u306f\u4e0d\u8981\u3067\u3059\u3002\u6cbb\u7642\u5f8c6\u5e74\u3067\uff0c\u5973\u6027\u30db\u30eb\u30e2\u30f3\u88dc\u5145\u306e\u307f\u3067\u751f\u6d3b\u3067\u304d\u3066\u3044\u307e\u3059\u3002\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3067\u306f\u6cbb\u7642\u3067\u9593\u8133\u4e0b\u5782\u4f53\u6a5f\u80fd\u304c\u6539\u5584\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u3068\u30ea\u30f3\u30d1\u7403\u6d78\u6f64\uff1a\u514d\u75ab\u6a5f\u80fd\u306e\u5f79\u5272<\/h4>\n<p><span class=\"docsum-authors full-authors\"><span class=\"docsum-journal-citation full-journal-citation\">Sawamura Y:\u00a0Immunohistochemical and in vitro functional analysis of pineal-germinoma infiltrating lymphocytes: report of a case. Neurosurgery\u00a01989<\/span><br \/>\nKato T, Sawamura Y:\u00a0<\/span>Occult neurohypophyseal germinomas in patients presenting with central diabetes insipidus.\u00a0<span class=\"docsum-journal-citation full-journal-citation\">Neurosurg Focus 1998<br \/>\n<\/span>Sudo A, Sawamura Y: High uptake on 11C-methionine positron emission tomographic scan of basal ganglia germinoma with cerebral hemiatrophy. AJNR 2003<br \/>\nLiu B: PD-1\/PD-L1 expression in a series of intracranial germinoma and its association with Foxp3+ and CD8+ infiltrating lymphocytes. PLoS One 2018<\/p>\n<ul>\n<li>germinoma\u306f\u3068\u3066\u3082\u4f4e\u3044\u7dda\u91cf\u306eX\u7dda\u691c\u67fb\u3060\u3051\u3067\u6d88\u5931\u3057\u3066\u3057\u307e\u3046\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u305d\u306e\u5f8c\uff0c\u968f\u5206\u7d4c\u3063\u3066\u304b\u3089\u518d\u767a\u3057\u305f\u308a\uff0c\u6cbb\u3063\u305f\u308a\u3068\u3044\u3046\u5831\u544a\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>germinoma\u306e\u7d44\u7e54\u306e\u306a\u304b\u306b\u306f\u305f\u304f\u3055\u3093\u306e\u30ea\u30f3\u30d1\u7403\u304c\u6d78\u6f64\u3057\u3066\u3044\u307e\u3059<\/li>\n<li>germinoma\u306f\uff0cMIB-1\u67d3\u8272\u3067\u9ad8\u3044\u816b\u760d\u7d30\u80de\u5206\u88c2\u80fd\u3068\u5897\u6b96\u80fd\u3092\u793a\u3057\u307e\u3059<\/li>\n<li>\u3067\u3082\u305d\u308c\u307b\u3069\u65e9\u304f\u816b\u760d\u304c\u5927\u304d\u304f\u306a\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u3053\u3053\u306b\u306f\u5927\u304d\u306a\u75c5\u7406\u5b66\u7684\u306a\u77db\u76fe\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u6162\u6027\u708e\u75c7\u6027\u7d44\u7e54\u304c\u816b\u760d\u5185\u306b\u751f\u3058\u305f\u308a\uff0clymphocytic germinal center\u304c\u898b\u3089\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u5c3f\u5d29\u75c7\u3084\u4f4e\u8eab\u9577\u3067\u767a\u75c7\u3057\u3066\u304b\u3089\uff0c\u6570\u5e74\u9593\u306f\u816b\u760d\u304cMRI\u3067\u307f\u3048\u306a\u3044\u3053\u3068\u3082\u3042\u308a\u307e\u3059\uff0coccult germinoma\u3068\u3044\u3044\u307e\u3059<\/li>\n<li>\u5927\u8133\u57fa\u5e95\u6838germinoma\u3082\uff0c\u8a8d\u77e5\u6a5f\u80fd\u4f4e\u4e0b\u3084\u9ebb\u75fa\u304c\u9032\u884c\u3057\u3064\u3064\u3082\u816b\u760d\u584a\u304c\u9855\u5728\u5316\u3057\u306a\u3044\u3053\u3068\u306f\u3057\u3070\u3057\u3070\u3067\u3059<\/li>\n<li>\u3053\u308c\u3089\u3092\u7dcf\u5408\u7684\u306b\u8003\u3048\u308b\u3068\uff0c\u60a3\u8005\u3055\u3093\u81ea\u8eab\u306e\u514d\u75ab\u6a5f\u80fd\u304cgerminoma\u306e\u5897\u5927\u3092\u6291\u5236\u3057\u3066\u3044\u308b\u53ef\u80fd\u6027\u304c\u5f37\u304f\u793a\u5506\u3055\u308c\u307e\u3059<\/li>\n<li>1989\u5e74\u306b\u6fa4\u6751\u306f\u3053\u306e\u30ea\u30f3\u30d1\u7403\u3092\u5206\u96e2\u3057\u3066\uff0c\u816b\u760d\u5185\u6d78\u6f64T\u7d30\u80de\u304c\u816b\u760d\u7d30\u80de\u969c\u5bb3\u6d3b\u6027\u3092\u6301\u3064\u3053\u3068\u3092\u8ad6\u6587\u306b\u3057\u305f\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>germinoma\u7d30\u80de\u306f\u9ad8\u3044\u30ec\u30d9\u30eb\u306ePD-L1\u3092\u767a\u73fe\u3057\u3066\u3044\u307e\u3059\uff0c\u4e00\u65b9\u3067\u6d78\u6f64\u30ea\u30f3\u30d1\u7403\u306fPD-1\u767a\u73fe\u304c\u307f\u3089\u308c\u307e\u3059<\/li>\n<li>\u3053\u308c\u3089\u306f\uff0cgetminoma\u304c\u5897\u5927\u3059\u308b\u6642\u306b\u306f\uff0c\u30ea\u30f3\u30d1\u7403\u306e\u7d30\u80de\u514d\u75ab\u53cd\u5fdc\u3092\u6291\u5236\u3067\u304d\u308b\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u307e\u3059<\/li>\n<\/ul>\n<div class=\"setumei\">\n<hr \/>\n<h5>\u6587\u732e\u60c5\u5831<\/h5>\n<h4><span class=\"authors-list-item \">\u5168\u8133\u5ba4\u7167\u5c0418\u30b0\u30ec\u30a4\u3068\u5c40\u6240\u7167\u5c04\u306e\u7d50\u679c<\/span><\/h4>\n<p><span class=\"authors-list-item \">Bartels U:\u00a0<\/span>Phase II trial of response-based radiation therapy for patients with localized germinoma: a Children&#8217;s Oncology Group study. Neuro Oncol 2022<br \/>\nPFS3\u5e74\u3092\u307f\u305f\u7b2c2\u76f8\u8a66\u9a13\u3067\u3059\u3002\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u3068\u30a8\u30c8\u30dd\u30b7\u30c9\u3067CR\u3068\u306a\u308c\u3070\uff0c\u5168\u8133\u5ba418\u30b0\u30ec\u30a4\u3068\u816b\u760d\u5e8a\u306b12\u30b0\u30ec\u30a4\u306eboost\u7167\u5c04\u304c\u52a0\u3048\u3089\u308c\u307e\u3057\u305f\u3002PR\u306e\u5834\u5408\u306f24\u30b0\u30ec\u30a4\u306e\u5168\u8133\u5ba4\u7167\u5c04\u306812\u30b0\u30ec\u30a4\u306eboost\u304c\u7528\u3044\u3089\u308c\u307e\u3057\u305f\u300290\u4f8b\u306e\u8a55\u4fa1\u53ef\u80fd\u306a\u60a3\u8005\u3055\u3093\u306e\u3046\u306174\u4f8b(82%)\u304c18\u30b0\u30ec\u30a4\u306e\u5168\u8133\u5ba4\u7167\u5c04\u3092\u53d7\u3051\u3066\u3044\u307e\u3057\u305f\u300218\u30b0\u30ec\u30a4\u306e\u7fa4\u30673\u5e74PFS\u306f94.5%\uff0c24\u30b0\u30ec\u30a4\u306e\u7fa4\u306793.75%\u3067\u3057\u305f\u300224\u30b0\u30ec\u30a4\u306e\u7fa4\u3067attention score\u304c\u6cbb\u7642\u5f8c9\u30f6\u6708\u304f\u3089\u3044\u3067\u751f\u3058\u305f\u3088\u3046\u3067\u3059\u3002noninferiority of the 18 Gy WVI\u3068\u3057\u3066\u306f\u660e\u3089\u304b\u306b\u6709\u610f\u306a\u7d50\u679c\u306f\u3067\u307e\u305b\u3093\u3067\u3057\u305f\u3002<br \/>\n\u300c\u89e3\u8aac\u300d3\u5e74\u306e\u3046\u3061\u306b5%\u304f\u3089\u3044\u306e\u518d\u767a\u304c\u8a8d\u3081\u3089\u308c\u305f\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u518d\u767a\u306f3\u5e74\u4ee5\u964d\u3082\u3068\u3066\u3082\u591a\u3044\u3067\u3059\uff0c\u3067\u3059\u304b\u3089\u3082\u3063\u3068PFS\u306e\u6570\u5024\u306f\u5e74\u3054\u3068\u306b\u4f4e\u4e0b\u3059\u308b\u3067\u3057\u3087\u3046\u3002\u307e\u305f\uff0c\u3082\u3057\u795e\u7d4c\u4e0b\u5782\u4f53\u306b\u816b\u760d\u304c\u3042\u308b\u3068\uff0c\u8996\u5e8a\u4e0b\u90e8\u3068\u4e0b\u5782\u4f53\u304c\u6700\u4f4e\u3067\u308230\u30b0\u30ec\u30a4\u88ab\u66dd\u3059\u308b\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u7528\u3044\u3066\u3044\u307e\u3059\u3002\u610f\u5916\u306b\u60aa\u3044\u6210\u7e3e\u3067\u3042\u308b\u3068\u3044\u3046\u5370\u8c61\u3092\u53d7\u3051\u307e\u3059\u3002\u3082\u3057\u5168\u8133\u5ba4\u7167\u5c04\u309218\u30b0\u30ec\u30a4\u307e\u3067\u4f4e\u4e0b\u3055\u305b\u308b\u306a\u3089\u3070\uff0c\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u3068\u30a8\u30c8\u30dd\u30b7\u30c9\u3068\u3044\u3046\u4f75\u7528\u5316\u5b66\u7642\u6cd5\u306e\u5f37\u5ea6\u304c\u4e0d\u8db3\u3057\u3066\u3044\u308b\u3088\u3046\u306a\u6c17\u304c\u3057\u307e\u3059\u3002<\/p>\n<\/div>\n<div class=\"setumei\">\n<h4><span style=\"color: #000080;\"><span style=\"caret-color: #000080;\"><b>\u5c3f\u5d29\u75c7\u304c\u3042\u308a\u677e\u679c\u4f53\u3068\u795e\u7d4c\u4e0b\u5782\u4f53\u306b\u816b\u760d\u304c\u3042\u308c\u3070\u5168\u3066\u304c\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u304b\uff1f<br \/>\n\u7d50\u8ad6\u306f\u305d\u308c\u3067\u3088\u3044\u3088\u3046\u3067\u3059<\/b><\/span><\/span><\/h4>\n<\/div>\n<p>Kanamori M: So-called bifocal tumors with diabetes insipidus and negative tumor markers: are they all germinoma? Neuro Oncol 2021<br \/>\n\u677e\u679c\u4f53\u3068\u795e\u7d4c\u4e0b\u5782\u4f53\u306e\u4e21\u65b9\u306b\u816b\u760d\u304c\u540c\u6642\u306b\u767a\u751f\u3059\u308b\u3082\u306e\u3092bifocal tumors\u3068\u547c\u3073\u307e\u3059\uff0c\u3042\u308b\u3044\u306fsynchronous tumors\u3068\u3082\u8a00\u3044\u307e\u3059\u3002\u5f93\u6765\u304b\u3089\u982d\u84cb\u5185\u80da\u7d30\u80de\u816b\u760d\u7279\u6709\u306e\u753b\u50cf\u6240\u898b\u3068\u8a00\u308f\u308c\u3066\u6765\u307e\u3057\u305f\u3002\u3053\u306e\uff12\u7b87\u6240\u767a\u751f\u306e\u816b\u760d\u304c\uff0c\u5c3f\u5d29\u75c7\u3067\u767a\u75c7\u3057\u3066\u816b\u760d\u30de\u30fc\u30ab\u30fc\u3082\u306f\u3063\u304d\u308a\u4e0a\u6607\u3057\u3066\u3044\u306a\u3044\u5834\u5408\uff0c\u5168\u3066germinoma\u3068\u8a00\u3063\u3066\u3088\u3044\u304b\u3069\u3046\u304b\u304c\u691c\u8a0e\u3055\u308c\u307e\u3057\u305f\u3002132\u4f8b\u304c\u3042\u3066\u306f\u307e\u308a\uff0c\u305d\u306e\u5185\u306e91\u4f8b\u3067\u7d44\u7e54\u63a1\u53d6\u304c\u3055\u308c\u307e\u3057\u305f\u3002\u9006\u306b\uff0c41\u4f8b (31%)\u3067\u306f\u7d44\u7e54\u63a1\u53d6\u306a\u3057\u306b\u6cbb\u7642\u304c\u3055\u308c\u305f\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u300289\u4f8b\u3067\u7d44\u7e54\u8a3a\u65ad\u304c\u306a\u3055\u308c\uff0c82\u4f8b (92%)\u304cgerminoma\u3067\u3057\u305f\u3002\u6210\u719f\u5947\u5f62\u816b\u304c2\u4f8b\u3068\u708e\u75c7\u304c2\u4f8b\u8a8d\u3081\u3089\u308c\u3066\u3044\u307e\u3059\u30023\u4f8b\u3067germinoma\u4ee5\u5916\u306e\u80da\u7d30\u80de\u816b\u760d\u306e\u8a3a\u65ad\u304c\u3064\u3044\u3066\u3044\u307e\u3059\u3002\u708e\u75c7\u3068\u3044\u3046\u306e\u306fgranulomatous inflammation\u3067\u3042\u308a\uff0cCT\u3084\u8840\u7ba1\u9020\u5f71\u691c\u67fb\u3092\u3057\u305f\u5f8c\u3067germinoma\u3092\u751f\u691c\u3057\u305f\u5834\u5408\u306b\u3088\u304f\u8a8d\u3081\u3089\u308c\u308b\u7d44\u7e54\u6240\u898b\u3067\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300f\u307b\u307c\u5168\u3066germionoma\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u6df7\u5728\u3057\u3066\u3044\u308b\u3082\u306e\u304c\u6210\u719f\u5947\u5f62\u816b\u3067\u3042\u308c\u3070\uff0cgerminoma\u306b\u6e96\u3058\u305f\u6cbb\u7642\u3092\u3057\u3066\uff0c\u305d\u306e\u5f8c\u306b\u6b8b\u3063\u305f\u6210\u719f\u5947\u5f62\u816b\u3092\u6458\u51fa\u3059\u308b\u3057\u304b\u5b8c\u6cbb\u306e\u65b9\u6cd5\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u3067\u3059\u304b\u3089\uff0c\u3059\u3079\u3066germinoma\u3068\u3057\u3066\u521d\u671f\u6cbb\u7642\u3092\u958b\u59cb\u3057\u3066\u3082\u8aa4\u308a\u306f\u306a\u3044\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u5bfe\u8c61\u304b\u3089\u5916\u308c\u308b\u7d44\u7e54\u8a3a\u65ad\u3055\u308c\u306a\u304b\u3063\u305f41\u4f8b\u3082germinoma\u3068\u3057\u3066\u6cbb\u7642\u3055\u308c\u3066\u3044\u305f\u306e\u3067\u3057\u3087\u3046\u3002\u6210\u719f\u5947\u5f62\u816b\u304c\u6df7\u3058\u3063\u3066\u3044\u308c\u3070\uff0c\u751f\u691c\u8853\u524d\u306eMRI\u3068CT\u3067\u305f\u3044\u3066\u3044\u306e\u5834\u5408\u306f\u4e88\u6e2c\u3067\u304d\u308b\u3082\u306e\u3067\u3059\u304b\u3089\uff0c\u3055\u3089\u306b\u751f\u691c\u8853\u306e\u610f\u7fa9\u306f\u4f4e\u304f\u306a\u308a\u307e\u3059\u3002\u3042\u3048\u3066\u7d50\u8ad6\u3067\uff0c\u7b46\u8005\u306f\u751f\u691c\u8853\u3092\u884c\u3046\u3079\u304d\u3060\u3068\u4e3b\u5f35\u3057\u3066\u3044\u307e\u3059\u304c\uff0c\u305d\u306e\u6839\u62e0\u3092\u5c0e\u304d\u51fa\u3059\u30c7\u30fc\u30bf\u3068\u306f\u771f\u9006\u306e\u7d50\u679c\u3067\u3059\u3002\u6fa4\u6751\u306f\uff0c\u7d4c\u8776\u5f62\u9aa8\u6d1e\u624b\u8853\u3067\u751f\u691c\u3092\u884c\u3044\u307e\u3059\u3002<\/p>\n<h4>\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u6c34\u982d\u75c7\u306b\u5bfe\u3057\u3066\u306f\u3042\u3048\u3066\u30ea\u30eb\u30af\u3092\u4f34\u3046\u7b2c\uff13\u8133\u5ba4\u958b\u7a93\u8853\u5f8c\u884c\u3046\u5fc5\u8981\u304c\u306a\u304f\u5916\u30c9\u30ec\u30ca\u30fc\u30b8\u3067\u3059\u3080\u4f8b\u304c\u3042\u308b<\/h4>\n<p class=\"heading-title\">RonslyR: Successful management of symptomatic hydrocephalus using a temporary external ventricular drain with or without endoscopic third ventriculostomy in pediatric patients with germinoma. J Neurusurg 2021<br \/>\n22\u4eba\u306e\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u60a3\u8005\u3055\u3093\u3067\uff0c\u5916\u30c9\u30ec\u30ca\u30fc\u30b8 EVD 5, ETV 5, EDV\/ETV 7\u4f8b\u3067\uff0c\u6b8b\u308a\u306e5\u4f8b\u306f\u6c34\u982d\u75c7\u306b\u5bfe\u3059\u308b\u5916\u79d1\u7684\u51e6\u7f6e\u306f\u306a\u3055\u308c\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u30ab\u30eb\u30dc\u30d7\u30e9\u30c1\u30f3\u3068\u30a8\u30c8\u30dd\u30b7\u30c9\u306e\u5316\u5b66\u7642\u6cd5\u304c\u884c\u308f\u308c\uff0c\u5e73\u57477\u65e5\u9593\u3067\u30ac\u30a4\u30c9\u30ec\u30ca\u30fc\u30b8\u306f\u629c\u53bb\u3055\u308c\u307e\u3057\u305f\u3002\u6700\u7d42\u7684\u306b12\u4f8b\u4e2d\u306e2\u4f8b\u3067VP\u30b7\u30e3\u30f3\u3068\u304c\u5fc5\u8981\u3068\u306a\u308a\u307e\u3057\u305f\u300210\u5e74\u306e\u8ffd\u8de1\u671f\u9593\u3067PFS\u306f96%\u3067\u3057\u305f\u3002\u7d50\u8ad6\u3068\u3057\u3066\uff0c\u30b7\u30e3\u30f3\u30c8\u304c\u5fc5\u8981\u3068\u306a\u308b\u60a3\u8005\u3067\u3042\u3063\u3066\u3082\uff0cFTV\u3068EVD\u3067\u7ba1\u7406\u3067\u304d\u308b\u3067\u3042\u308d\u3046\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4><span style=\"color: #000080;\"><strong>\u9577\u671f\u751f\u5b58\u8005\u3067\u8133\u8840\u7ba1\u969c\u5bb3\u30682\u6b21\u816b\u760d\u304c\u591a\u3044<\/strong><\/span><\/h4>\n<div class=\"setumei\">\n<p>Acharya S et al.: Long-term outcomes and late effects for childhood and young adulthood intracranial germinomas. Neuro Oncol 2014 [Epub]<br \/>\n\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u6cbb\u7642\u3092\u53d7\u3051\uff15\u5e74\u4ee5\u4e0a\u751f\u5b58\u3057\u305f405\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e\u7d71\u8a08\u30c7\u30fc\u30bf\u3067\u3059\u300220\u5e74\u5168\u751f\u5b58\u5272\u5408\u304c84%\u3067\uff0c30\u5e74\u751f\u5b58\u304c62%\u3067\u3057\u305f\u3002\u6b63\u5e38\u4eba\u3068\u6bd4\u8f03\u3059\u308b\u3068\u8133\u8840\u7ba1\u969c\u5bb3\u306b\u3088\u308b\u6b7b\u4ea1\u30ea\u30b9\u30af\u304c59\u500d\u3067\u3042\u308a\uff0c25\u5e74\u306e\u6642\u70b9\u3067\u306f\u30ac\u30f3\u30682\u6b21\u816b\u760d\u306b\u3088\u308b\u6b7b\u4ea1\u306f16%\u30686%\u306b\u9054\u3057\u305f\u305d\u3046\u3067\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300d2008\u5e74\u306b\uff0c\u5168\u304f\u540c\u3058\u547d\u984c\u306b\u95a2\u3057\u3066\u5e83\u5cf6\u5927\u5b66\u6749\u5c71\u4e00\u5f66\u5148\u751f\u3068\u4e00\u7dd2\u306b\u8abf\u67fb\u3057\u305f\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002 \u9577\u671f\u751f\u5b58\u3057\u305f203\u4eba\u306e\u60a3\u8005\u3055\u3093\u3067\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u502412.5\u5e74\u3068\u3044\u3046\u8a73\u7d30\u306a\u691c\u8a0e\u3092\u3057\u307e\u3057\u305f\u30022\u6b21\u816b\u760d\u304c22\u4eba (11%)\u3067\uff0c\u8133\u8840\u7ba1\u969c\u5bb3\u304c14\u4eba (7%)\u3067\u767a\u751f\u3057\u3066\u3044\u307e\u3057\u305f\u3002\u767a\u75c7\u5e74\u9f62\u4e2d\u592e\u5024\u306f27.1\u6b73\u3067\u3057\u305f\u30022\u6b21\u816b\u760d\u306e\u4e2d\u3067\u306f\u81a0\u82bd\u816b\u304c5\u4eba\u3082\u767a\u751f\u3057\u3066\u3044\u3066\uff0c\u8840\u7ba1\u969c\u5bb3\u306f\u30a6\u30a3\u30ea\u30b9\u52d5\u8108\u8f2a\u72ed\u7a84\u75c7\u304c\u591a\u3044\u3082\u306e\u3067\u3057\u305f\u3002\u3053\u308c\u3089\u304c\u751f\u3058\u305f\u60a3\u8005\u3055\u3093\u3078\u306e\u653e\u5c04\u7dda\u91cf\u3092\u8abf\u3079\u305f\u3068\u3053\u308d\uff0c32\u4eba\u306e\u60a3\u8005\u3055\u3093\u306e\u5185\uff0c30\u4eba\u306740\u30b0\u30ec\u30a4\u4ee5\u4e0a\u306e\u7dda\u91cf\u304c\u7528\u3044\u3089\u308c\u3066\u3044\u307e\u3057\u305f\u300240\u30b0\u30ec\u30a4\u4ee5\u4e0b\u306e\u7dda\u91cf\u3067\u306f\u3053\u308c\u3089\u306e\u9045\u767a\u6027\u969c\u5bb3\u304c\u307b\u3068\u3093\u3069\u767a\u751f\u3057\u306a\u3044\u3068\u3082\u8a00\u3048\u307e\u3059\u3002<br \/>\n\u3053\u306e\u3088\u3046\u306a\u8abf\u67fb\u306f20\u5e74\u3042\u308b\u3044\u306f30\u5e74\u524d\u306b\u884c\u308f\u308c\u305f\u6cbb\u7642\u306e\u9577\u671f\u6210\u7e3e\u3092\u307f\u3066\u3044\u308b\u3082\u306e\u3067\u3059\u3002\u73fe\u5728\u3067\u306f30\u30b0\u30ec\u30a4\u4ee5\u4e0a\u306e\u7dda\u91cf\u306f\u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u6cbb\u7642\u306b\u4f7f\u7528\u3055\u308c\u306a\u3044\u306e\u3067\uff0c\u904e\u53bb\u306e\u30c7\u30fc\u30bf\u3068\u3057\u3066\u610f\u5473\u304c\u3042\u308b\u3082\u306e\u304b\u3069\u3046\u304b\u306f\u89e3\u308a\u307e\u305b\u3093\u30022014\u5e74\u306bNeuro Oncology\u3068\u3044\u3046\u6a29\u5a01\u306e\u9ad8\u3044\u96d1\u8a8c\u306b\u767a\u8868\u3055\u308c\u305f\u306e\u3067\u3053\u306e\u307e\u307e\u5f15\u7528\u3055\u308c\u308b\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u304c\uff0c\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3059\u3002<\/p>\n<\/div>\n<div class=\"setumei\">\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/otomarikai.jpg\" rel=\"attachment wp-att-9013\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-9013\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/otomarikai-550x391.jpg\" alt=\"otomarikai\" width=\"550\" height=\"391\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/otomarikai-550x391.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/otomarikai-300x214.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/otomarikai-768x547.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/otomarikai.jpg 850w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/a>\u3000\u3000\u3000\u30002016\u5c0f\u5150\u8133\u816b\u760d\u306e\u4f1a\u306e\u304a\u6cca\u307e\u308a\u4f1a\u3067\u3059<\/p>\n<h5>\u6587\u732e<\/h5>\n<ul>\n<li>Acharya S et al.: Long-term outcomes and late effects for childhood and young adulthood intracranial germinomas. Neuro Oncol 2014 [Epub]<\/li>\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. J Clin Oncol 20: 857-865 2002<\/li>\n<li>Balmaceda C, Heller G, Rosenblum M, Diez B, Villablanca JG, Kellie S, Maher P, Vlamis V, Walker RW, Leibel S, Finlay JL: Chemotherapy without irradiation &#8211; a novel approach for newly diagnosed cns germ cell tumors &#8211; results of an international cooperative trial. J Clin Oncol 14: 2908-2915, 1996<\/li>\n<li>Balmaceda C, Modak S, Finlay J: Chemotherapy for the central nervous system germ cell tumors. (in) Intracranial Germ Cell Tumors. Sawamura Y, Shirato H, de Tribolet N (eds), Springer-Verlag, Wien, 1998, pp243-281<\/li>\n<li>Bamberg M, Kortmann RD, Calaminus G, Becker G, Meisner C, Harms D, Gobel U: Radiation therapy for intracranial germinoma: Results of the German cooperative prospective trials MAKEI 83\/86\/89. J Clin Oncol 17: 2585-2592, 1999<\/li>\n<li><span class=\"authors-list-item \">Bartels U:\u00a0<\/span>Phase II trial of response-based radiation therapy for patients with localized germinoma: a Children&#8217;s Oncology Group study. Neuro Oncol 2022<\/li>\n<\/ul>\n<\/div>\n<div class=\"inline-authors\">\n<div class=\"authors\"><\/div>\n<\/div>\n<div class=\"setumei\">\n<ul>\n<li>Brain Tumor Registry of Japan (1969-1996), 11th edition, Neurol Med Chirur 43: 1-49, 2003 (Suppl)<\/li>\n<li>Calaminus G, Andreussi L, Garre ML, Kortmann RD, Schober R, Gobel U: Secreting germ cell tumors of the central nervous system (CNS). First results of the cooperative German\/Italian pilot study (CNS sGCT). 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Sawamura Y, Shirato H, de Tribolet N (eds), Springer-Verlag, Wien, 1998, pp137-145<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>intracranial germinoma, CNS germinoma \u30b8\u30e3\u30fc\u30df\u30ce\u30fc\u30de\u306e\u518d\u767a\u306e\u76f8\u8ac7\u3092\u53d7\u3051\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059 \u653e\u5c04\u7dda\u6cbb\u7642\u306e\u9818\u57df\u304c\u72ed\u3044\uff08\u5c40\u6240\u7167\u5c04\uff09\u305f\u3081\u306b\u751f\u3058\u308b\u3053\u3068\u304c\u307b\u3068\u3093\u3069\u3067\u3059 \u5168\u8133\u5ba4\u3082\u3057\u304f\u306f\u3088\u308a\u5e83\u3044\u7167\u5c04\u91ce [&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-177","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\/177","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=177"}],"version-history":[{"count":147,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/177\/revisions"}],"predecessor-version":[{"id":179,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/177\/revisions\/179"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/media?parent=177"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/categories?post=177"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/tags?post=177"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}