{"id":3607,"date":"2013-08-16T18:14:34","date_gmt":"2013-08-16T09:14:34","guid":{"rendered":"\/sawamura\/?p=3607"},"modified":"2025-11-18T12:43:30","modified_gmt":"2025-11-18T03:43:30","slug":"diffuseastrocytoma","status":"publish","type":"post","link":"https:\/\/plaza.umin.ac.jp\/sawamura\/glioma\/diffuseastrocytoma\/","title":{"rendered":"\u661f\u7d30\u80de\u816b IDH\u5909\u7570\u578b astroytoma IDH-mutant WHO grade 2, 3, 4\uff0c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b diffuse astrocytoma WHO grade 2"},"content":{"rendered":"<h4>\u304a\u304a\u307e\u304b\u306a\u3053\u3068<\/h4>\n<ul>\n<li>\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306f\uff0c\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u540d\u3067\u3059<\/li>\n<li>2021\u5e74\u304b\u3089\u306f\u907a\u4f1d\u5b50\u8a3a\u65ad\u3068\u306a\u308a\uff0c<span style=\"color: #000080;\"><strong>\u661f\u7d30\u80de\u816bIDH\u5909\u7570\u578b\u3068\u3088\u3070\u308c\uff0c\u30b0\u30ec\u30fc\u30c9\u304c2\u304b\u30894<\/strong><\/span>\u306b\u5206\u985e\u3055\u308c\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u307b\u3068\u3093\u3069\u304c\u30b0\u30ec\u30fc\u30c92\u3067\u3059<\/strong><\/span><\/li>\n<li>\u82e5\u3044\u6210\u4eba30\u6b73\u4ee3\u306b\u3082\u3063\u3068\u3082\u591a\u3044\u3067\u3059<\/li>\n<li>\u5c0f\u5150\u306b\u3082\u307f\u3089\u308c\u307e\u3059<\/li>\n<li>\u521d\u767a\u75c7\u72b6\u306f\uff0c<span style=\"color: #000080;\"><strong>\u3066\u3093\u304b\u3093\u767a\u4f5c<\/strong><\/span>\u304c\u591a\u3044\u306e\u3067\u3059\u304c\uff0c\u884c\u52d5\u7570\u5e38\u3084\u4eba\u683c\u306e\u5909\u5316\uff0c\u8a00\u8a9e\u306e\u969c\u5bb3\uff0c\u8efd\u5ea6\u306e\u9ebb\u75fa\u306a\u3069\u306e\u6c17\u3065\u304b\u308c\u306a\u3044\u3088\u3046\u306a\uff0c\u3086\u3063\u304f\u308a\u9032\u884c\u3059\u308b\u8efd\u3044\u75c7\u72b6\u3067\u767a\u75c7\u3059\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u6700\u8fd1\u3067\u306f\uff0cMRI\u3067\u5076\u7136\u767a\u898b\u3055\u308c\u308b\u7121\u75c7\u72b6\u306e\u3082\u306e\u3082\u591a\u304f\u306a\u308a\u307e\u3057\u305f<\/li>\n<li>\u307b\u3068\u3093\u3069\u306f\u5927\u8133\u306b\u767a\u751f\u3057\u307e\u3059<\/li>\n<li>\u306a\u305c\u3060\u304b\u5c0f\u8133\u306b\u306f\u3067\u304d\u306a\u3044\u816b\u760d\u3067\u3059\uff0c\u5c0f\u8133\u306b\u3067\u304d\u305f\u5834\u5408\u306b\u306f<span style=\"color: #000080;\"><a style=\"color: #000080;\" title=\"\u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b\" href=\"\/sawamura\/pediattumor\/pilo\/\">\u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b \u30b0\u30ec\u30fc\u30c91<\/a>\u3092\u8003\u3048\u307e\u3059<\/span><\/li>\n<li>\u3086\u3063\u304f\u308a\u5897\u5927\u3057\u3066\uff0c<strong><span style=\"color: #ff0000;\">\u8133\u306e\u4e2d\u306b\u3057\u307f\u8fbc\u3080\u3088\u3046\u306b\u5e83\u304c\u308b<\/span><\/strong> (<span style=\"color: #ff0000;\"><strong>\u6d78\u6f64<\/strong><\/span> infiltration) \u306e\u304c\u7279\u5fb4\u3067\u3059<\/li>\n<li>MRI\u753b\u50cf\u3067\u307f\u3048\u308b\u3088\u308a\u3082\u5b9f\u969b\u306f\u3082\u3063\u3068\u5468\u56f2\u306b\u5e83\u304c\u3063\u3066\u3044\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\">\u30b0\u30ec\u30fc\u30c92\u304b\u3089\uff0c<a style=\"color: #000080;\" title=\"\u661f\u7d30\u80de\u7cfb\u816b\u760d\" href=\"\/sawamura\/braintumors\/glioma\/astrocytictumor\/\">\u30b0\u30ec\u30fc\u30c9\uff13<\/a><\/span>\u3084<span style=\"color: #000080;\"><a style=\"color: #000080;\" title=\"\u81a0\u82bd\u816b\uff08\u3053\u3046\u304c\u3057\u3085\uff09\" href=\"\/sawamura\/braintumors\/glioma\/glioblastom\/\">\u30b0\u30ec\u30fc\u30c94<\/a><\/span>\u3078\u60aa\u6027\u5316\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u9006\u306b\uff0c\u4f55\u5e74\u3082\u7d4c\u904e\u3092\u898b\u3066\u3082\u307b\u3068\u3093\u3069\u5927\u304d\u304f\u306a\u3089\u306a\u3044\u3082\u306e\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u907a\u4f1d\u5b50\u8a3a\u65ad\u3059\u308b\u3068\uff0c<span style=\"color: #000080;\"><strong>IDH1\/2\u3068ATRX\u907a\u4f1d\u5b50\u5909\u7570\u304c\u3042\u308a\u307e\u3059<\/strong><\/span><\/li>\n<li>\u3057\u3070\u3057\u3070\uff0c<strong><em>TP 53<\/em><\/strong>\u306e\u907a\u4f1d\u5b50\u5909\u7570\u3092\u4f34\u3044\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><span style=\"color: #333333;\">\u7d44\u7e54\u8a3a\u65ad\u304c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c9\uff12\u3067\u3042\u3063\u3066\u3082\uff0c<\/span><strong>IDH1\u907a\u4f1d\u5b50\u306e\u5909\u7570\u304c\u306a\u3044\u3082\u306e\uff08\u91ce\u751f\u578b\uff0c\u30ef\u30a4\u30eb\u30c9\u30bf\u30a4\u30d7\uff09\u3067\u306f\u4e88\u5f8c\u4e0d\u826f<\/strong><\/span>\u3067\uff0c7\u5272\u7a0b\u5ea6\u3067\u81a0\u82bd\u816b\u3068\u3044\u3046\u9ad8\u5ea6\u60aa\u6027\u816b\u760d\u306b\u76f8\u5f53\u3057\u307e\u3059\u306e\u3067\uff0c\u30b0\u30ec\u30fc\u30c92\u304b\u3089\u306f\u305a\u3055\u308c\u307e\u3057\u305f<\/li>\n<li>\u9006\u306bIDH\u5909\u7570\u578b\u3067\u7d44\u7e54\u50cf\u304c\u81a0\u82bd\u816b\u3067\u3042\u308c\u3070\uff0cIDH-mutant astrocytoma grade 4\u3068\u547c\u3070\u308c\u307e\u3059<\/li>\n<li>\u6ce8\u610f\u3057\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u306e\u306f\uff0c\u7d44\u7e54\u304c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3067IDH\u91ce\u751f\u578b\u3067\u3082\uff0c\u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c91\u306e\u90e8\u5206\u50cf\u3092\u307f\u3066\u3044\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\uff0c\u3053\u308c\u3092\u30b0\u30ec\u30fc\u30c94\u3068\u3057\u3066\u6cbb\u7642\u3059\u308b\u3068\u5927\u5909\u306a\u3053\u3068\u306b\u306a\u308a\u307e\u3059!<\/li>\n<li>\u6cbb\u7642\u6cd5\u9078\u629e\u306f\uff0c\u816b\u760d\u306e\u9032\u884c\u306e\u7a0b\u5ea6\u3067\u6c7a\u3081\u3089\u308c\u307e\u3059\uff0c\u3067\u3059\u304b\u3089\u816b\u760d\u304c<span style=\"color: #000080;\"><strong>\u767a\u898b\u3055\u308c\u305f\u3089\u307e\u305a\u77ed\u671f\u9593\u306bMRI\u691c\u67fb\u3092\u7e70\u308a\u8fd4\u3057\u307e\u3059<\/strong><\/span><\/li>\n<li>\u3064\u3044\u306b2025\u5e74\uff0c\u3044\u307e\u307e\u3067\u6709\u52b9\u306a\u6cbb\u7642\u85ac\u304c\u306a\u304b\u3063\u305f<span style=\"color: #ff0000;\"><strong>\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c9\uff12<\/strong><\/span>\u306b\uff0c<a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/glioma\/gliioma-voranigo\/\"><span style=\"color: #ff0000;\"><strong>\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6\u00a0vorasidenib\uff08\u30dc\u30e9\u30cb\u30b4\u3000Voranigo\uff09<\/strong><\/span>\u3068\u3044\u3046\u7d4c\u53e3\u85ac\u304c\u767b\u5834\u3057\u307e\u3057\u305f<\/a>\u3000\u30fe(^\u25bd^)\u30ce<\/li>\n<\/ul>\n<h5>\u661f\u7d30\u80de\u816b 2021\u5e74WHO\u5206\u985e<\/h5>\n<p><span style=\"color: #333333;\">\u3082\u3063\u3068\u3082\u5927\u304d\u306a\u5909\u66f4\u70b9\u306f\uff0c\u7d44\u7e54\u8a3a\u65ad\u3067\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b \u304c <span style=\"color: #000080;\"><strong>\u661f\u7d30\u80de\u816bIDH\u5909\u7570\u578b\u30b0\u30ec\u30fc\u30c92, 3, 4<\/strong><\/span>\u3068\u306a\u308a\uff0c<span style=\"color: #ff0000;\"><strong>\u9000\u5f62\u6210\u6027\u661f\u7d30\u80de\u816b\u306e\u75c5\u540d\u304c\u6d88\u3048\u305f<\/strong><\/span>\u3053\u3068\u3067\u3059\u3002<\/span><\/p>\n<div>\n<h5>\u6210\u4eba\u3073\u307e\u3093\u6027\u30b0\u30ea\u30aa\u30fc\u30de\u30002021\u5e74\u5206\u985e<br \/>\nAdult-type diffuse gliomas<\/h5>\n<\/div>\n<p><span style=\"color: #000080;\"><strong>1. \u661f\u7d30\u80de\u816b IDH\u5909\u7570\u578b\u00a0(\u30b0\u30ec\u30fc\u30c92)<\/strong><span style=\"color: #333333;\">\uff1a \u00a0\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3068\u8a00\u308f\u308c\u305f\u3082\u306e\u306e\u5927\u90e8\u5206<\/span><\/span><br \/>\n<span style=\"color: #000080;\"><strong>Astrocytoma, IDH mutant<\/strong><strong>, nuclear ATRX lost<\/strong><\/span><\/p>\n<p><span style=\"color: #000080;\"><strong>2. \u661f\u7d30\u80de\u816b IDH\u5909\u7570\u578b\u00a0(\u30b0\u30ec\u30fc\u30c93)<\/strong><span style=\"color: #333333;\">\uff1a \u00a0<\/span><\/span><span style=\"color: #000080;\"><span style=\"color: #333333;\">\u9000\u5f62\u6210\u6027\u661f\u7d30\u80de\u816b\u306e\u3053\u3068\u3067\u3059<\/span><strong><br \/>\n<\/strong><\/span><span style=\"color: #000080;\"><strong>Astrocytoma, IDH mutant, anaplastic histology<br \/>\n<\/strong><\/span><\/p>\n<p><span style=\"color: #000080;\"><strong>3. \u661f\u7d30\u80de\u816b IDH\u5909\u7570\u578b\u00a0(\u30b0\u30ec\u30fc\u30c94)<\/strong><span style=\"color: #333333;\"> : \u00a0 \u00a0CDKN\u306b\u6b20\u5931\u304c\u3042\u308b\uff0c\u8840\u7ba1\u5897\u751f\u3084\u58ca\u6b7b\u3082\u898b\u3089\u308c\u307e\u3059<\/span><strong><br \/>\nAstrocytoma, IDH mutant, <em>CDKN2A\/B\u00a0<\/em>homozygous deletion<br \/>\n<\/strong><\/span><\/p>\n<h5>\u5c0f\u5150\u30bf\u30a4\u30d7\u306e\u3073\u307e\u3093\u6027 \u4f4e\u60aa\u6027\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de\u30002021\u5e74\u5206\u985e<br \/>\nPediatric-type diffuse low-grade gliomas<\/h5>\n<p><span style=\"color: #000080;\"><strong>4. \u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b,\u00a0<em>MYB<\/em>\u3042\u308b\u3044\u306f<em>MYBL1\u00a0<\/em>\u907a\u4f1d\u5b50\u7570\u5e38\u00a0\u00a0(\u30b0\u30ec\u30fc\u30c91)<\/strong><\/span><br \/>\n<span style=\"color: #000080;\"><strong>Diffuse astrocytoma, <em>MYB<\/em> or <em>MYBL1<\/em>-altered<\/strong><\/span><\/p>\n<hr \/>\n<p><span style=\"color: #ff0000;\"><strong>\u7d44\u7e54\u8a3a\u65ad\u3067\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3067\u3082\uff0c<\/strong><strong>IDH\u91ce\u751f\u578b wild type<\/strong><\/span>\u3067\uff0c<span style=\"color: #000080;\"><strong><em>TERT<\/em> promotor mutation<\/strong><\/span>\u3082\u3057\u304f\u306f<strong><span style=\"color: #000080;\"><em>EGFR<\/em> amplification<\/span><\/strong>\u3082\u3057\u304f\u306f<strong><span style=\"color: #000080;\">+7\/-10 copy number changes<\/span><\/strong>\u304c\u3042\u308c\u3070\uff0c<strong><span style=\"color: #ff0000;\">\u81a0\u82bd\u816b\u30b0\u30ec\u30fc\u30c94 (molecular GBM)\u3068\u8a3a\u65ad\u3057\u307e\u3059<\/span><\/strong>\u304b\u3089\uff0c\u661f\u7d30\u80de\u816b\u306e\u4ef2\u9593\u306b\u306f\u5165\u308a\u307e\u305b\u3093<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrograde4-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-21195\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrograde4-1-300x289.jpg\" alt=\"\" width=\"300\" height=\"289\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrograde4-1-300x289.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrograde4-1-550x531.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrograde4-1.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrograde4-2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-21196\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrograde4-2-300x287.jpg\" alt=\"\" width=\"300\" height=\"287\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrograde4-2-300x287.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrograde4-2-550x527.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrograde4-2.jpg 709w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>80\u4ee3\u306e\u5973\u6027\u306b\u5076\u7136\u898b\u3064\u304b\u3063\u305f\u3082\u306e\u3067\u3059\u3002\u53f3\u306e\u5cf6\u306e\u30b0\u30ea\u30aa\u30fc\u30de insular glioma\u3067\uff0c\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u306a\u3044\u3073\u307e\u3093\u6027\u30b0\u30ea\u30aa\u30fc\u30de\u3067\u3059\u3002\u53f3\u5074\u306f2\u30f6\u6708\u534a\u5f8c\u306eMRI\u3067\uff0c\u3068\u3066\u3082\u65e9\u304f\u5e83\u304c\u3063\u3066\u3044\u307e\u3059\u306e\u3067\uff0c\u751f\u691c\u8853\u3092\u3057\u307e\u3057\u305f\u3002\u7d44\u7e54\u8a3a\u65ad\u306f\uff0c\u58ca\u6b7b\u3084\u5fae\u5c0f\u8840\u7ba1\u5897\u751f\u306f\u306a\u304f\uff0c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c92\u3067\u3057\u305f\u3002TERT promotor mutant, IDH1 WT, IDH2 WT, H3F3A-K27 WT, H3F3A-G34 WT, m HIST1H3B WT, 1p\/19q intact, CDKN2A\/2B negative\u3067\u3059\u3002<br \/>\n\u3053\u306e\u4f8b\u306f\uff0cmolecular GBM\u3064\u307e\u308a\uff0c<strong><span style=\"color: #000080;\">glioblastoma IDH-WT WHO grade 4<\/span><\/strong>\u3068\u8a3a\u65ad\u3055\u308c\u307e\u3059\u3002<\/p>\n<hr \/>\n<h1><span style=\"color: #000080;\">\u661f\u7d30\u80de\u816b\u3000\u30b0\u30ec\u30fc\u30c9\uff12 IDH \u5909\u7570\u578b<\/span><\/h1>\n<h5>\u3053\u3053\u304b\u3089\u4e0b\u306f\uff0c<span style=\"color: #ff0000;\">\u661f\u7d30\u80de\u816b IDH\u5909\u7570\u578b \u30b0\u30ec\u30fc\u30c92\u00a0<\/span>\u306e\u8a18\u8f09\u3067\u3059<br \/>\n<span style=\"color: #000080;\">\u65e7\u6765\u306e\u300c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u300d\u3067\u3042\u308a\u661f\u7d30\u80de\u816b\u306e\u307b\u3068\u3093\u3069\u3092\u5360\u3081\u307e\u3059<\/span><\/h5>\n<h5><span style=\"color: #000080;\"><a style=\"color: #000080;\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/glioma\/anaplastic-astrocytoma\/\">\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c93<\/a>\u3068<a style=\"color: #000080;\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/glioma\/glioblastom\/\">\u661f\u7d30\u80de\u816b<\/a><a style=\"color: #000080;\" href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/glioma\/glioblastom\/\">\u30b0\u30ec\u30fc\u30c94<\/a><\/span>\u306f\u5225\u30da\u30fc\u30b8\u3092\u53c2\u8003\u306b\u6cbb\u7642\u3092\u63a2\u3063\u3066\u304f\u3060\u3055\u3044\uff0c\u3053\u306e\u4e0b\u306b\u306f\u8a18\u8ff0\u306f\u3042\u308a\u307e\u305b\u3093<\/h5>\n<h5>\u6ce8\u610f :\u00a0\u7d44\u7e54\u304c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3067IDH\u91ce\u751f\u578b\u3067\u3082\uff0c<span style=\"color: #ff0000;\">\u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c91\u306e\u90e8\u5206\u50cf<\/span>\u3092\u307f\u3066\u3044\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\uff0c\u3053\u308c\u3092\u30b0\u30ec\u30fc\u30c94\u3068\u3057\u3066\u6cbb\u7642\u3059\u308b\u3068\u5927\u5909\u306a\u3053\u3068\u306b\u306a\u308a\u307e\u3059!<\/h5>\n<h5>\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c9\uff12\u306f\u6cbb\u3059\u3053\u3068\u304c\u3067\u304d\u308b\u816b\u760d\u3067\u3059<\/h5>\n<h4><span style=\"color: #000080;\"><strong>\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306e\u753b\u50cf\u4e0a\u306e3\u3064\u306e\u30bf\u30a4\u30d7<\/strong><\/span><\/h4>\n<p>\u5b9f\u969b\u306b\u306f\u7570\u306a\u3063\u305fMRI\u50cf\u3092\u793a\u30593\u7a2e\u985e\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u304c\u77e5\u3089\u308c\u3066\u3044\u307e\u3057\u305f\u3002<br \/>\n1\u3064\u76ee\u306f\u60aa\u6027\u5316\u3082\u3057\u3084\u3059\u3044\u3057\u751f\u547d\u4e88\u5f8c\u304c\u60aa\u3044\u3082\u306e\u3067\u3059\u3002\u304b\u306a\u308a\u306e\u3082\u306e\u304c\u30b0\u30ec\u30fc\u30c93\/4\u3068\u540c\u3058\u3088\u3046\u306a\u81e8\u5e8a\u50cf\u3092\u793a\u3057\u307e\u3059\u3002\u8133\u306e\u4e2d\u5fc3\u90e8\u306b\u767a\u751f\u3059\u308b\u3082\u306e\u306f\uff0c\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u3067\u306f\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306a\u306e\u3067\u3059\u304cH3 K27\u907a\u4f1d\u5b50\u5909\u7570\u304c\u3042\u308a\u3001\u73fe\u5728\u306f\u907a\u4f1d\u5b50\u8a3a\u65ad\u3067 \u3073\u307e\u3093\u6027\u6b63\u4e2d\u30b0\u30ea\u30aa\u30fc\u30de \u30b0\u30ec\u30fc\u30c94\u3068\u3055\u308c\u308b\u3082\u306e\u3067\u3059\u3002\u65e7\u6765\u306e\u30b0\u30ea\u30aa\u30de\u30c8\u30fc\u30b7\u30b9\u3068\u547c\u79f0\u3055\u308c\u305f\u3082\u306e\u3082\u542b\u307f\u307e\u3059\u3002<br \/>\n2\u3064\u76ee\u30683\u3064\u76ee\u306f\u3086\u3063\u304f\u308a\u4f55\u5e74\u3082\u304b\u3051\u3066\u5927\u304d\u304f\u306a\u308b\u3057\uff0c\u624b\u8853\u3067\u6cbb\u308b\u53ef\u80fd\u6027\u3082\u3042\u308b\u3082\u306e\u3067\uff0c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3068\u3044\u3063\u3066\u3082\u304b\u306a\u308a\u6027\u8cea\u304c\u9055\u3044\u307e\u3059\u3002\u53e4\u304f\u304b\u3089<span style=\"color: #000080;\"><strong>IDH-1\/2\u306e\u907a\u4f1d\u5b50\u5909\u7570<\/strong><\/span>\u304c\u3042\u308b\u661f\u7d30\u80de\u816b\u306f\u9650\u5c40\u6027\u3067\u5341\u5206\u306a\u6458\u51fa\u304c\u3067\u304d\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3068\u3055\u308c\u3066\u304d\u307e\u3057\u305f\u3002<\/p>\n<h5>1 \u8133\u6df1\u90e8\u306b\u6ef2\u3080\u3088\u3046\u306b\u5e83\u7bc4\u56f2\u306b\u3042\u308a\u5897\u5927\u901f\u5ea6\u304c\u901f\u3044\u3082\u306e<\/h5>\n<h5>2 \u6ef2\u3080\u3088\u3046\u306b\u5e83\u304c\u3063\u3066\u5897\u5927\u901f\u5ea6\u304c\u3068\u3066\u3082\u300c\u9045\u3044\u300d\u3082\u306e<\/h5>\n<h5>3 \u8868\u9762\u306b\u3042\u3063\u3066\u5883\u754c\u304c\u660e\u77ad\u3067\u3042\u307e\u308a\u6d78\u6f64\u3057\u306a\u3044\u3082\u306e<\/h5>\n<h4><strong>\u753b\u50cf\u6240\u898b<\/strong><\/h4>\n<ul>\n<li>CT\u3067\u306f\uff0c\u4f4e\u5438\u53ce\u57df\u3067\u5468\u56f2\u306e\u8133\u3088\u308a\u5c11\u3057\u9ed2\u3063\u307d\u304f\u898b\u3048\u307e\u3059<\/li>\n<li>MRI \u306e<strong><span style=\"color: #000080;\">T2\u30fbFLAIR(\u30d5\u30ec\u30a2)\u753b\u50cf\u3067\u6de1\u304f\u767d\u304f\u898b\u3048\u308b<\/span><\/strong>\uff08\u9ad8\u4fe1\u53f7\uff09\u306e\u304c\u7279\u5fb4\u3067\u3059<\/li>\n<li>\u4e00\u822c\u7684\u306b\u306f\uff0c\u3073\u307e\u3093\u6027\u3067\u5468\u56f2\u304c\u306f\u3063\u304d\u308a\u3057\u306a\u3044<strong><span style=\"color: #000080;\">\u8133\u306e\u4e2d\u306b\u300c\u306b\u3058\u3080\u3088\u3046\u306a\u816b\u760d\u300d<\/span><\/strong>\u306b\u898b\u3048\u307e\u3059<\/li>\n<li>\u521d\u671f\u306b\u306f\u3001\u4e00\u3064\u306e\u8133\u56de\u306b\u9650\u5c40\u3057\u3066\u5883\u754c\u304c\u660e\u77ad\u306a\u5c0f\u3055\u306a\u816b\u760d\u3068\u3057\u3066\u767a\u898b\u3055\u308c\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059 (single gyrus glioma)<\/li>\n<li>\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u9020\u5f71\u5264\u3067\u5897\u5f37\u3055\u308c\u308b\u3053\u3068\u306f\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u3067\u5897\u5f37\u3055\u308c\u305f\u5834\u5408\u306f\u30b0\u30ec\u30fc\u30c93\u4ee5\u4e0a\u306e\u661f\u7d30\u80de\u7cfb\u816b\u760d\u304c\u6df7\u3058\u3063\u3066\u3044\u308b\u3053\u3068\u3092\u7591\u3044\u307e\u3059<\/li>\n<li>\u77f3\u7070\u5316\u3084\u306e\u3046\u80de\u306f\u3042\u308a\u5f97\u308b\u306e\u3067\u3059\u304c\u3068\u3066\u3082\u7a00\u3067\u3059<\/li>\n<li>\u3042\u3063\u305f\u5834\u5408\u306b\u306f\u4e4f\u7a81\u8d77\u81a0\u816b\u3092\u7591\u3063\u305f\u65b9\u304c\u3044\u3044\u3067\u3057\u3087\u3046<\/li>\n<li>\u5e73\u5747\u3059\u308b\u3068<span style=\"color: #000080;\"><strong>\u5e74\u306b6mm\u304f\u3089\u3044\u5927\u304d\u304f\u306a\u308a<\/strong><\/span>\u307e\u3059<\/li>\n<li>\u3067\u3082\uff0c\u3086\u3063\u304f\u308a\u5927\u304d\u304f\u306a\u3063\u30665\u5e74\u304f\u3089\u3044\u898b\u3066\u3044\u3066\u3082\u3042\u307e\u308a\u5927\u304d\u3055\u304c\u5909\u308f\u3089\u306a\u3044\u3082\u306e\u304b\u3089\uff0c3\u30f6\u6708\u304f\u3089\u3044\u3067\u500d\u304f\u3089\u3044\u306b\u306a\u3063\u3066\u3057\u307e\u3046\u3082\u306e\u3082\u3042\u308a\u307e\u3059\uff0c\u6cb9\u65ad\u304c\u3067\u304d\u307e\u305b\u3093<\/li>\n<li>\u5cf6 insel\u3092\u4fb5\u3059\u661f\u7d30\u80de\u816b (insular glioma)\u306f\u4e88\u5f8c\u4e0d\u826f\u3068\u3055\u308c\u307e\u3059<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-8348 alignnone\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay1-200x200.jpg\" alt=\"astrocytomaay1\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay1-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-8350 alignnone\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay3-200x200.jpg\" alt=\"astrocytomaay3\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay3-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay3-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay3-550x550.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay3-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay3.jpg 567w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-8351 alignnone\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay2-200x200.jpg\" alt=\"astrocytomaay2\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay2-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay2-550x550.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay2-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaay2.jpg 567w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><br \/>\n\u5de6\u5074\u982d\u8449\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3067\u3059\u3002\u5de6\u5074\u306eT1\u5f37\u8abf\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u50cf\u3067\u306f\u307b\u3068\u3093\u3069\u816b\u760d\u306f\u898b\u3048\u307e\u305b\u3093\u3002\u771f\u3093\u4e2d\u306eT2\u5f37\u8abf\u753b\u50cf\u3067\u3082\u898b\u3065\u3089\u3044\u3067\u3059\u3002\u53f3\u5074\u306e\u30d5\u30ec\u30a2\u753b\u50cf\u3067\u767d\u304f\u306b\u3058\u3093\u3067\u3044\u308b\u3068\u3053\u308d\u306b\u816b\u760d\u304c\u3042\u308a\u307e\u3059\u3002\u3069\u3053\u307e\u3067\u304c\u816b\u760d\u306e\u5883\u754c\u306a\u306e\u304b\u304c\u306f\u3063\u304d\u308a\u3057\u306a\u3044\u816b\u760d\u3067\u3059\u3002\u5de6\u306e\u6d77\u99ac\uff08\u8a18\u61b6\u306e\u4e2d\u67a2\uff09\u3092\u4fb5\u3057\uff0c\u3068\u3066\u3082\u3086\u3063\u304f\u308a\u5927\u304d\u304f\u306a\u308b\u30bf\u30a4\u30d7\u3067\uff0c\u3053\u306e\u60a3\u8005\u3055\u3093\u306f10\u5e74\u4ee5\u4e0a\u6cbb\u7642\u3092\u3057\u306a\u3044\u3067\u7d4c\u904e\u3092\u898b\u3066\u3044\u307e\u3059\u3002\u5168\u6458\u51fa\u3067\u304d\u306a\u3044\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c92\u3067\u3059\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/diffuseastrolocal.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-9779\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/diffuseastrolocal-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/diffuseastrolocal-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/diffuseastrolocal-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a>\u30d5\u30ec\u30a2\u753b\u50cf\u3067\u3059\u3002\u5de6\u4e0a\u524d\u982d\u56de\u306e\u661f\u7d30\u80de\u816b\u3067\u3059\u304c\uff0c\u5883\u754c\u304c\u3068\u3066\u3082\u306f\u3063\u304d\u308a\u3057\u3066\u3044\u3066\u9650\u5c40\u6027 localized single gyrus glioma \u3067\u3059\u3002\u3073\u307e\u3093\u6027 diffuse\u306b\u306f\u898b\u3048\u307e\u305b\u3093\u3002IDH1\u306e\u5909\u7570\u304c\u3042\u308a\uff0c1p\/19q\u306e\u6b20\u5931\u306f\u306a\u3044\u306e\u3067\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c92\u3067\u3059\u3002\u4e0a\u306e\u4f8b\u3068\u306f\u5168\u304f\u9055\u3046\u81e8\u5e8a\u50cf\u3092\u793a\u3057\u307e\u3059\u304c\uff0c\u5206\u5b50\u75c5\u7406\u3067\u3082\u533a\u5225\u306f\u3064\u304d\u307e\u305b\u3093\u3002\u9811\u5f35\u3063\u3066\u65e9\u3081\u306b\u5168\u6458\u51fa\u3057\u3066\u6cbb\u3057\u3066\u3057\u307e\u3063\u305f\u65b9\u304c\u3044\u3044\u30bf\u30a4\u30d7\u3067\u3059\u3002\u518d\u767a\u3092\u907f\u3051\u308b\u305f\u3081\u306b\uff0csupratotal resection\u3068\u8a00\u3063\u3066\uff0c\u5468\u56f2\u306e\u6b63\u5e38\u8133\u7d44\u7e54\u308210mm\u304f\u3089\u3044\u4f59\u5206\u306b\u6458\u51fa\u3057\u307e\u3059\u3002<\/p>\n<h4><strong>T2-FLAIR mismatch sign (T2\u3068\u30d5\u30ec\u30a2\u306e\u4fe1\u53f7\u304c\u9055\u3046\u3053\u3068)<\/strong><\/h4>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17081\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr2-300x297.jpg\" alt=\"\" width=\"300\" height=\"297\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr2-300x297.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr2-550x545.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr2-768x761.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr2.jpg 1134w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17082\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr1-293x300.jpg\" alt=\"\" width=\"293\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr1-293x300.jpg 293w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr1-550x564.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr1-768x787.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasr1.jpg 1134w\" sizes=\"auto, (max-width: 293px) 100vw, 293px\" \/><\/a><\/p>\n<p>protoplasmic astrocytoma\u306b\u7279\u5fb4\u7684\u306aMRI\u6240\u898b\u3067\u3059\u3002T2\u5f37\u8abf\u753b\u50cf\uff08\u5de6\u5074\uff09\u3067\u306f\u767d\u304f\uff08\u5f37\u3044\u5747\u4e00\u306a\u9ad8\u4fe1\u53f7\uff09\u898b\u3048\u307e\u3059\u3002\u3067\u3082\u30d5\u30ec\u30a2\u753b\u50cf\uff08\u53f3\u5074\uff09\u3067\u306f\u767d\u304f\u7e01\u53d6\u3063\u305f\u3088\u3046\u306b\u898b\u3048\u307e\u3059\u3002\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306e\u5927\u304d\u306a\u7279\u5fb4\u3068\u3055\u308c\u307e\u3059\u3002\u5185\u90e8\u304c\u3068\u3066\u3082\u67d4\u3089\u304b\u3044\u30c9\u30ed\u30c9\u30ed\u3057\u305f\u816b\u760d\u306e\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17261\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe2-300x291.jpg\" alt=\"\" width=\"300\" height=\"291\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe2-300x291.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe2-550x534.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe2-768x746.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe2.jpg 984w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17262\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe1-300x298.jpg\" alt=\"\" width=\"300\" height=\"298\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe1-300x298.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe1-550x547.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe1-768x763.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomasrhe1.jpg 984w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<p>mucoid degeneration\u3092\u542b\u3080protoplasmic astrocytoma\u306e\u50cf\u3067\u3059\u3002\u30b0\u30ec\u30fc\u30c92\u306e\u5178\u578b\u7684\u75c5\u7406\u50cf\u3067\u3059\u3002<\/p>\n<hr \/>\n<h5>\u91cd\u8981\uff01\u898b\u3064\u304b\u3063\u305f\u3089\u77ed\u671f\u9593\u306bMRI\u3092\u7e70\u308a\u8fd4\u3059<\/h5>\n<ul>\n<li>\u75c5\u7406\u8a3a\u65ad\u3088\u308a\u3082<span style=\"color: #000080;\"><strong>\u907a\u4f1d\u5b50\u8a3a\u65ad\u3088\u308a\u3082\uff0cMRI\u753b\u50cf\u8a3a\u65ad\u306e\u65b9\u304c\u60a3\u8005\u3055\u3093\u306e\u4e88\u5f8c\uff08\u547d\u306e\u5371\u306a\u3055\uff09\u304c\u3088\u304f\u308f\u304b\u308a\u307e\u3059<\/strong><\/span><\/li>\n<li>\u521d\u8a3a\u3067\uff0c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3092\u7591\u3063\u305f\u3089\uff0c\u521d\u671f\u306b\u306f\u6708\u306b\u4e00\u56de\u306eMRI\u3092\u3057\u3066\u3082\u3044\u3044\u3067\u3057\u3087\u3046<\/li>\n<li>2\u30f6\u6708\u9593\u304f\u3089\u3044\u306e\u77ed\u671f\u9593\u306b\u5927\u304d\u304f\u306a\u308b\u3082\u306e\u304b\uff0c\u305d\u308c\u3068\u3082\u6570\u30f6\u6708\u304f\u3089\u3044\u3067\u306f\u5168\u304f\u5909\u5316\u306a\u3044\u3082\u306e\u304b\u3092\u307e\u305aMRI\u3067\u898b\u6975\u3081\u307e\u3059<\/li>\n<\/ul>\n<h4>\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306e\u75c5\u7406\u5206\u985e<\/h4>\n<ul>\n<li>\u75c5\u7406\u8a3a\u65ad\u3067\u306f\u3068\u306b\u304b\u304f\uff0cIDH1\/IDH2\u907a\u4f1d\u5b50\u5909\u7570\u306e\u3042\u308b\u306a\u3057\u3092\u8abf\u3079\u306a\u3051\u308c\u3070\u306a\u308a\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #000080;\"><strong>IDH1 codon 132<\/strong><\/span>\u3068ATRX\u306e\u514d\u75ab\u67d3\u8272\u3092\u3057\u3066\u5909\u7570\u304c\u3042\u308c\u3070\u8a3a\u65ad\u304c\u3064\u304d\u307e\u3059<\/li>\n<li><span style=\"color: #ff0000;\"><strong>IDH1 R132H\u5909\u7570\u306f\u304c80-90\uff05\u307b\u3069\u3067\u3059\u304c\uff0c\u4ed6\u306e\u90e8\u4f4d\u306e\u5909\u7570\u3067\u3059\u3068\u514d\u75ab\u67d3\u8272\u3067\u306f\u898b\u9003\u3057\u3066\u3057\u307e\u3044\u307e\u3059<\/strong><\/span><\/li>\n<li>\u5fc5\u8981\u3067\u3042\u308c\u3070\uff0c<span style=\"color: #000080;\"><strong>IDH2 codon 172<\/strong><\/span> missense mutation\u3092\u307f\u307e\u3059\u00a0(IDH1\/2 mutation hotspot sequencing)<\/li>\n<li><span style=\"color: #000080;\"><strong>\u7d44\u7e54\u5f62\u614b\u5b66\u7684\u8a3a\u65ad\u3082\u3042\u308f\u305b\u3066\u6574\u5408\u6027\u3092\u78ba\u8a8d<\/strong><\/span>\u3057\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u514d\u75ab\u67d3\u8272\u3067R132\u304c\u9670\u6027\u3067\u3042\u3063\u3066\u3082\uff0c\u7c21\u5358\u306b\u306f\u91ce\u751f\u578b wild type\u3068\u6c7a\u3081\u3064\u3051\u306a\u3044<\/strong><\/span>\u3053\u3068\u3082\u5927\u5207\u3067\u3059<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c<span style=\"color: #000080;\"><strong>\u7c21\u5358\u306b\u306fwild type\u3068\u306f\u3044\u3048\u305a<\/strong><\/span>\uff0c\u305d\u306e\u6642\u306b\u306f\u30b7\u30fc\u30af\u30a8\u30f3\u30b9\u304c\u5fc5\u8981\u3068\u306a\u308a\u307e\u3059<\/li>\n<li>WHO\u306f\uff0c\u7d44\u7e54\u8a3a\u3067\u306e<span style=\"color: #000080;\"><strong>\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306e\u307b\u3068\u3093\u3069\u306bIDH\u5909\u7570\u304c\u3042\u308b<\/strong><\/span>\u3068\u3057\u3066\u3044\u307e\u3059<\/li>\n<li><span style=\"color: #333333;\">2021\u5e74\u6642\u70b9\u3067\u306f\uff0cIDH\u91ce\u751f\u578b\u3067\u3042\u3063\u305f\u5834\u5408\u306f\uff0c\u591a\u304f\u306e\u5834\u5408\u306f\u81a0\u82bd\u816b \u30b0\u30ec\u30fc\u30c94\u3068\u3057\u3066\u6cbb\u7642\u3057\u307e\u3059<\/span><\/li>\n<li>\u91ce\u751f\u578b\u3067\uff0c<span style=\"color: #000080;\"><strong>\u9ad8\u5ea6\u306eEGFR\u5897\u5e45\uff0cTERT\u30d7\u30ed\u30e2\u30fc\u30bf\u5909\u7570\uff0c\u7b2c7\u67d3\u8272\u4f53\u306e\u30b2\u30a4\u30f3\u3068\u7b2c10\u67d3\u8272\u4f53\u306e\u5168\u6b20\u5931\u304c\u3042\u308c\u3070\u30b0\u30ec\u30fc\u30c94<\/strong><\/span>\u3068\u306a\u308b\u306e\u3067\uff0c\u81a0\u82bd\u816b\u3068\u540c\u3058\u6cbb\u7642\u3092\u3057\u307e\u3059<\/li>\n<li>\u307e\u305f\u9006\u306b\uff0c<span style=\"color: #000080;\"><strong>IDH<\/strong><strong>\u5909\u7570\u304c\u306a\u3051\u308c\u3070\uff0c\u795e\u7d4c\u7bc0\u81a0\u816b, \u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b\u3068\u3044\u3046\u826f\u6027\u816b\u760d\u306e\u90e8\u5206\u50cf\u3092\u307f\u3066\u3044\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093<\/strong><\/span><\/li>\n<li>\u4e4f\u7a81\u8d77\u81a0\u816b\u3068\u306e\u9451\u5225\u306e\u305f\u3081\u306b\uff0c<span style=\"color: #000080;\"><strong>ATRX\u907a\u4f1d\u5b50\u767a\u73fe\u304c\u306a\u3044<\/strong><\/span>\u3053\u3068\u3092\u514d\u75ab\u7d44\u7e54\u67d3\u8272\u3067\u78ba\u304b\u3081\u307e\u3059\uff0c<span style=\"color: #000080;\"><strong>ATRX\u6b20\u640d\u304c\u3042\u308c\u30701p\/19q\u67d3\u8272\u4f53\u3092\u8abf\u3079\u306a\u304f\u3066\u3082\u661f\u7d30\u80de\u7cfb\u816b\u760d<\/strong><\/span>\u3068\u8a3a\u65ad\u3067\u304d\u307e\u3059<\/li>\n<li>2022\u5e74\u6642\u70b9\u3067\uff0c\u30b0\u30ec\u30fc\u30c92 \u661f\u7d30\u80de\u816b\u3067\u306fMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u3092\u691c\u67fb\u3059\u308b\u81e8\u5e8a\u7684\u610f\u7fa9\u306f\u306a\u3044\u3068\u3055\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u65e5\u672c\u3067\u306f\u4fdd\u967a\u8a3a\u7642\u3067\u305d\u308c\u3092\u8abf\u3079\u308b\u3053\u3068\u304c\u3067\u304d\u306a\u3044\u304b\u3089\uff0c\u5f53\u5206\uff0c\u6b63\u78ba\u306a\u75c5\u7406\u8a3a\u65ad\u306f\u7121\u7406\uff01\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u307e\u305f\uff0c\u6587\u732e\u3092\u8abf\u3079\u3066\u3082IDH\u5909\u7570\u306e\u3042\u308b\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306b\u3069\u306e\u3088\u3046\u306a\u6cbb\u7642\u6cd5\u304c\u9078\u629e\u3055\u308c\u308b\u3079\u304d\u306a\u306e\u304b\u306f\u51fa\u3066\u304d\u307e\u305b\u3093\uff0c\u81e8\u5e8a\u7814\u7a76\u304c\u8ffd\u3044\u3064\u3044\u3066\u3044\u306a\u3044\u306e\u3067\u3059<\/li>\n<li>\u7d44\u7e54\u8a3a\u65ad\u3067gemistocytic variant\u3060\u3051\u306f\u533a\u5225\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/IDH1mutant-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-large wp-image-9782\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/IDH1mutant-1-550x356.jpg\" alt=\"\" width=\"550\" height=\"356\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/IDH1mutant-1-550x356.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/IDH1mutant-1-300x194.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/IDH1mutant-1-768x497.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/IDH1mutant-1.jpg 1686w\" sizes=\"auto, (max-width: 550px) 100vw, 550px\" \/><\/a><\/p>\n<p>\u3053\u306e\u4f8b\u3067\u306f\uff0cIDH1 R132H\u306e\u5909\u7570\u3042\u308a\uff0cIDH2\u306e\u5909\u7570\u306f\u306a\u3044\u3068\u3044\u3046\u89e3\u6790\u7d50\u679c\u3067\u3059<\/p>\n<h4><strong>\u6cbb\u7642<\/strong><\/h4>\n<div>\n<ul>\n<li>\u307e\u305a<span style=\"color: #ff0000;\"><strong>\u6cbb\u7642\u3092\u3059\u308b\u3079\u304d\u304b\u3069\u3046\u304b\u3092\u8003\u3048\u307e\u3059<\/strong><\/span><\/li>\n<li>\u5224\u65ad\u3092\u8ff7\u3046\u5834\u5408\u306b\u306fMRI\u30921\u6708\u3054\u3068\u304f\u3089\u3044\u306b\u7e70\u308a\u8fd4\u3057\u307e\u3059<\/li>\n<li>\u6570\u5e74\u4ee5\u4e0aMRI\u3067\u7d4c\u904e\u89b3\u5bdf\u3067\u304d\u308b\u3082\u306e\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u8a3a\u65ad\u3060\u3051\u3092\u306f\u3063\u304d\u308a\u3055\u305b\u305f\u3044\u6642\u306f\uff0c<strong><span style=\"color: #ff0000;\">\u751f\u691c\u8853<\/span><\/strong>\uff08\u816b\u760d\u3092\u3061\u3087\u3073\u3063\u3068\u63a1\u308b\uff09\u3092\u3057\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u6cbb\u7642\u306e\u76ee\u6a19\u306f\u300c\u793e\u4f1a\u5fa9\u5e30\u304c\u3067\u304d\u308b\u300d<\/strong><\/span>\u3053\u3068\u3067\u3059\uff0c\u5358\u306a\u308b\u5ef6\u547d\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u9650\u5c40\u6027\u3067\u5b8c\u5168\u6458\u51fa\u3067\u304d\u308b\u3082\u306e\u306f\uff0c\u9811\u5f35\u3063\u3066\u5b8c\u5168\u6458\u51fa\u3057\u307e\u3059\uff0c\u305d\u308c\u3060\u3051\u3067\u5b8c\u6cbb\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>40\u4ee3\u3088\u308a\u82e5\u3044\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c\u5168\u6458\u51fa\u3067\u304d\u308c\u3070\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u306a\u3044\u3067\u7d4c\u904e\u3092\u898b\u3066\u3082\u826f\u3044\u3067\u3057\u3087\u3046<\/li>\n<li>\u6b27\u7c73\u306e\u5927\u304d\u306a\u81e8\u5e8a\u7814\u7a76\u3067\u306f\uff0c\u661f\u7d30\u80de\u816b\uff08\u30b0\u30ec\u30fc\u30c9\uff12\uff09\u306b\u5bfe\u3057\u3066\u306e<span style=\"color: #000080;\"><strong>\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u6709\u52b9\u6027\uff08\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\uff09\u306f\u306f\u3063\u304d\u308a\u3057\u307e\u305b\u3093\u3067\u3057\u305f\u304c\uff0c\u6700\u8fd1\u3067\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u52a0\u3048\u3089\u308c\u308b\u4f8b\u304c\u5897\u3048\u3066\u3044\u307e\u3059<\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\uff08\u75c7\u72b6\u304c\u60aa\u304f\u306a\u3089\u306a\u3044\u3067\u751f\u5b58\u3067\u304d\u308b\u671f\u9593\uff09\u306f\u5ef6\u9577\u3067\u304d\u308b<\/strong><\/span>\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059<\/li>\n<li>\u5897\u5927\u4f38\u5c55\u306e\u901f\u3044\u3082\u306e\u3084\u624b\u8853\u5f8c\u306b\u816b\u760d\u304c\u5897\u5927\u3057\u305f\u3068\u304d\uff08\u518d\u71c3\uff09\u306b50\u30b0\u30ec\u30a4\u524d\u5f8c\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3059<\/li>\n<li>\u307e\u305f\u3055\u3089\u306b\uff0c2024\u5e74\uff0c\u81e8\u5e8a\u7b2c3\u76f8\u8a66\u9a13\u306e\u7d50\u679c\u3067\uff0c\u521d\u671f\u6cbb\u7642\u3067\u653e\u5c04\u7dda\u6cbb\u764250.4Gy\u306b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u52a0\u3048\u305f\u65b9\u304c10\u5e74\u751f\u5b58\u5272\u5408\u304c40\uff05\u304b\u308970\uff05\u307e\u3067\u4e0a\u6607\u3059\u308b\u3068\u5831\u544a\u3055\u308c\u307e\u3057\u305f\u3002<\/li>\n<li><span style=\"color: #000080;\"><strong>2023\u5e74\u306b\uff0c<span style=\"color: #ff0000;\"><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/glioma\/gliioma-voranigo\/\">\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6 vorasidenib<\/a><span style=\"color: #000080;\">\uff08\u98f2\u307f\u85ac\uff09<\/span><\/span>\u306e\u81e8\u5e8a\u7b2c3\u76f8\u8a66\u9a13\u306e\u7d50\u679c\u304c\u767a\u8868\u3055\u308c\uff0c\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577<\/strong><\/span>\u304c\u8a3c\u660e\u3055\u308c\u307e\u3057\u305f\uff0c\u7c73\u56fd\u3067\u8a8d\u53ef\u3055\u308c\u3002\u3082\u3046\u3059\u3050\u65e5\u672c\u3067\u3082\u4f7f\u7528\u3067\u304d\u308b\u3088\u3046\u306b\u306a\u308b\u306e\u3067\u3057\u3087\u3046<\/li>\n<li>\u3067\u3059\u304b\u3089\u73fe\u6bb5\u968e\u3067\u306e\u4e00\u822c\u7684\u306a\u6cbb\u7642\u306f\uff0c<span style=\"color: #ff0000;\"><strong>\u3082\u3057\u3067\u304d\u308c\u3070\u5168\u90e8\u6458\u51fa\u3059\u308b<\/strong><\/span><\/li>\n<li>\u7121\u7406\u3057\u306a\u3044\u624b\u8853 (maximal-safe resection) \u3067\u816b\u760d\u304c\u6b8b\u308c\u3070\u7d4c\u904e\u89b3\u5bdf\u3067\u69d8\u5b50\u3092\u898b\u308b<\/li>\n<li>\u661f\u7d30\u80de\u816b\u309260%\u6458\u51fa\u3057\u3066\u3082\uff0c70%\u6458\u51fa\u3057\u3066\u3082\uff0c80%\u6458\u51fa\u3057\u3066\u3082\u751f\u547d\u4e88\u5f8c\u306f\u5909\u308f\u308a\u307e\u305b\u3093<\/li>\n<li>\u3068\u306b\u304b\u304f<span style=\"color: #000080;\"><strong>\u899a\u9192\u4e0b\u624b\u8853\u3092\u5fc5\u8981\u4ee5\u4e0a\u306b\u884c\u308f\u306a\u3044<\/strong><\/span><\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u3088\u308a\u591a\u304f\u3092\u6458\u51fa\u3057\u305f\u65b9\u304c\u3044\u3044\u3068\u3044\u3046&#8221;\u5358\u7d14 naive&#8221; \u306a\u8003\u3048\u65b9\u306f\u3067\u304d\u307e\u305b\u3093<\/strong><\/span><\/li>\n<li>80\uff05\u6458\u51fa\u3057\u305f\u6642\u70b9\u3067\uff0c\u3042\u306810\uff05\u6458\u51fa\u3092\u52a0\u3048\u306690\uff05\u6458\u51fa\u306b\u3059\u308b\u305f\u3081\u306b\uff0c\u5f8c\u907a\u75c7\uff08\u795e\u7d4c\u8131\u843d\u75c7\u72b6\u3068\u3044\u3044\u307e\u3059\uff09\u3092\u51fa\u3059\u30ea\u30b9\u30af\u3092\u4fb5\u3059\u3079\u304d\u3067\u306f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li><span style=\"color: #ff0000;\"><strong>\u6b8b\u3063\u305f\u816b\u760d\u304c\u5927\u304d\u304f\u306a\u308a\u305d\u3046\u306a\u5834\u5408\u300150\u30b0\u30ec\u30a4\u524d\u5f8c\u306e\u653e\u5c04\u7dda\u6cbb\u7642<\/strong><\/span>\u3092\u3057\u307e\u3059<\/li>\n<li>\u75c5\u7406\u8a3a\u65ad\u3067MIB-1(Ki67)\u306a\u3069\u3067\u624b\u8853\u3067\u6b8b\u3063\u305f\u816b\u760d\u304c\u660e\u3089\u304b\u306b\u5927\u304d\u304f\u306a\u308b\u306e\u304c\u308f\u304b\u308a\uff08\u5f37\u304f\u4e88\u60f3\u3055\u308c\u308b\uff09\u307e\u3059\u306e\u3067\uff0c\u3053\u306e\u6642\u306b\u306f\u624b\u8853\u5f8c\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u79fb\u308a\u307e\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3068\u3066\u3082\u5e83\u3044\u9818\u57df\u306b\u5fc5\u8981\u3068\u306a\u308b\u5834\u5408\u306b\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306b\u3086\u3063\u304f\u308a\u3067\u3059\u304c\u77e5\u80fd\uff08\u8a8d\u77e5\u6a5f\u80fd\uff09\u306e\u4f4e\u4e0b\u304c\u751f\u3058\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u306a\u305c\u81a0\u82bd\u816b\u306e\u3088\u3046\u306b60\u30b0\u30ec\u30a4\u3092\u7528\u3044\u306a\u3044\u304b\u3068\u3044\u3046\u3068\uff0c\u3082\u3063\u3068\u4f4e\u3044\u7dda\u91cf\u3067\u3082<span style=\"color: #000080;\"><strong>\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c92\u3067\u306f\u9577\u671f\u751f\u5b58\u304c\u671f\u5f85\u3067\u304d\u308b<\/strong><\/span>\u304b\u3089\u3067\u3059<\/li>\n<li>55-60\u30b0\u30ec\u30a4\u3068\u3044\u3046<span style=\"color: #333333;\">\u5927\u304d\u306a\u7dda\u91cf\u306f\uff0c\u304b\u306a\u308a\u9ad8\u7387\u306b\u8133\u306e\u6a5f\u80fd\u3092\u843d\u3068\u3057\u305f\u308a\uff08\u8a8d\u77e5\u6a5f\u80fd\u4f4e\u4e0b\uff09\uff0c\u8133\u58ca\u6b7b\u3092\u751f\u3058\u305f\u308a\u3057\u307e\u3059<\/span><\/li>\n<li><span style=\"color: #333333;\">\u624b\u8853\u3084\u653e\u5c04\u7dda\u6cbb\u7642<\/span>\u3092\u53d7\u3051\u308b\u524d\u306b\u526f\u4f5c\u7528\u3092\u3057\u3063\u304b\u308a\u805e\u304d\u307e\u3057\u3087\u3046<\/li>\n<li><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/glioma\/gliioma-voranigo\/\"><span style=\"color: #000080;\"><strong>\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6\u306e\u767b\u5834\u3067\uff0c\u304a\u305d\u3089\u304f\u5316\u5b66\u7642\u6cd5\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u304c\u5909\u308f\u308a\u307e\u3059<\/strong><\/span><\/a><\/li>\n<li>\u5b9f\u969b\u306e\u8a3a\u7642\u3067\u306f\u653e\u5c04\u7dda\u306b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u304c\u4f75\u7528\u3055\u308c\u308b\u3053\u3068\u304c\u591a\u3044\u3068\u8a00\u3048\u307e\u3059<\/li>\n<li>\u653e\u5c04\u7dda\u3092\u52a0\u3048\u306a\u3044\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5358\u72ec\u6cbb\u7642\u3067\u306f\u816b\u760d\u306e\u9032\u884c\u3092\u6291\u3048\u304d\u308c\u307e\u305b\u3093<\/li>\n<li>2020\u5e74\uff0cIDH\u5909\u7570\u304c\u3042\u308b\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306b\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306ePCV\u5316\u5b66\u7642\u6cd5\u304c\u6709\u52b9\u3067\u3042\u308b\u3068\u306e\u5831\u544a\u304c\u306a\u3055\u308c\u307e\u3057\u305f\u304c\uff0c\u65e5\u672c\u3067\u306f\u4f7f\u7528\u3067\u304d\u307e\u305b\u3093<\/li>\n<\/ul>\n<h4><span style=\"color: #ff0000;\">\u7c73\u56fdFDA\u304c2024\u5e748\u6708\u306b\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6\u3092\u627f\u8a8d\u3057\u3066\u6cbb\u7642\u3067\u4f7f\u7528\u3067\u304d\u308b\u3088\u3046\u306b\u306a\u308a\u307e\u3057\u305f<\/span><\/h4>\n<h5><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/glioma\/gliioma-voranigo\/\">\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6\u306e\u4f7f\u3044\u65b9<\/a><\/h5>\n<p>\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6\u3092\u6295\u4e0e\u3059\u308b\u3068\u5909\u7570\u578b\u306eIDH1\/2\u907a\u4f1d\u5b50\u306e\u50cd\u304d\u3092\u6291\u3048\u3066\uff0c\u816b\u760d\u7d30\u80de\u5185\u306e2-HG\u304c\u6e1b\u5c11\u3057\u307e\u3059\u3002\u305d\u3046\u3059\u308b\u3068\u816b\u760d\u7d30\u80de\u304a\u5897\u6b96\u80fd\u304c\u4f4e\u304f\u306a\u3063\u3066\u816b\u760d\u5897\u5927\u3092\u6291\u5236\u3057\u307e\u3059\u3002<br \/>\n\u81e8\u5e8a\u306e\u5834\u3067\u306f\uff0c\u7d4c\u53e3\u6295\u4e0e\u3067\u30dc\u30e9\u30b7\u30c7\u30cb\u30d640mg\u30921\u65e5\u4e00\u56de\u670d\u7528\u3057\u307e\u3059\u3002\u5bfe\u8c61\u306f\uff0c12\u6b73\u4ee5\u4e0a\uff0c\u30b0\u30ec\u30fc\u30c92\u306e\u661f\u7d30\u80de\u816b\u304b\u4e4f\u7a81\u8d77\u81a0\u816b\uff0cIDH1\/2\u5909\u7570\u304c\u3042\u308b\u3053\u3068\uff0c\u624b\u8853\u5f8c\u3067\u751f\u691c\u8853\u3067\u3082\u90e8\u5206\u6458\u51fa\u3067\u3082\u5168\u6458\u51fa\u3067\u3082\u6295\u4e0e\u3067\u304d\u307e\u3059\u3002\u65e5\u672c\u3067\u306f\uff0c\u65e5\u672c\u30bb\u30eb\u30f4\u30a3\u30a8\u304c2024\u5e7412\u670824\u65e5\u3001\u6297\u304c\u3093\u5264\u30fb\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6\u30af\u30a8\u30f3\u9178\u6c34\u548c\u7269\u306b\u3064\u3044\u3066\u3001IDH1\u53c8\u306fIDH2\u907a\u4f1d\u5b50\u5909\u7570\u967d\u6027\u306e\u795e\u7d4c\u81a0\u816b\u3092\u5bfe\u8c61\u75be\u60a3\u306b\u627f\u8a8d\u7533\u8acb\u3057\u307e\u3057\u305f\u3002<\/p>\n<h5>\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6\u306e\u526f\u4f5c\u7528\uff08\u6709\u5bb3\u4e8b\u8c61\uff09<\/h5>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-23079\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vorasidenib-235x300.png\" alt=\"\" width=\"235\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vorasidenib-235x300.png 235w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/vorasidenib.png 434w\" sizes=\"auto, (max-width: 235px) 100vw, 235px\" \/><br \/>\n<span style=\"color: #000080;\"><strong>\u5026\u6020\u611f\uff0c\u75b2\u52b4\u611f\uff0c<\/strong><strong>\u982d\u75db\uff0c\u5614\u6c17\uff0c\u4e0b\u75e2<\/strong><\/span>\uff0c\u7b4b\u8089\u75db\uff08\u9aa8\u683c\u7b4b\u75db\uff09\uff0c\u95a2\u7bc0\u75db\uff0c\u4fbf\u79d8\uff0c\u98a8\u90aa\u306a\u3069\u306e\u611f\u67d3\u75c7\uff0c\u7a00\u306b\u3066\u3093\u304b\u3093\u767a\u4f5c<br \/>\n\u8840\u6db2\u691c\u67fb\u3067\u306f\uff0cALT, AST, \u03b3-GTP, ALP, \u30d3\u30ea\u30eb\u30d3\u30f3\u4e0a\u6607\uff0c\u597d\u4e2d\u7403\u6e1b\u5c11\u3067\u3059\u3002\u81d3\u5668\u969c\u5bb3\u3067\u306f\u809d\u969c\u5bb3\u304c\u3082\u3063\u3068\u3082\u983b\u5ea6\u304c\u9ad8\u3044\u3067\u3059\u3002<br \/>\n\u3072\u3069\u3044<span style=\"color: #000080;\"><strong>\u5026\u6020\u611f\u304c\u65e5\u5e38\u751f\u6d3b\u306e\u969c\u5bb3<\/strong><\/span>\u3068\u306a\u308a\u307e\u3059\u304c\uff0c\u4f53\u529b\u3092\u306a\u304f\u3055\u306a\u3044\u7a0b\u5ea6\u306b\u904b\u52d5\u3057\u3066\uff0c\u307e\u305f\u5927\u4e8b\u306a\u4ed5\u4e8b\u306e\u305f\u3081\u306b\u4f11\u61a9\u3092\u3068\u3063\u3066\u3068\u3044\u3046\u30d0\u30e9\u30f3\u30b9\u304c\u5927\u5207\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n<h4>\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306b\u5bfe\u3059\u308b\u30e8\u30fc\u30ed\u30c3\u30d1 EORTC\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\uff1a2017\u5e74<\/h4>\n<ol>\n<li>Watch-and-wait \u7d4c\u904e\u89b3\u5bdf\uff0c\u3088\u3046\u3059\u3092\u898b\u308b<\/li>\n<li>resection, as feasible \u7d4c\u904e\u3092\u898b\u3066\u5fc5\u8981\u304c\u3042\u308b\u3068\u5224\u65ad\u3059\u308c\u3070\uff0c\u53ef\u80fd\u306a\u7bc4\u56f2\u306e\u816b\u760d\u6458\u51fa\u3092\u884c\u3046<\/li>\n<li>radiotherapy followed by PCV\u3000\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u305d\u306e\u5f8c\u306ePCV\u5316\u5b66\u7642\u6cd5<\/li>\n<li>temozolomide plus radiotherapy followed by temozolomide \u653e\u5c04\u7dda\u6cbb\u7642\u3068\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5316\u5b66\u7642\u6cd5<\/li>\n<\/ol>\n<p>\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30ebII\uff0c\u63a8\u5968\u5ea6B\u3067\u3059\uff0c\u8853\u5f8c\u306efirst-line treatment\u3068\u3057\u3066 3\u3092\u512a\u5148\u3057\u307e\u3059\u3002\u65e5\u672c\u3067\u306fPCV\u306f\u4f7f\u3048\u307e\u305b\u3093\u304b\u3089\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3068\u306a\u308a\u307e\u3059\u3002\u3053\u306e\u6839\u62e0\u3068\u306a\u3063\u305fN Eng J Med\u306e\u8ad6\u6587\u306f\uff0c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3068\u4e4f\u7a81\u8d77\u81a0\u816b\u304c\u6df7\u5728\u3057\u305f\u6bcd\u96c6\u56e3\u3092\u89e3\u6790\u3057\u305f\u3082\u306e\u3067\u3059\u304b\u3089\uff0c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c92\u306b\u304a\u3044\u3066\u771f\u5b9f\u306a\u306e\u304b\u3069\u3046\u304b\u306f\u306f\u3063\u304d\u308a\u3057\u307e\u305b\u3093\u3002<\/p>\n<\/div>\n<h4><strong>\u9650\u5c40\u6027\u306e\u661f\u7d30\u80de\u816b\u304c\u3042\u308a\u307e\u3059<\/strong><\/h4>\n<p>\u3053\u306e\u3088\u3046\u306a\u8868\u5c64\u9650\u5c40\u6027\u306e\u30bf\u30a4\u30d7\u304c\u6b21\u306eWHO\u5206\u985e\u3067\u3069\u306e\u3088\u3046\u306b\u4f4d\u7f6e\u3065\u3051\u3055\u308c\u308b\u306e\u304b\u306f\u308f\u304b\u308a\u307e\u305b\u3093\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh31.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-7033 size-medium\" title=\"astrocytomakh3\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh31-285x300.jpg\" alt=\"\" width=\"285\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh31-285x300.jpg 285w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh31-550x577.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh31.jpg 709w\" sizes=\"auto, (max-width: 285px) 100vw, 285px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh41.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-7488\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh41-269x300.jpg\" alt=\"astrocytomakh4\" width=\"269\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh41-269x300.jpg 269w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh41-539x600.jpg 539w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh41.jpg 850w\" sizes=\"auto, (max-width: 269px) 100vw, 269px\" \/><\/a><\/p>\n<p>\u7121\u75c7\u72b6\u3067\u767a\u898b\u3055\u308c\u305f\u82e5\u5e74\u6210\u4eba\u306e\u661f\u7d30\u80de\u816b <span style=\"color: #000080;\"><strong>IDH mutant, 1p\/19q-intact<\/strong> <\/span>\u3067\u3059\u3002\u8133\u306e\u8868\u9762\u306b\u3042\u308a\uff0c\u4e00\u3064\u306e\u8133\u56de\u306b\u9650\u5c40\u3059\u308b\u30bf\u30a4\u30d7\u3067<strong><span style=\"color: #ff0000;\">single gyrus glioma<\/span><\/strong>\u3068\u3044\u3044\u307e\u3059\u3002\u00a0\u3053\u308c\u3067\u3082\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306a\u306e\u304b\u306a\u3068\u8003\u3048\u3066\u3057\u307e\u3046\u3088\u3046\u306a\u3082\u306e\u3067\u3059\u3002\u8ff7\u308f\u305a\u306b\u958b\u982d\u624b\u8853\u3067\u306e\u6458\u51fa\u3092\u52e7\u3081\u307e\u3057\u305f\u3002\u753b\u50cf\u3067\u898b\u3048\u308b\u3088\u308a\u3082\u3084\u3084\u5e83\u3044\u7bc4\u56f2\u306e\u5468\u56f2\u8133\u6458\u51fa supratotal resection\u304c\u3067\u304d\u305f\u4f8b\u3067\uff0c\u624b\u8853\u5f8c\u4f55\u5e74\u304b\u7d4c\u3061\u307e\u3059\u304c\u5e78\u3044\u518d\u767a\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-7034\" title=\"astrocytomakh1\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh1-300x227.jpg\" alt=\"\" width=\"300\" height=\"227\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh1-300x227.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh1-550x417.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh1.jpg 1134w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-7035\" title=\"astrocytomakh2\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh2-300x227.jpg\" alt=\"\" width=\"300\" height=\"227\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh2-300x227.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh2-550x417.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomakh2.jpg 1134w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u75c5\u7406\u306f\uff0c\u661f\u7d30\u80de\u306b\u7279\u6709\u306e\u80de\u4f53\u3092\u6709\u3057\u30b0\u30ea\u30a2\u7dda\u7dad\u304c\u660e\u77ad\u306a\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3067\u3059\uff08\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u62e1\u5927\u3067\u898b\u3048\u307e\u3059\uff09<\/p>\n<h4>\u30b0\u30ea\u30aa\u30de\u30c8\u30fc\u30b7\u30b9\u306e\u3088\u3046\u306a\u661f\u7d30\u80de\u816b\u304c\u3042\u308a\u307e\u3059<\/h4>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20360\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant1-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant1-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant1-550x552.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant1-768x771.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant2-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20359\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant2-1-300x298.jpg\" alt=\"\" width=\"300\" height=\"298\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant2-1-300x298.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant2-1-550x545.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant2-1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant2-1-768x762.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant2-1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u8efd\u5ea6\u306e\u5de6\u4e0b\u80a2\u306e\u9ebb\u75fa\u3067\u767a\u75c7\u3057\u305f50\u4ee3\u306e\u60a3\u8005\u3055\u3093\u3067\u3059\u3002\u4e00\u898b\uff0c\u304b\u3064\u3066\u306e\u30b0\u30ea\u30aa\u30de\u30c8\u30fc\u30b7\u30b9 <span style=\"color: #000080;\"><strong>gliomatosis<\/strong><\/span> \u3042\u308b\u3044\u306f diffuse hemispheric glioma WHO grade 4 \u306e\u3088\u3046\u306b\u898b\u3048\u308b\u975e\u5e38\u306b\u5e83\u7bc4\u56f2\u306a\u75c5\u5909\u3067\u3059\u3002\u3057\u304b\u3057\uff0c\u75c5\u7406\u8a3a\u65ad\u306f \u661f\u7d30\u80de\u816b <span style=\"color: #000080;\"><strong>IDH mutant<\/strong><\/span> WHO grade 2\u3067\u3057\u305f\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-20361\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant3-298x300.jpg\" alt=\"\" width=\"298\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant3-298x300.jpg 298w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant3-550x553.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant3-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant3-768x773.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2012\/04\/astrocytomaidhmutant3.jpg 815w\" sizes=\"auto, (max-width: 298px) 100vw, 298px\" \/><\/a><br \/>\n\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u3088\u304f\u53cd\u5fdc\u3057\uff0c\u7247\u9ebb\u75fa\u306f\u6d88\u5931\u3057\u3066\uff0c\u753b\u50cf\u4e0a\u306e\u816b\u760d\u9ad8\u4fe1\u53f7\u3082\u307b\u307c\u6d88\u5931\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n<h4><strong>\u4e88\u5f8c<\/strong><\/h4>\n<ul>\n<li>\u624b\u8853\u3067\u6458\u51fa\u3067\u304d\u308b<strong>\u304a<span style=\"color: #000080;\">\u3068\u306a\u3057\u3044\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306f\u6cbb\u7652\u3059\u308b<\/span><\/strong>\u306e\u3067\uff0c\u624b\u8853\u5f8c\u306f\u666e\u901a\u306e\u4eba\u3068\u540c\u3058\u4eba\u751f\u3067\u3059<\/li>\n<li>\u307e\u305f\u816b\u760d\u304c\u3042\u308a\u306a\u304c\u3089\u3082\u624b\u8853\u3084\u653e\u5c04\u7dda\u6cbb\u7642\u306720\u5e74\uff0c30\u5e74\u3068\u66ae\u3089\u3057\u3066\u3044\u3051\u308b\u60a3\u8005\u3055\u3093\u3082\u3044\u307e\u3059<\/li>\n<li>\u5168\u4f53\u3068\u3057\u3066\u306f<strong><span style=\"color: #000080;\">5\u5e74\u751f\u5b58\u5272\u5408\u306f70%\u307b\u3069<\/span><\/strong>\u3067\u3059<\/li>\n<li><span style=\"color: #000080;\"><span style=\"caret-color: #000080;\"><b>IDH\u5909\u7570\u304c\u306a\u3044\u3068\u661f\u7d30\u80de\u816b\u306e\u751f\u547d\u4e88\u5f8c\u306f\u4e0d\u826f<span style=\"color: #333333;\">\u3067<\/span><\/b><span style=\"color: #333333;\">\uff0c5\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f50%\u4ee5\u4e0b\u3067<\/span><\/span><\/span><span style=\"color: #333333;\"><span style=\"caret-color: #000080;\">\u3059<\/span><\/span><\/li>\n<li>\u77ed\u671f\u9593\u306b\u5897\u5927\u50be\u5411\u304c\u306f\u3063\u304d\u308a\u3059\u308b\u3082\u306e\uff0c6cm\u4ee5\u4e0a\u306e\u5927\u304d\u306a\u3082\u306e\uff0c\u8133\u5e79\u90e8\u3092\u4fb5\u3059\u3082\u306e\uff0c\u4e2d\u9ad8\u5e74\u306e\u3082\u306e\uff0c\u4e21\u5074\u5927\u8133\u534a\u7403\u306b\u53ca\u3076\u3082\u306e\uff0c\u767a\u75c7\u6642\u304b\u3089\u75c7\u72b6\u304c\u60aa\u3044\u3082\u306e\u306a\u3069\u3067\u306f\uff0c3\u5e74\u4ee5\u5185\u306b3\u5272\u304f\u3089\u3044\u306e\u60a3\u8005\u3055\u3093\u304c\u6b7b\u4ea1\u3057\u307e\u3059\uff0c\u3067\u3082\u3053\u308c\u3089\u306f\u30b0\u30ec\u30fc\u30c93\u304b4\u306e\u661f\u7d30\u80de\u816b\u3067\u3059<\/li>\n<\/ul>\n<h4>2020\u5e74\u4ee5\u524d\u306bIDH wild-type \u91ce\u751f\u578b\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3068\u3055\u308c\u3066\u304d\u305f\u3082\u306e<\/h4>\n<ul>\n<li>\u591a\u304f\u306f\uff0c\u306b\u3058\u3080\u3088\u3046\u306b\u6de1\u304f\u5e83\u304c\u308b\u816b\u760d\u3067\u3059<\/li>\n<li>\u81a0\u82bd\u816b\u30b0\u30ec\u30fc\u30c94\u306e\u81e8\u5e8a\u7d4c\u904e\u3092\u305f\u3069\u308b\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u7279\u306b\u9ad8\u9f62\u8005\u3067\u306f\u75c5\u6c17\u306e\u9032\u884c\u306f\u65e9\u3044\u3067\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u771f\u306e\u81a0\u82bd\u816b\u30b0\u30ec\u30fc\u30c94\u307b\u3069\u306f\u30a2\u30b0\u30ec\u30c3\u30b7\u30d6\u3067\u306f\u306a\u3044\u3082\u306e\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>IDH\u5909\u7570\u304c\u306a\u3044\u91ce\u751f\u578b\u306e\u4e88\u5f8c\u306f\u60aa\u3044\u306e\u3067\uff0c\u5168\u3066\u81a0\u82bd\u816b\u3068\u540c\u3058\u6cbb\u7642\u3092\u3059\u308b\u3068\u3044\u3046\u8003\u3048\u306f\uff0c2023\u5e74\u6642\u70b9\u3067\u306f\u6b63\u3057\u304f\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u4e88\u5f8c\u304c\u3068\u3066\u3082\u826f\u3044\u3082\u306e\u3082\u3042\u308a\uff0c2020\u5e74\u6642\u70b9\u3067\uff0c\u75c5\u7406\u8a3a\u65ad\u3067\u306f\u30b0\u30ec\u30fc\u30c93\u304b4\u3068\u3055\u308c\u307e\u3059<\/li>\n<li><span style=\"color: #000080;\"><strong>\u9ad8\u5ea6\u306eEGFR\u5897\u5e45\uff0cTERT\u30d7\u30ed\u30e2\u30fc\u30bf\u5909\u7570\uff0c\u7b2c7\u67d3\u8272\u4f53\u306e\u30b2\u30a4\u30f3\u3068\u7b2c10\u67d3\u8272\u4f53\u306e\u5168\u6b20\u5931\u306a\u3069\u304c\u3042\u308c\u3070\u30b0\u30ec\u30fc\u30c94\u3068\u3057\u307e\u3059\u304c\uff0c\u73fe\u5b9f\u306b\u65e5\u672c\u3067\u3053\u308c\u3092\u691c\u67fb\u3067\u304d\u308b\u65bd\u8a2d\u306f\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093<\/strong><\/span><\/li>\n<li>\u4e00\u822c\u306e\u65bd\u8a2d\u3067\u306f\uff0c<span style=\"color: #000080;\"><strong>MRI\u306e\u7d4c\u904e\u89b3\u5bdf\u304c\u4e88\u5f8c\u3092\u898b\u308b\u305f\u3081\u306e\u91cd\u8981\u306a\u53c2\u8003\u30c7\u30fc\u30bf<\/strong><\/span>\u3068\u306a\u308a\u307e\u3059<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-10221\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/owldastro-300x206.jpg\" alt=\"\" width=\"300\" height=\"206\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/owldastro-300x206.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/owldastro-768x529.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/owldastro-550x379.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/owldastro.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/p>\n<h1>\u3053\u3053\u304b\u3089\u4e0b\u306f\u96e3\u3057\u304f\u306a\u308a\u307e\u3059<\/h1>\n<h4><strong>\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306e\u624b\u8853\u6240\u898b<\/strong><\/h4>\n<ul>\n<li>\u8868\u9762\u306b\u3042\u308b\u3082\u306e\u3067\u306f\uff0c\u8133\u304c\u816b\u308c\u3066\uff0c\u8133\u8868\u304c\u5e73\u3089\u306b\u306a\u3063\u3066\u3044\u307e\u3059 (gyrus flattening)<\/li>\n<li>\u8272\u306f\u6b63\u5e38\u306e\u8133\u3068\u540c\u3058\u3067\u898b\u5206\u3051\u304c\u3064\u304b\u306a\u3044\u3053\u3068\u304c\u591a\u3044\u3067\u3059<\/li>\n<li>\u816b\u760d\u304c\u5927\u304d\u304f\u3066\u30b3\u30f3\u30d1\u30af\u30c8\u306b\u3042\u308b\u90e8\u5206\u3067\u306f\uff0c\u7070\u8272\u304c\u304b\u3063\u305f\u308a\u5c11\u3057\u9ec4\u8272\u3063\u307d\u304b\u3063\u305f\u308a\u3057\u3066\u6b63\u5e38\u8133\u3068\u306f\u7570\u306a\u308b\u8272\u8abf\u306e\u3053\u3068\u304c\u3042\u308a\uff0c\u3084\u3084\u786c\u304f\u5f3e\u6027\u304c\u3042\u3063\u3066\u7c98\u308a\u304c\u3042\u308a\uff0c\u81a0\uff08\u306b\u304b\u308f\uff09\u816b\u3068\u547c\u3070\u308c\u308b\u816b\u760d\u306e\u7279\u5fb4\u3092\u793a\u3057\u307e\u3059<\/li>\n<li>\u9ec4\u8272\u900f\u660e\u306e\u6db2\u4f53\u3092\u542b\u3093\u3060\u5927\u304d\u306a\u306e\u3046\u80de\u304c\u898b\u3089\u308c\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u307e\u305f\uff0c\u816b\u760d\u306e\u30b3\u30a2\u306e\u90e8\u5206\u3067\u306f\u5c0f\u3055\u306a\u306e\u3046\u80de\u5f62\u6210\u304c\u96c6\u7c07\u3059\u308b\u90e8\u4f4d\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u5fae\u5c0f\u306e\u3046\u80de\u304c\u591a\u3044\u90e8\u5206\u3067\u306f\u30bc\u30e9\u30c1\u30f3\u69d8\u306b\u67d4\u3089\u304b\u304f\u306a\u308a\uff0c\u5438\u5f15\u5668\u3067\u30ba\u30eb\u30ba\u30eb\u5438\u3048\u307e\u3059\uff0cT2\u5f37\u8abf\u753b\u50cf\u3067\u5f37\u3044\u9ad8\u4fe1\u53f7\u3068\u306a\u3063\u3066\u3044\u308b\u3068\u3053\u308d\u306f\u8584\u3044\u7070\u8272\u3067\u67d4\u3089\u304b\u304f\u30c9\u30ed\u30c9\u30ed\u3057\u3066\u3044\u307e\u3059<\/li>\n<li>\u51fa\u8840\u306f\u6b63\u5e38\u8133\u3068\u540c\u3058\u3067\u307b\u3068\u3093\u3069\u3042\u308a\u307e\u305b\u3093<\/li>\n<li>\u77f3\u7070\u5316\u306f\u975e\u5e38\u306b\u7a00\u3067\uff0c\u7802\u7c92\u4f53 psammoma\u304c\u89b3\u5bdf\u3055\u308c\u305f\u5834\u5408\u306f\uff0c\u4e4f\u7a81\u8d77\u661f\u7d30\u80de\u816b\u306e\u53ef\u80fd\u6027\u3092\u8003\u3048\u305f\u65b9\u304c\u3044\u3044\u3067\u3057\u3087\u3046<\/li>\n<li>\u4e4f\u7a81\u8d77\u661f\u7d30\u80de\u816b\u306f\uff0c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3088\u308a\u3082\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3067\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3067\u304d\u308b\u53ef\u80fd\u6027\u304c\u9ad8\u3044\u3082\u306e\u3067\u3059\u304b\u3089\uff0c\u305d\u308c\u3092\u8003\u616e\u306b\u5165\u308c\u3066\u6458\u51fa\u306e\u7a0b\u5ea6\u3092\u5224\u65ad\u3057\u307e\u3059<\/li>\n<li>\u816b\u760d\u3092\u6458\u51fa\u3057\u3066\u3044\u304f\u3068\uff0c\u5438\u5f15\u7ba1\u30d0\u30a4\u30dd\u30fc\u30e9\u3067\u89e6\u3063\u305f\u611f\u3058\u304c\u3084\u3084\u5f3e\u6027\u304c\u3042\u308b firmness, elastic firm\u3082\u3057\u304f\u306f\u8133\u3088\u308a\u67d4\u3089\u304b\u3044 softening\u90e8\u5206\u304c\u3042\u308a\uff0c\u661f\u7d30\u80de\u816b\u304c\u3042\u308b\u3053\u3068\u304c\u8a8d\u8b58\u3067\u304d\u307e\u3059<\/li>\n<li>\u3067\u3082\uff0c\u5883\u754c\u306b\u8fd1\u3065\u304f\u3068\u6b63\u5e38\u8133\u3068\u5168\u304f\u533a\u5225\u304c\u3064\u304b\u306a\u3044\u89e6\u611f\u3068\u8272\u306b\u306a\u308a\u307e\u3059\u3002<strong><span style=\"color: #ff0000;\">\u8272\u8abf\u306f\u6b63\u5e38\u3067\u3082\uff0c\u300c<\/span><span style=\"color: #ff0000;\">\u307b\u3093\u306e\u6975\u308f\u305a\u304b\u306a\u7c98\u308a\u306e\u3042\u308b\u3068\u3053\u308d\u300d\u3092\u6458\u51fa\u3057\u304d\u308b<\/span><\/strong><span style=\"color: #ff0000;\"><span style=\"color: #000000;\">\u3068<span style=\"color: #333333;\">\u816b\u760d\u306e\u30b3\u30a2\u306e\u90e8\u5206\u306f\u6458\u51fa\u3067\u304d\u3066\u3044\u307e<\/span>\u3059\uff0c<\/span><\/span>\u3053\u308c\u304c\u661f\u7d30\u80de\u816b\u6458\u51fa\u306e\u30c6\u30af\u30cb\u30c3\u30af\u306e\u771f\u9ac4\u3067\u3059<\/li>\n<li>\u5b9f\u969b\u306b\u306f\uff0c\u816b\u760d\uff08\u8133\uff09\u306e\u5207\u65ad\u9762\u3092\u5438\u5f15\u7ba1\u3067\u3061\u3087\u3063\u3068\u5f15\u3063\u5f35\u3063\u3066\u307f\u307e\u3059\uff0c\u5438\u3048\u3066\u3053\u306a\u3044\u3067\u7c98\u3063\u3068\u5f15\u3063\u5f35\u3089\u308c\u308b\u3088\u3046\u306a\u3089\u305d\u3053\u306f\u816b\u760d\u3067\u3059<\/li>\n<li>\u6b63\u5e38\u8133\u306f\u5438\u5f15\u7ba1\u306e\u3042\u308b\u7a0b\u5ea6\u306e\u5438\u5f15\u529b\u3067\u5438\u3048\u3066\u3057\u307e\u3046\u306e\u3067\uff0c\u305d\u306e\u9650\u754c\u70b9\u3092\u6307\u5148\u306e\u611f\u899a\u3068\u3057\u3066\u8a18\u61b6\u3057\u3066\u304a\u304f\u3068\u3053\u306e\u64cd\u4f5c\u304c\u3067\u304d\u308b\u3088\u3046\u306b\u306a\u308a\u307e\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u6df1\u90e8\u306e\u6b63\u5e38\u8133\u3078\u306e\u6d78\u6f64\u5883\u754c\u3067\u306f\uff0c\u6b63\u5e38\u8133\u3068\u306e\u8b58\u5225\u306f\u307e\u3063\u305f\u304f\u3067\u304d\u306a\u304f\u306a\u308a\u307e\u3059<\/li>\n<li>\u3053\u308c\u306f\u75c5\u7406\u7d44\u7e54\u6240\u898b\u3092\u8003\u3048\u308c\u3070\u5f53\u305f\u308a\u524d\u306e\u3053\u3068\u3067\uff0c\u816b\u760d\u7d30\u80de neoplastic astrocytes \u306f\uff0c\u8133\u306e\u6b63\u5e38\u69cb\u9020\uff08\u795e\u7d4c\u7d30\u80de\u3084\u8ef8\u7d22\uff09\u3092\u7834\u58ca\u3059\u308b\u3053\u3068\u7121\u304f\u3082\u3050\u308a\u3053\u3080\u3088\u3046\u306b\u5e83\u304c\u3063\u3066\u3044\u307e\u3059<\/li>\n<li>\u3053\u3053\u306f\u8853\u4e2dMRI\u306b\u3082\u5199\u3089\u305a\uff0cALA\u3067\u3082\u898b\u3048\u307e\u305b\u3093<\/li>\n<li>\u3067\u3059\u304b\u3089\uff0c\u816b\u760d\u3092\u53d6\u308a\u304d\u3063\u305f\u3068\u5224\u65ad\u3057\u3066\u304b\u3089\uff0c\u53ef\u80fd\u3067\u3042\u308c\u3070\u3055\u3089\u306b\u6570mm\u306e\u6b63\u5e38\u8133\u3068\u601d\u308f\u308c\u308b\u90e8\u5206\u306e\u5207\u9664\u3092\u52a0\u3048\u307e\u3059<\/li>\n<li>\u66f4\u306b\u6458\u51fa\u3092\u7d9a\u3051\u308b\u3053\u3068\u306b\u3069\u308c\u3060\u3051\u306e\u610f\u5473\u304c\u3042\u308b\u306e\u304b\u3092\u3088\u304f\u3088\u304f\u8003\u3048\u308b\u3068\u3053\u308d\u3067\u3059<\/li>\n<\/ul>\n<h4><strong>\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c9\uff12\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3044\u3064\u3059\u308b\u3079\u304d\u304b<\/strong><\/h4>\n<ul>\n<li><span style=\"color: #ff0000;\"><strong>\u79d1\u5b66\u7684\u306b\u306f\u7b54\u3048\u304c\u51fa\u3066\u3044\u307e\u305b\u3093<\/strong><\/span><\/li>\n<li><strong><span style=\"color: #ff0000;\">\u305d\u3082\u305d\u3082\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u3042\u307e\u308a\u52b9\u304b\u306a\u3044\u816b\u760d\u3067\u3059<\/span><\/strong><\/li>\n<li>\u624b\u8853\u3067\u5b8c\u5168\u6458\u51fa\u3067\u304d\u305f\u3068\u5224\u65ad\u3055\u308c\u308c\u3070\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u305b\u3093<\/li>\n<li>\u5927\u304d\u304f\u306a\u3063\u3066\u3044\u308b\u3053\u3068\u304c\u660e\u3089\u304b\u306a\u816b\u760d\u3067\uff0c\u90e8\u5206\u6458\u51fa\u3057\u304b\u3067\u304d\u306a\u304b\u3063\u305f\u5834\u5408\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3059<\/li>\n<li>\u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u306f\uff0c\u624b\u8853\u5f8c\u306b\u6b8b\u5b58\u816b\u760d\u304c\u3042\u308a\uff0c40-45\u6b73\u4ee5\u4e0a\u3067\u3042\u308c\u3070\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3059\uff0c\u9006\u306b\u305d\u308c\u4ee5\u4e0b\u306e\u82e5\u3044\u5e74\u9f62\u3067\u306f\u816b\u760d\u304c\u6b8b\u3063\u3066\u3044\u3066\u3082\u7d4c\u904e\u89b3\u5bdf\u3059\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u624b\u8853\u5f8c\u306b\u518d\u767a\u3057\u305f\u6642\u3084\uff0c\u6b8b\u3063\u305f\u816b\u760d\u304c\u7d4c\u904e\u3092\u898b\u3066\u5927\u304d\u304f\u306a\u308c\u3070\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3059<\/li>\n<li>\u6a19\u6e96\u7684\u6cbb\u7642\u6cd5\u306f\uff0c<span style=\"color: #ff0000;\"><strong>50.4\u30b0\u30ec\u30a4\u309228\u5206\u5272\uff0c1\u65e51.8 Gy<\/strong><\/span><\/li>\n<li>\u7167\u5c04\u9818\u57df\u306e\u5e83\u3055\u306b\u3088\u3063\u3066\u306f\uff0c45 &#8211; 46\u30b0\u30ec\u30a4\u309223 &#8211; 25\u5206\u5272\uff081\u65e5\u7dda\u91cf1.8 &#8211; 2\u30b0\u30ec\u30a4\uff09\u304b\u308954\u30b0\u30ec\u30a4\u309230\u5206\u5272\uff081\u65e5\u7dda\u91cf1.8\u30b0\u30ec\u30a4\uff09\u306e\u7bc4\u56f2\u3067\u884c\u3044\u307e\u3059<\/li>\n<li>\u30b0\u30ec\u30fc\u30c93\u306f\u7dda\u91cf\u3092 54Gy \u306b\u5897\u3084\u3057\u307e\u3059\u3057\uff0c\u8853\u5f8c\u306b\u3059\u3050\u958b\u59cb\u3057\u307e\u3059<\/li>\n<\/ul>\n<h4>\u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3 2025<\/h4>\n<p>\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c92\u30683\u306b\u5bfe\u3059\u308b\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u65b9\u91dd\u3092\u6c7a\u3081\u305f\u3082\u306e\u3067\u3059\u3002GTV\u306f\uff0cT2\/FLAIR\u3067\u7570\u5e38\u306b\u898b\u3048\u308b\u90e8\u5206\u3092\u5168\u3066\u542b\u307f\u307e\u3059\u3002\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u816b\u760d\u306f\u5f53\u7136\u542b\u307f\uff0c\u624b\u8853\u3055\u308c\u3066\u3044\u308c\u3070\u6458\u51fa\u8154\u3082\u56f2\u307f\u307e\u3059\u3002\u30b0\u30ec\u30fc\u30c93\u3067\uff0c\u660e\u3089\u304b\u306b\u8133\u6d6e\u816b\u3068\u8003\u3048\u3089\u308c\u308b\u90e8\u5206\u306fGTV\u304b\u3089\u5916\u3057\u307e\u3059\u3002<span style=\"color: #000080;\"><strong>CTV\u306f\uff0c\u30b0\u30ec\u30fc\u30c92\u306710mm\uff0c\u30b0\u30ec\u30fc\u30c93\u306715mm\u306e\u30de\u30fc\u30b8\u30f3\u3092\u53d6\u308a\u307e\u3059\u3002\u7dda\u91cf\u306f\uff0c\u30b0\u30ec\u30fc\u30c92\u306750.4 Gy 28\u5206\u5272\uff0c\u30b0\u30ec\u30fc\u30c93\u306759.4\u00a0Gy 33\u5206\u5272\u3067\u3059\u3002\u53ef\u80fd\u306a\u9650\u308aIMRT\u306e\u30c6\u30af\u30cb\u30c3\u30af\u3092\u7528\u3044\u307e\u3059<\/strong><\/span>\u3002<\/p>\n<h4>\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u5f85\u6a5f\u3059\u308b\u6839\u62e0\u306b\u306a\u3063\u305f\u6709\u540d\u306a\u8ad6\u6587<\/h4>\n<p>van den Bent MJ, et al.: Long-term efficacy of early versus delayed radiotherapy for low-grade astrocytoma and oligodendroglioma in adults: the EORTC 22845 randomised trial. Lancet 366: 2005<br \/>\n1986\u5e74\u306b\u958b\u59cb\u3055\u308c\u7d0420\u5e74\u304b\u304b\u3063\u3066\u7d50\u8ad6\u304c\u51fa\u3055\u308c\u305f\u3082\u306e\u3067\u3059\u3002157\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u8853\u5f8c\u65e9\u671f\u306b54\u30b0\u30ec\u30a4\uff08\u4e00\u65e5\u7dda\u91cf1.8\u30b0\u30ec\u30a4\uff09\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u3002\u5bfe\u3057\u3066\u5225\u306e157\u4eba\u306e\u60a3\u8005\u3055\u3093\u306f\u816b\u760d\u5897\u5927\u306a\u3069\u304c\u751f\u3058\u308b\u307e\u3067\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u5f85\u6a5f\u3055\u308c\u307e\u3057\u305f( wait-and-see)\u3002\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024 PFS\u306f\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u308b\u30685.3\u5e74\uff0c\u5f85\u6a5f\u3059\u308b\u30683.4\u5e74\u3067\u3057\u305f\u3002\u3057\u304b\u3057\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u306f7.4\u5e74\u30687.2\u5e74\u3067\u5909\u308f\u308a\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u75c7\u5019\u6027\u3066\u3093\u304b\u3093\u306e\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u306f\u65e9\u671f\u653e\u5c04\u7dda\u6cbb\u7642\u304c\u512a\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u3057\u304b\u3057\u5f53\u7136\u306a\u304c\u3089\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u3088\u308b\u8133\u6a5f\u80fd\u4f4e\u4e0b\u304c\u751f\u3058\u308b\u53ef\u80fd\u6027\u306f\u65e9\u671f\u6cbb\u7642\u7fa4\u3067\u65e9\u307e\u308b\u306f\u305a\u3067\u3059\u3002\u7d50\u8ad6\u3068\u3057\u3066\u3001\u72b6\u614b\u306e\u826f\u3044\u60a3\u8005\u3055\u3093\u306b\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u5ef6\u671f\u3067\u304d\u308b\u3067\u3042\u308d\u3046\u3068\u306e\u3053\u3068\u3067\u3057\u305f\u3002<br \/>\n\u300c\u89e3\u8aac\u300d\u6b63\u78ba\u306b\u306f\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\uff0c\u4e4f\u7a81\u8d77\u81a0\u816b\uff0c\u4e4f\u7a81\u8d77\u661f\u7d30\u80de\u816b\uff0c\u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b\u304c\u542b\u307e\u308c\u3066\u3044\u308b\u306e\u3067\uff0c<strong><span style=\"color: #000080;\">\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306e\u6cbb\u7642\u6210\u7e3e\u3068\u306f\u8a00\u3048\u307e\u305b\u3093<\/span><\/strong>\u3002\u3067\u3082\u3053\u306e\u30c7\u30fc\u30bf\u3057\u304b\u306a\u3044\u306e\u3067\u3053\u306e\u8ad6\u6587\u304c\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u9078\u629e\u306e\u305f\u3081\u306b\u4eca\u3067\u3082\u5f15\u7528\u3055\u308c\u307e\u3059\u3002\u3082\u3046\u53e4\u304f\u306a\u308a\u307e\u3057\u305f\u304c\u3053\u306e\u8ad6\u6587\u3092\u6cbb\u7642\u306e\u6839\u62e0\u306b\u4f7f\u7528\u3055\u308c\u3066\u3044\u308b\u8133\u816b\u760d\u306e\u5c02\u9580\u5bb6\u3082\u591a\u3044\u3067\u3059\u3002\u540c\u3058\u81e8\u5e8a\u8a66\u9a13\u3092\u884c\u304a\u3046\u3068\u3057\u3066\u3082\uff0c\u4eca\u5f8c\u3055\u3089\u306b20\u5e74\u4ee5\u4e0a\u5f85\u305f\u306a\u3051\u308c\u3070\u7d50\u679c\u306f\u5f97\u3089\u308c\u307e\u305b\u3093\u3002\u6c38\u9060\u306e\u547d\u984c\u3068\u8a00\u3048\u308b\u3067\u3057\u3087\u3046\u3002<\/p>\n<h4>\u65e7\u7d44\u7e54\u8a3a\u65ad\u75c5\u7406 astrocytoma grade 2<\/h4>\n<ul>\n<li><span style=\"color: #000080;\"><strong>fibrirally astrocytoma<\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>gemistocytic astrocytoma<\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>protoplasmic astrocytoma<\/strong><\/span><\/li>\n<\/ul>\n<p>\u4f1d\u7d71\u7684\u306b\u4e0a\u8a18\u306e3\u3064\u306b\u5206\u985e\u3055\u308c\u3066\u304d\u307e\u3057\u305f\u304c\uff0c2016\u5e74\u306b\u524a\u9664\u3055\u308c\u307e\u3057\u305f\uff0c\u5168\u3066\u307e\u3068\u3081\u3066\u7d44\u7e54\u50cf\u3068\u3057\u3066\u306f\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b diffuse astrocytoma \u3067\u3059<\/p>\n<h4>gemistocytic astrocytoma \u80a5\u80d6\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b<\/h4>\n<p><span style=\"color: #333333;\">gemistocytic astrocytoma\u306f\uff0c\u5927\u304d\u306a\u597d\u9178\u6027\u306e\u5927\u304d\u306a\u80de\u4f53\u3092\u6709\u3059\u308b\u5927\u578b\u306e\u661f\u7d30\u80de\u304c\u591a\u304f\u898b\u3089\u308c\u308b\u3082\u306e\u3092\u3044\u3044\u307e\u3059\u3002germistocytes\u304c20%\u3092\u8d85\u3048\u306a\u3044\u3068\u3053\u306e\u7d44\u7e54\u75c5\u7406\u8a3a\u65ad\u540d\u306f\u4f7f\u7528\u3057\u307e\u305b\u3093\u3002<br \/>\n<\/span><span style=\"color: #333333;\"><span style=\"color: #000080;\"><strong>\u304b\u3064\u3066\uff0c\u30b0\u30ec\u30fc\u30c93\u3042\u308b\u3044\u306f\u30b0\u30ec\u30fc\u30c94\u3078\u9032\u884c\uff08\u60aa\u6027\u8ee2\u5316\uff09\u3059\u308b\u6027\u8cea<\/strong><\/span>\u3092\u6709\u3057\u3066\u3044\u308b\u3068\u3055\u308c\u3066\u304d\u307e\u3057\u305f\u3002\u3057\u304b\u3057\uff0c\u3053\u308c\u306fIDH\u5909\u7570\u306e\u6709\u7121\u304c\u306f\u3063\u304d\u308a\u3057\u306a\u3044\u6642\u671f\u306e\u30c7\u30fc\u30bf\u3067\u3059\u30022018\u5e74\u6642\u70b9\u3067\u306f\uff0cIDH\u5909\u7570\u304c\u3042\u308bgemistocytic astrocytoma\u304c\uff0c\u30b0\u30ec\u30fc\u30c9\uff12\u3088\u308a\u60aa\u6027\u5ea6\u304c\u9ad8\u3044\u304b\u3069\u3046\u304b\u306f\u4e0d\u660e\u3067\u3059\u3002<span style=\"color: #000080;\"><strong>IDH wild-type\u306f\u60aa\u6027\u5316\u3059\u308b<\/strong><\/span>\u3068\u8003\u3048\u305f\u307b\u3046\u304c\u3044\u3044\u306e\u3067\uff0c\u30b0\u30ec\u30fc\u30c93\u306b\u5bfe\u5fdc\u3059\u308b\u6cbb\u7642\u65b9\u91dd\u3092\u9078\u629e\u3057\u307e\u3059\u3002<\/span><\/p>\n<h1><a href=\"\/sawamura\/pathocase\/diffuseastrocytomapatho\/\">\u75c5\u7406\u306f\u5225\u306e\u30da\u30fc\u30b8\u306b\u8a73\u3057\u304f\u3042\u308b\u306e\u3067\u3053\u3053\u3092\u30af\u30ea\u30c3\u30af<\/a><\/h1>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromib1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft wp-image-4992\" title=\"astromib1\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromib1-550x486.jpg\" alt=\"\" width=\"315\" height=\"291\" \/><\/a><br \/>\nKi-67\u3068\u3044\u3046\u6297\u4f53\u3092\u4f7f\u3063\u305f\u514d\u75ab\u7d44\u7e54\u67d3\u8272\u3067<span style=\"color: #ff0000;\"><strong>MIB-1 index<\/strong><span style=\"color: #333333;\">\u3068\u3044\u3046\u3082\u306e\u3092\u898b\u307e\u3059\u3002<\/span><strong>\u5e73\u5747\u30672.5%\u304f\u3089\u3044\uff0c\u9ad8\u304f\u3066\u30824\uff05<\/strong><\/span>\u3067\u3059\u3002\u305d\u308c\u4ee5\u4e0a\u306f\u30b0\u30ec\u30fc\u30c93\u306e\u53ef\u80fd\u6027\u304c\u9ad8\u304f\u306a\u308a\u307e\u3059\u3002\u5de6\u306e\u5199\u771f\u306eMIB-1\u306e\u67d3\u8272\u7387 labling index \u306f3.5%\u304f\u3089\u3044\u3067\uff0c\u30b0\u30ec\u30fc\u30c92\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3068\u3057\u3066\u306f\u3084\u3084\u9ad8\u3044\u5024\u3067\u3059\u3002MIB-1\u67d3\u8272\u7387\u304c\u9ad8\u304f\u306a\u308b\u3068\u60aa\u6027\u5ea6\u304c\u9ad8\u3044\u50be\u5411\u306b\u3042\u308b\u3068\u8003\u3048\u3089\u308c\u307e\u3059\u3002<\/p>\n<h4>\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306e\u907a\u4f1d\u5b50\u5909\u7570<\/h4>\n<p>\u30b0\u30ec\u30fc\u30c9\uff12\u306e\u4e4f\u7a81\u8d77\u81a0\u816b\u3067\u306f\u7b2c\uff11\u67d3\u8272\u4f53\u5358\u81551p\u3068\u7b2c19\u67d3\u8272\u4f53\u9577\u8155 19q\u306e\u6b20\u5931 (1p\/19q codeletion) \u304c\u3042\u308b\u3053\u3068\u304c\u77e5\u3089\u308c\u3066\u3044\u307e\u3059\u3002\u30b0\u30ec\u30fc\u30c9\uff12\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3067\u306f TP53\u3068ATRX\u306e\u5909\u7570\u304c\u307f\u3089\u308c\u307e\u3059\u3002\u307e\u305f\uff0c<span style=\"color: #000080;\"><strong>IDH (isocitrate dehydrogenase)<\/strong><\/span>\u3068\u3044\u3046\u907a\u4f1d\u5b50\u306e\u7570\u5e38\u304c\u3042\u308b\u3068\u6cbb\u308a\u3084\u3059\u3044\u3042\u308b\u3044\u306f\u751f\u5b58\u671f\u9593\u304c\u9577\u3044\u3068\u3044\u3046\u3053\u3068\u3082\u77e5\u3089\u308c\u3066\u304d\u307e\u3057\u305f\u3002\u9006\u306b\u8a00\u3048\u3070\uff0cIDH1\u306e\u5909\u7570\u304c\u7121\u3044\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b IDH wild type \u91ce\u751f\u578b\u3067\u306f\uff0c\u30b0\u30ec\u30fc\u30c93\u3084\u30b0\u30ec\u30fc\u30c94\u306e\u661f\u7d30\u80de\u816b\u306e\u3088\u3046\u306b\u816b\u760d\u306e\u9032\u884c\u304c\u65e9\u304f\u3066\u5236\u5fa1\u3067\u304d\u306a\u3044\u53ef\u80fd\u6027\u304c\u9ad8\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u3055\u3089\u306b\u304b\u306a\u308a\u524d\u304b\u3089\uff0cIDH\u306e\u5909\u7570\u306e\u3042\u308b\u30b0\u30ea\u30aa\u30fc\u30de\u306f\u624b\u8853\u6458\u51fa\u7387\u304c\u9ad8\u3044\uff08\u3042\u308b\u610f\u5473\u3067\u306f\u6d78\u6f64\u80fd\u304c\u4f4e\u304f\u3066\u9650\u5c40\u6027\uff09\u3068\u3055\u308c\u3066\u304d\u307e\u3057\u305f\u3002\u3053\u306e\u907a\u4f1d\u5b50\u8a3a\u65ad\u3082\u6cbb\u7642\u306e\u53c2\u8003\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n<h4>\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u304c\u60aa\u6027\u5316\u3059\u308b\u3042\u308b\u3044\u306f\u6025\u306b\u5897\u5927\u3059\u308b\u3053\u3068<\/h4>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-16442\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks1-300x289.jpg\" alt=\"\" width=\"300\" height=\"289\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks1-300x289.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks1-550x531.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks1-768x741.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/>2000\u5e74\u9803\u306e\u4f8b\u3067\u3059\u3002\u3066\u3093\u304b\u3093\u3067\u767a\u75c7\u3057\u305f20\u4ee3\u306e\u5973\u6027\u3067\u3059\u3002\u5de6\u524d\u982d\u8449\u306e\u30b0\u30ea\u30aa\u30fc\u30de\u3067\uff0c\u624b\u8853\u3067\u307b\u3068\u3093\u3069\u3067\u6458\u51fa subtotal removal\u3057\u3066\uff0c\u6df1\u90e8\u767d\u8cea\u306b\u6b8b\u3063\u305f\u75c5\u5909\u3092\u7d4c\u904e\u89b3\u5bdf\u3057\u307e\u3057\u305f\u3002MRI\u306f\u8853\u5f8c\u306e\u3082\u306e\u3067\u3059\u3002Ip, 19q\u306fFISH\u3067\u6b20\u5931\u306a\u3057\u3002MIB1\u306f1-2%\u3068\u4f4e\u304f\uff0cMGMT\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306a\u3057\uff0cdiffuse astrocytoma WHO grade 2\u3068\u7d44\u7e54\u8a3a\u65ad\u3055\u308c\u307e\u3057\u305f\u3002\u5927\u5b66\u75c5\u9662\u3067\u3057\u305f\u304c\u5f53\u6642\u306fIDH\u907a\u4f1d\u5b50\u8a3a\u65ad\u306f\u3057\u3066\u304a\u3089\u305a\uff0c\u3073\u307e\u3093\u6027\u661f\u7d30\u816b\u30b0\u30ec\u30fc\u30c92\u3067\u3057\u305f\u3002\u3053\u308c\u3082\u307e\u305f\u5f53\u6642\u306e\u6a19\u6e96\u7684\u306a\u8003\u3048\u3067\uff0c\u9032\u884c\u304c\u3042\u308b\u307e\u3067\u306f\u7d4c\u904e\u89b3\u5bdf\u3068\u3057\u307e\u3057\u305f\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-16443\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2-300x296.jpg\" alt=\"\" width=\"300\" height=\"296\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2-300x296.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2-550x542.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2-768x757.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-16444\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2-1-300x300.jpg\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2-1-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2-1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks2-1.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>2\u5e74\u5f8c\u306b\u6025\u6fc0\u306a\u9032\u884c rapid progression\u3057\u307e\u3057\u305f\u3002\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u6240\u898b\u3082\u51fa\u73fe\u3057\u307e\u3057\u305f\u3002IMRT\u306759.4Gy\/27\u5206\u5272\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5316\u5b66\u7642\u6cd5\u3092\u3057\u307e\u3057\u305f\u304c\uff0c\u816b\u760d\u306f\u6291\u5236\u3067\u304d\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-16445\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks4-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks4-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks4-298x300.jpg 298w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks4-550x553.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks4-768x773.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks4.jpg 1134w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks5.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-16446\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks5-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks6.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-thumbnail wp-image-16447\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomaks6-200x200.jpg\" alt=\"\" width=\"200\" height=\"200\" \/><\/a><\/p>\n<p>\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u3082\u9032\u884c\u3057\u3066\uff0c\u767d\u8cea\u306b\u6cbf\u3063\u305f\u6d78\u6f64\u4f38\u5c55\u3092\u3057\u307e\u3057\u305f\u3002\u8133\u5e79\u90e8\u6a4b\u306e\u53f3\u5074\u307e\u3067\u6d78\u6f64 invasion\u3057\u3066\u3044\u307e\u3059\u3002\u3053\u306e\u4f38\u5c55\u306f\u661f\u7d30\u80de\u7cfb\u816b\u760d\u306e\u7279\u5fb4\u3067\u3082\u3042\u308a\u307e\u3059\u3002<\/p>\n<p>2016\u5e74\u5206\u985e\u3067\u306f\uff0cdiffuse astrocytoma WHO grade 2\u3067\u3059\u3002\u3057\u304b\u3057\u3053\u308c\u306f\u304a\u305d\u3089\u304f\uff0c2021\u5e74\u5206\u985e\u3067\u306f <span style=\"color: #000080;\"><strong>IDH wild-type astrocytoma grade 4<\/strong><\/span>\u3068\u3055\u308c\u307e\u3059\u3002<\/p>\n<h4>\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306eIDH \u91ce\u751f\u578b wild type \u3086\u3063\u304f\u308a\u5897\u5927\u3059\u308b\u3082\u306e\u304c\u3042\u308b\u304b\uff1f<\/h4>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17737\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild1-291x300.jpg\" alt=\"\" width=\"291\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild1-291x300.jpg 291w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild1-550x567.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild1-768x792.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild1.jpg 850w\" sizes=\"auto, (max-width: 291px) 100vw, 291px\" \/><\/a><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild2.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17738\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild2-300x298.jpg\" alt=\"\" width=\"300\" height=\"298\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild2-300x298.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild2-550x547.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild2-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild2-768x763.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild2.jpg 850w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u7121\u75c7\u72b6\u3067\u767a\u898b\u3055\u308c\u305f\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3067\u3059\u3002\u53f3\u5074\u306f\u305d\u306e6\u5e74\u5f8c\uff0c\u975e\u5e38\u306b\u7de9\u5f90\u306b\u5897\u5927\u3057\u3066\u3044\u307e\u3059\u3002\u826f\u6027\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c92\u3092\u7591\u3044\uff0c\u624b\u8853\u3067\u5468\u56f2\u8133\u3082\u542b\u3081\u3066\u5b8c\u5168\u6458\u51fa supratotal resection \u3057\u307e\u3057\u305f\u3002\u75c5\u7406\u8a3a\u65ad\u306f\uff0c\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b WHO \u30b0\u30ec\u30fc\u30c92\uff0cMIB-1\u306f2%\uff0c1p\/19q\u6b20\u5931\u306a\u3057\u3067\u3057\u305f\u3002\u5927\u5b66\u75c5\u9662\u306e\u75c5\u7406\u90e8\u3067\u3059\u304c\u5f53\u6642\u306fIDH\u306e\u691c\u67fb\u3092\u3057\u3066\u3044\u307e\u305b\u3093\u3002<\/p>\n<p><a href=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild3-1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-medium wp-image-17740\" src=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild3-1-292x300.jpg\" alt=\"\" width=\"292\" height=\"300\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild3-1-292x300.jpg 292w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild3-1-550x566.jpg 550w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild3-1-768x790.jpg 768w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astrocytomawild3-1.jpg 850w\" sizes=\"auto, (max-width: 292px) 100vw, 292px\" \/><\/a><br \/>\n\u8853\u5f8c4\u5e74\u76ee\u306e\u3082\u306e\u3067\u3059\u3002\u6df1\u90e8\u306b\u5c0f\u3055\u306a\u518d\u767a\u50cf\u304c\u51fa\u73fe\u3057\u307e\u3057\u305f\u3002\u3053\u308c\u3082\u4e88\u60f3\u306e\u7bc4\u56f2\u5185\u3067\u3057\u305f\u3002\u3053\u308c\u3082\u624b\u8853\u3067\u5168\u6458\u51fa\u3057\u307e\u3057\u305f\u3002\u666e\u901a\u306a\u3089\u3042\u3068\u306f\u7d4c\u904e\u89b3\u5bdf\u3092\u3059\u308b\u306e\u307f\u3067\u3059\u3002<br \/>\n\u3057\u304b\u3057\uff0c\u75c5\u7406\u8a3a\u65ad\u3067\u306f IDH1, IDH2\u3068\u3082\u306b\u5909\u7570\u306a\u3057\uff0c<span style=\"color: #000080;\"><strong>\u91ce\u751f\u578b wild type<\/strong><\/span>\u3067\u3057\u305f\u30021p\/19q non-codel, ATRX mutant\u3067\u3059\u3002\u6025\u901f\u306a\u60aa\u6027\u5316\u304c\u61f8\u5ff5\u3055\u308c\u307e\u3057\u305f\u306e\u3067\u8853\u5f8c\u306b\u5c40\u6240\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u52a0\u3048\u307e\u3057\u305f\u3002\u305d\u308c\u4ee5\u964d\u306f\u816b\u760d\u518d\u71c3\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n<p><span style=\"color: #000080;\"><strong>\u7d4c\u904e\u306f\uff0cIDH mutant diffuse astrocytoma WHO grade 2\u3067\u3059\u3002\u3067\u3082\uff0c\u518d\u767a\u50cf\u3067wild type\u3067\u3057\u305f<\/strong><\/span>\u3002malignant transformation\u306a\u306e\u304b\uff1f\u3053\u306e\u3088\u3046\u306a\u4f8b\u3092\u3069\u3046\u89e3\u91c8\u3057\u3066\u3088\u3044\u306e\u304b\u4e0d\u660e\u3067\u3059\u3002<\/p>\n<h4><strong>\u30c6\u30f3\u30c8\u4e0b\u306e\u661f\u7d30\u80de\u816b<\/strong><\/h4>\n<ul>\n<li>\u30c6\u30f3\u30c8\u4e0b\u661f\u7d30\u80de\u816b\u306f\uff0c\u30c6\u30f3\u30c8\u4e0a\u661f\u7d30\u80de\u816b\u3068\u7570\u306a\u3063\u305f\u907a\u4f1d\u5b50\u7570\u5e38\u3092\u767a\u73fe\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<li>\u30c6\u30f3\u30c8\u4e0a\u306e\u661f\u7d30\u80de\u306e80%\u4ee5\u4e0a\u306b\u4e00\u5b9a\u306e\u4f4d\u7f6e\u306bIDH\u306e\u5909\u7570\u304c\u3042\u308b\u306e\u306b\u5bfe\u3057\u3066\uff0c\u30c6\u30f3\u30c8\u4e0b\u306e\u3082\u306e\u306f80%\u304c\u7570\u306a\u3063\u305f\u4f4d\u7f6e\u306b\u5909\u7570 non-canonical IDH mutation \u3092\u751f\u3058\u3066\u3044\u307e\u3059<\/li>\n<li>ATRX\u306e\u6b20\u5931\u306f50%\u4ee5\u4e0b<\/li>\n<li>MGMT\u306e\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306f60%\u4ee5\u4e0b\u306b\u3057\u304b\u8a8d\u3081\u3089\u308c\u307e\u305b\u3093<\/li>\n<li>\u653e\u5c04\u7dda\u6cbb\u7642\u3084\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5316\u5b66\u7642\u6cd5\u306e\u6709\u52b9\u6027\u304c\u4f4e\u3044\u50be\u5411\u306b\u306a\u308b\u907a\u4f1d\u5b50\u5909\u7570\u30c7\u30fc\u30bf\u3067\u3082\u3042\u308a\uff0c\u751f\u547d\u4e88\u5f8c\u306f\u30c6\u30f3\u30c8\u4e0a\u306e\u3082\u306e\u3088\u308a\u4e0d\u826f\u3067\u3059<\/li>\n<li>\u3057\u304b\u3057\uff0c\u8133\u5e79\u90e8\u6d78\u6f64\u3092\u4f34\u3046\u3068\u3044\u3046\u753b\u50cf\u6240\u898b\u304b\u3089\uff0c\u751f\u547d\u4e88\u5f8c\u4e0d\u826f\u3068\u3044\u3046\u306e\u306f\uff0c\u907a\u4f1d\u5b50\u5909\u7570\u3092\u8003\u3048\u306a\u304f\u3066\u3082\u5f53\u305f\u308a\u524d\u3067\u3042\u308b\u3068\u3044\u3046\u610f\u898b\u3082\u3042\u308a\u307e\u3059<\/li>\n<li>\u3057\u304b\u3057\u4e00\u65b9\u3067\uff0c<span style=\"color: #000080;\"><strong>\u5c0f\u8133\u306b\u767a\u751f\u3059\u308b\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306f\uff0c\u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b\u306b\u4f3c\u305f\uff0c\u3068\u3066\u3082\u826f\u597d\u306a\u4e88\u5f8c\u3092\u793a\u3059\u3082\u306e\u304c\u3042\u308a\u307e\u3059<\/strong><\/span><\/li>\n<li>\u3053\u306e<span style=\"color: #000080;\"><strong>\u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c9\uff11\u3092\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c9\uff12\u3068\u6271\u3046\u3053\u3068\u306b\u306f\u5927\u304d\u306a\u81e8\u5e8a\u7684\u306a\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3059\uff0c\u7c21\u5358\u306b\u75c5\u7406\u8a3a\u65ad\u3092\u4fe1\u3058\u306a\u3044<\/strong><\/span><\/li>\n<li><span style=\"color: #000080;\"><strong>\u6bdb\u69d8\u7d30\u80de\u6027\u661f\u7d30\u80de\u816b\u306e\u7d44\u7e54\u306e\u4e00\u90e8\u304c\uff0c\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c92\u306b\u985e\u4f3c\u3059\u308b<\/strong><\/span>\u3053\u3068\u304c\u3042\u308a\u307e\u3059<\/li>\n<\/ul>\n<hr \/>\n<h5>\u3053\u3053\u304b\u3089\u306f\u3088\u308a\u5c02\u9580\u7684\u306a\u77e5\u8b58<\/h5>\n<h4>\u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3<\/h4>\n<p>Baumert BG:\u00a0ESTRO-EANO guideline on target delineation and radiotherapy for IDH-mutant WHO CNS grade 2 and 3 diffuse glioma.Radioth Oncol 2025<br \/>\n\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c92\u30683\u306b\u5bfe\u3059\u308b\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u65b9\u91dd\u3092\u6c7a\u3081\u305f\u3082\u306e\u3067\u3059\u3002GTV\u306f\uff0cT2\/FLAIR\u3067\u7570\u5e38\u306b\u898b\u3048\u308b\u90e8\u5206\u3092\u5168\u3066\u542b\u307f\u307e\u3059\u3002\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u308b\u816b\u760d\u306f\u5f53\u7136\u542b\u307f\uff0c\u624b\u8853\u3055\u308c\u3066\u3044\u308c\u3070\u6458\u51fa\u8154\u3082\u56f2\u307f\u307e\u3059\u3002\u30b0\u30ec\u30fc\u30c93\u3067\uff0c\u660e\u3089\u304b\u306b\u8133\u6d6e\u816b\u3068\u8003\u3048\u3089\u308c\u308b\u90e8\u5206\u306fGTV\u304b\u3089\u5916\u3057\u307e\u3059\u3002CTV\u306f\uff0c\u30b0\u30ec\u30fc\u30c92\u306710mm\uff0c\u30b0\u30ec\u30fc\u30c93\u306715mm\u306e\u30de\u30fc\u30b8\u30f3\u3092\u53d6\u308a\u307e\u3059\u3002\u7dda\u91cf\u306f\uff0c\u30b0\u30ec\u30fc\u30c92\u306750.4 Gy 28\u5206\u5272\uff0c\u30b0\u30ec\u30fc\u30c93\u306759.4\u00a0Gy 33\u5206\u5272\u3067\u3059\u3002\u53ef\u80fd\u306a\u9650\u308aIMRT\u306e\u30c6\u30af\u30cb\u30c3\u30af\u3092\u7528\u3044\u307e\u3059\u3002<\/p>\n<h4>\u30b0\u30ec\u30fc\u30c9\uff12\u30b0\u30ea\u30aa\u30fc\u30de\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u306b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u4f75\u7528\u3057\u305f\u65b9\u304c\u826f\u3044<\/h4>\n<p>Schiff D: LTBK-07. PROGRESSION-FREE AND OVERALL SURVIVAL RESULTS OF ECOG-ACRIN E3F05: A PHASE 3 INTERGROUP TRIAL OF RADIATION \u00b1 TEMOZOLOMIDE FOR GRADE II GLIOMAS. Neuro Oncol 2024<br \/>\n2024\u5e74\u672b\u306eSNO\u3067\u5831\u544a\u3055\u308c\u305f\u3068\u3066\u3082\u91cd\u8981\u306a\u767a\u8868\u3067\u3059\u3002\u81e8\u5e8a\u7b2c\uff13\u76f8\u7121\u4f5c\u70baE3FO5 trial\u306e\u7d99\u7d9a\u7d50\u679c\u3067\u3059\u3002172\u540d\u306e\u4f4e\u60aa\u6027\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de\u306e\u60a3\u8005\u3055\u3093\u3092\u6cbb\u7642\u5f8c\u306b10\u5e74\u4ee5\u4e0a\u7d4c\u904e\u89b3\u5bdf\u3057\u305f\u7d50\u679c\u3067\u3059\u3002\u521d\u671f\u6cbb\u7642\u3067\u653e\u5c04\u7dda\u6cbb\u764250.4Gy\u3068\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e\u4f75\u7528\u3092\u884c\u306a\u3063\u305f\u60a3\u8005\u3055\u3093\u3067\u306f10\u5e74\u751f\u5b58\u5272\u5408\u304c70\uff05\u306b\u5bfe\u3057\u3066\uff0c\u4f75\u7528\u3057\u306a\u304b\u3063\u305f\u7fa4\u3067\u306f47\uff05\u3067\u3057\u305f\u3002\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e\u4f75\u7528\u304c\u30b0\u30ec\u30fc\u30c92\u30b0\u30ea\u30aa\u30fc\u30de\u3067\u6709\u52b9\u3067\u3042\u308b\u3068\u3044\u3046\u8cb4\u91cd\u306a\u5831\u544a\u3067\u3059\u3002\u3082\u3061\u308d\u3093\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e\u6709\u5bb3\u4e8b\u8c61\u3084\u7d4c\u6e08\u7684\u8eab\u4f53\u7684\u306a\u8ca0\u62c5\u306f\u3042\u308b\u306e\u3067\u3059\u304c\uff0c\u3053\u306e\u751f\u5b58\u5272\u5408\u306e\u5dee\u306f\u3068\u3066\u3082\u5927\u304d\u306a\u3082\u306e\u3067\u3059\u3002<br \/>\nDr Schiff\u306f\u91cd\u8981\u306a\u7d50\u679c\u3092\u542b\u3080\u3068\u7d9a\u3051\u307e\u3059\u3002\u306a\u3093\u3068\uff0c\u4e4f\u7a81\u8d77\u81a0\u816b\u3068\u661f\u7d30\u80de\u816b\u3067\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u304c\u540c\u7a0b\u5ea6\u3067\u3042\u3063\u305f\u3068\u3044\u3046\u306e\u3067\u3059\u3002\u666e\u901a\u306f\u3069\u3046\u8003\u3048\u3066\u3082\uff0c\u4e4f\u7a81\u8d77\u81a0\u816b\u306e\u65b9\u304c\u306f\u308b\u304b\u306b\u826f\u3044\u6210\u7e3e\u306e\u306f\u305a\u3067\u3059\u304c\uff1f<\/p>\n<h4>\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6\u306f\u3066\u3093\u304b\u3093\u767a\u4f5c\u306e\u983b\u5ea6\u3082\u4e0b\u3052\u308b<\/h4>\n<p class=\"text-[26px] font-medium leading-8\">Rosa K: Vorasidenib Shows Consistent Efficacy With Manageable Safety in IDH1\/2-Mutant Diffuse Glioma. 2024 Nov, SNO, Houston<br \/>\n\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6 vorasidenib (Voranigo)\u306eINDIGO\u8a66\u9a13\u306e\u8ffd\u52a0\u5831\u544a\u3067\u3059\u3002\u5bfe\u8c61\u306fIDH1\/2-mutated diffuse glioma\uff08\u661f\u7d30\u80de\u816b\u3068\u4e4f\u7a81\u8d77\u81a0\u816b\u304c\u5165\u308a\u307e\u3059\uff09\u3002\u670d\u7528\u3057\u305f\u7fa4\u3067\u3066\u3093\u304b\u3093\u767a\u4f5c\u306e\u767a\u75c7\u7387\u304c\u4f4e\u304b\u3063\u305f\u305d\u3046\u3067\u3059\u3002\u307e\u305f\u670d\u7528\u7fa4\u3067\u816b\u760d\u306e\u4f53\u7a4d\u304c\u6e1b\u5c11\u3057\u305f\u306e\u306b\u5bfe\u3057\uff0c\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f\u816b\u760d\u4f53\u7a4d\u304c\u5897\u5927\u3057\u307e\u3057\u305f\u30022023\u5e743\u6708\u306e\uff13\u56de\u76ee\u306e\u4e2d\u9593\u89e3\u6790\u3067\u306f\uff0c\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6\u7fa4\u306ePFS\u4e2d\u592e\u5024\u306f\u3055\u3089\u306b\u5ef6\u3073\u3066\u307e\u3060\u8a55\u4fa1\u3067\u304d\u305a\uff0c\u30d7\u30e9\u30bb\u30dc\u7fa4\u3067\u306f11.4\u30f6\u6708\u3067\u3057\u305f\u3002\u660e\u3089\u304b\u306a\u6709\u610f\u5dee\u304c\u8a8d\u3081\u3089\u308c\u307e\u3057\u305f\u3002<\/p>\n<h4><span class=\"title_default\">\u30dc\u30e9\u30b7\u30c7\u30cb\u30d6 vorasidenib\u306f\uff0c\u30b0\u30ec\u30fc\u30c92\u306e\u661f\u7d30\u80de\u816b\u3068\u4e4f\u7a81\u8d77\u81a0\u816b\u306e\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u3092\u5ef6\u9577\u3059\u308b\uff1a\u81e8\u5e8a\u7b2c3\u76f8\u8a66\u9a13\u306e\u7d50\u679c<\/span><\/h4>\n<p>Mellinghoff IK:\u00a0<span class=\"title_default\">Vorasidenib in IDH1- or IDH2-mutant low-Grade glioma. New Engl J Med 2023<br \/>\nvorasidenib\u306f\u3001\u5909\u7570\u578bIDH1\/2\u9175\u7d20\u306e\u4f5c\u7528\u3092\u963b\u5bb3\u3059\u308b\u7d4c\u53e3\u85ac\u3067\u3001\u816b\u760d\u306e2-\u30d2\u30c9\u30ed\u30ad\u30b7\u30b0\u30eb\u30bf\u30eb\u9178\uff082-HG\uff09\u309290\uff05\u4ee5\u4e0a\u4f4e\u4e0b\u3055\u305b\u307e\u3059\u3002\u7d4c\u53e3\u85ac\u3067\u3059\u304c\u8133\u5185\u79fb\u884c\u304c\u3088\u3044\u85ac\u5264\u3067\u3059\u3002\u8853\u5f8c\u306e\u6b8b\u5b58\u816b\u760d\u3042\u308b\u3044\u306f\u518d\u71c3 168\u4f8b\u306bvorasidenib (40 mg once daily) \u304c\u6295\u4e0e\u3055\u308c\u307e\u3057\u305f\u3002\u89b3\u5bdf\u671f\u9593\u4e2d\u592e\u502414.2\u30f6\u6708\u306e\u6642\u70b9\u3067\uff0c7\u5272\u306e\u60a3\u8005\u3055\u3093\u304cvorasidenib\u3042\u308b\u3044\u306f\u30d7\u30e9\u30bb\u30dc\u3092\u7d99\u7d9a\u670d\u7528\u3057\u3066\u3044\u307e\u3057\u305f\u3002<span style=\"color: #ff0000;\"><strong>PFS\u4e2d\u592e\u5024\u306f\uff0cvorasidenib\u306727.7\u30f6\u6708\uff0c\u30d7\u30e9\u30bb\u30dc\u306711.1\u30f6\u6708<\/strong><\/span>\u3067\u3057\u305f\u3002\u30b0\u30ec\u30fc\u30c93\u4ee5\u4e0a\u306e\u6709\u5bb3\u4e8b\u8c61\u306f22.8%\u3067\u307f\u3089\u308c\uff0cALT\u306e\u4e0a\u6607\u304c\u76ee\u7acb\u3063\u305f\u305d\u3046\u3067\u3059\u3002\u6709\u5bb3\u4e8b\u8c61\u306b\u3088\u308b\u4e2d\u6b62\u306f3.6%\u3067\u3057\u305f\u3002<\/span><\/p>\n<h4>75\uff05\u4ee5\u4e0a\u6458\u51fa\u3059\u308b\u3068\u5168\u751f\u5b58\u671f\u9593\u304c\u5ef6\u3073\u308b<\/h4>\n<p class=\"chaptertitle\">Shawn L:\u00a0Interactive Effects of Molecular, Therapeutic, and Patient Factors on Outcome of Diffuse Low-Grade Glioma. JCO 2023<br \/>\n\u661f\u7d30\u80de\u816b\u30b0\u30ec\u30fc\u30c92\u3068\u4e4f\u7a81\u8d77\u81a0\u816b\u30b0\u30ec\u30fc\u30c92\uff0c392\u4f8b\u3092\u89e3\u6790\u3057\u305f\u7d50\u679c\u3067\u3059\u3002\u7d50\u8ad6\u306f\uff0c75\uff05\u4ee5\u4e0a\u306eEOR\uff08\u6458\u51fa\u5272\u5408\uff09\u3067\u5168\u751f\u5b58\u671f\u9593\u304c\u4f38\u3073\uff0c80\uff05\u4ee5\u4e0a\u306eEOR\u3067\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u306e\u5ef6\u9577\u304c\u3042\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u5f93\u6765\u3068\u540c\u69d8\u306b\uff0c\u795e\u7d4c\u6a5f\u80fd\u3092\u6e29\u5b58\u3057\u3066\u306e\u6700\u5927\u9650\u306e\u6458\u51fa\u3092\u6cbb\u7642\u65b9\u91dd\u3068\u3059\u308b\u3079\u304d\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u9006\u306b\uff0cEOR\u304c75\uff05\u306b\u9054\u3057\u306a\u3044\u5834\u5408\u306f\u3088\u308a\u591a\u304f\u3092\u6458\u51fa\u3057\u3066\u3082\u5927\u5dee\u306f\u306a\u3044\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u661f\u7d30\u80de\u816b\u3067\u306f\uff0c\u8853\u5f8c\u6b8b\u5b58\u816b\u760d\u304c4.6ml\u4ee5\u4e0a\uff0c\u3042\u308b\u3044\u306f\u8853\u524d\u306e\u816b\u760d\u4f53\u7a4d\u304c43.1ml\u3092\u8d85\u3048\u3066\u3044\u3066\u8853\u5f8c4.6ml\u4ee5\u4e0b\u306e\u3082\u306e\u306f\u5168\u751f\u5b58\u671f\u9593\u4e2d\u592e\u5024\u304c\u77ed\u3044\u3002\u4e4f\u7a81\u8d77\u81a0\u816b\u3067\u306f\uff0c\u8853\u524d\u306e\u816b\u760d\u4f53\u7a4d\u304c43.1ml\u3092\u8d85\u3048\u3066\u3044\u3066\u3082\uff0c\u8853\u5f8c\u4f53\u7a4d\u304c4.6ml\u4ee5\u4e0a\u3067\u3082\u4ee5\u4e0b\u3067\u3082\u4e2d\u9593\u7684\u306a\u751f\u5b58\u671f\u9593\u3092\u793a\u3057\u307e\u3057\u305f\u3002\u751f\u5b58\u671f\u9593\u304c\u6700\u3082\u9577\u304b\u3063\u305f\u306e\u306f\uff0c\u661f\u7d30\u80de\u816b\u3067\u3082\u4e4f\u7a81\u8d77\u81a0\u816b\u3067\u3082\uff0c\u8853\u524d\u4f53\u7a4d\u304c43.1ml\u4ee5\u4e0b\u3067\uff0c\u8853\u5f8c\u4f53\u7a4d\u304c4.6ml\u4ee5\u4e0b\u3067\u3042\u3063\u305f\u5834\u5408\u3067\u3059\u3002<\/p>\n<h4>\u5e83\u7bc4\u56f2\u6458\u51fa supratotal resection \u306f\uff0cIDH\u5909\u7570\u578b\u30b0\u30ea\u30aa\u30fc\u30de\u306eFPS\u3068OS\u3092\u304b\u306a\u308a\u5ef6\u9577\u3059\u308b<\/h4>\n<p class=\"heading-title\">Rossi M: Association of Supratotal Resection with Progression-Free Survival, Malignant Transformation, and Overall Survival in Lower-Grade Gliomas. Neuro Oncol 2020<br \/>\n319\u4f8b\u306eIDH\u5909\u7570\u578b\u30b0\u30ea\u30aa\u30fc\u30de\uff08\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3082\u4e4f\u7a81\u8d77\u81a0\u816b\u306a\u3069\u3082\u542b\u3080\uff09\u306b\u7a4d\u6975\u7684\u306a\u6458\u51fa\u8853\u304c\u8a66\u307f\u3089\u308c\u307e\u3057\u305f\u3002\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u5024\u306f6.8\u5e74\u3067190\u4f8b (60%)\u3067progression \u518d\u71c3\u304c\u751f\u3058\u307e\u3057\u305f\u300235%\u306e\u60a3\u8005\u3055\u3093\u3067supratotal resection\u304c\u3067\u304dprogression\u306f6\u4f8b (5.4%\uff09\u3067\u3057\u305f\u3002\u4e00\u65b9\u3067\uff0c\u90e8\u5206\u6458\u51fa\u3084\u4e9c\u5168\u6458\u51fa\u306e\u60a3\u8005\u3055\u3093\u3067\u306f82%\u306bprogression\u304c\u751f\u3058\u307e\u3057\u305f\u3002supratotal resection\u306e\u60a3\u8005\u3055\u3093\u3067\u306f92\u30f6\u6708\u306e\u6642\u70b9\u3067PFS 94%\u3067\u3057\u305f\u3002\u3053\u306e\u7d50\u679c\u306fIDH\u4ee5\u5916\u306e\u907a\u4f1d\u5b50\u7570\u5e38\u3084\u816b\u760d\u30b0\u30ec\u30fc\u30c9\u306b\u306f\u512a\u4f4d\u306a\u95a2\u9023\u6027\u306f\u306a\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n<h4>PCV\u5316\u5b66\u7642\u6cd5\u304c\u6709\u52b9<\/h4>\n<div class=\"article-citation\">\n<p><span class=\"authors-list-item \">Bell EH:\u00a0<\/span>Comprehensive Genomic Analysis in NRG Oncology\/RTOG 9802: A Phase III Trial of Radiation Versus Radiation Plus Procarbazine, Lomustine (CCNU), and Vincristine in High-Risk Low-Grade Glioma. J Clin Oncol 2020<br \/>\n\u6709\u540d\u306aRTOG 9802\u306e\u8ffd\u52a0\u5206\u6790\u3067\u3059\u3002\u30b0\u30ec\u30fc\u30c9II\u306e\u30b0\u30ea\u30aa\u30fc\u30de106\u4f8b\u3067\u3059\u3002IDH\u91ce\u751f\u578b\u304c26\u4f8b\uff0cIDH\u5909\u7570\u578b1p\/19q\u5171\u6b20\u5931\u306a\u3057(diffuse astrocytoma)\u304c43\u4f8b\uff0cIDH\u5909\u7570\u578b1p\/19\u5171\u6b20\u5931(oligodendroglioma)\u304c37\u4f8b\u3067\u3059\u3002IDH\u5909\u7570\u578b1p\/19q\u5171\u6b20\u5931\u306a\u3057\u3068IDH\u5909\u7570\u578b1p\/19\u5171\u6b20\u5931\u3067\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306ePCV\u5316\u5b66\u7642\u6cd5\u3092\u884c\u306a\u3063\u305f\u7fa4\u3067\uff0cPFS\u3068OS\u306e\u6709\u610f\u306a\u5ef6\u9577\u304c\u3042\u308a\u307e\u3057\u305f\u3002IDH\u91ce\u751f\u578b\u3067\u306f\u5316\u5b66\u7642\u6cd5\u306e\u6709\u52b9\u6027\u306f\u306a\u304b\u3063\u305f\u3068\u306e\u7d50\u679c\u3067\u3059\u3002IDH\u5909\u7570\u578b\u306ehigh-risk low-grade glioma\u306e\u60a3\u8005\u3055\u3093\u306fPCV\u5316\u5b66\u7642\u6cd5\u3092\u53d7\u3051\u308b\u4fa1\u5024\u304c\u3042\u308b\u3068\u7d50\u8ad6\u3057\u3066\u3044\u307e\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300dIDH\u5909\u7570\u578b1p\/19q\u5171\u6b20\u5931\u306a\u3057\u306fdiffuse astrocytoma\uff0cIDH\u5909\u7570\u578b1p\/19\u5171\u6b20\u5931\u306foligodendroglioma\u3068\u6349\u3048\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002\u3060\u3068\u3059\u308b\u3068\uff0c\u5f93\u6765\uff0c<span style=\"color: #000080;\"><strong>\u5316\u5b66\u7642\u6cd5\u304c\u7121\u52b9\u3068\u3055\u308c\u305f\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306b\u653e\u5c04\u7dda\u5f8c\u306e\u5316\u5b66\u7642\u6cd5\u304c\u6709\u52b9\u3068\u306a\u308b\u3068\u3044\u3046\uff0c\u5e38\u8b58\u3092\u304b\u306a\u308a\u8986\u3059\u7d50\u8ad6\u3067\u3059<\/strong><\/span>\u3002\u3053\u3053\u3067\u6ce8\u610f\u3059\u308b\u3053\u3068\u306f\uff0c\u5f8c\u65b9\u8996\u7684\u306a\u89e3\u6790 multivariable analyses\u3067\u3042\u308b\u3053\u3068\uff0c\u7121\u4f5c\u70ba\u8a66\u9a13\u3067\u306f\u306a\u3044\u3053\u3068\uff0c\u4f8b\u6570\u304c43\u4f8b\u3068\u5c11\u6570\u3067\u3042\u308b\u3053\u3068\u3067\u3059\u3002\u307e\u305f\u5bfe\u8c61\u3068\u306a\u3063\u305f\u3082\u306e\u306f\uff0c\u81e8\u5e8a\u7684\u306bhigh risk\u3068\u6349\u3048\u3089\u308c\u308b\u30b0\u30ec\u30fc\u30c9II\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306a\u306e\u3067\u3059\u3002PCV\u306f2020\u5e74\u6642\u70b9\u3067\uff0c\u65e5\u672c\u3067\u306f\u4f7f\u7528\u3067\u304d\u307e\u305b\u3093\u3002<\/p>\n<\/div>\n<h4>\u9ad8\u7dda\u91cf\u7167\u5c04\u306b\u5229\u70b9\u306f\u306a\u3044<\/h4>\n<p class=\"heading-title\"><span class=\"authors-list-item \">Breen WG:\u00a0<\/span>Final report from Intergroup NCCTG 86-72-51 (Alliance): a phase III randomized clinical trial of high-dose versus low-dose radiation for adult low-grade glioma. Neuro Oncol 2020<br \/>\nNCCTG-86-72-51\u306e\u6700\u7d42\u5831\u544a\u3067\u3059\u30021986\u5e74\u304b\u30891994\u5e74\u307e\u3067203\u4eba\u306elow-grade glioma (diffuse astroytoma, oilgodendroglioma, oligoastrocytoma) \u306e\u60a3\u8005\u3055\u3093\u304c\u7121\u4f5c\u70ba\u306b\uff0c50.4Gy (28\u5206\u5272) \u3042\u308b\u3044\u306f 64.8Gy (36\u5206\u5272) \u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u53d7\u3051\u307e\u3057\u305f\u300225\u5e74\u306b\u53ca\u3076\u8ffd\u8de1\u8abf\u67fb\u306e\u7d50\u679c\u3067\u3059\u3002\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u306f5.2\u5e74\uff0c\u5168\u751f\u5b58\u671f\u9593\u306f8.4\u5e74\u3067\u3057\u305f\u3002\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u5024\u306f17.2\u5e74\u3067\uff0c33\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u6700\u7d42\u89b3\u5bdf\u6642\u70b9\u3067\u751f\u5b58\u3057\u3066\u3044\u307e\u3057\u305f\u3002\u9ad8\u7dda\u91cf\u7167\u5c04\u306f15\u5e74\u5168\u751f\u5b58\u5272\u5408\u3082\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u3082\u6539\u5584\u3057\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u5168\u751f\u5b58\u671f\u9593\u306f\uff0c\u816b\u760d\u304c5cm\u672a\u6e80\u304b\u3064baseline MMSE27\u70b9\u4ee5\u4e0a\uff0c\u3082\u3057\u304f\u306f\u5168\u6458\u51fa GTR\u3067\u304d\u305f\u5834\u5408\u306b\u826f\u597d\u3067\u3057\u305f\u3002\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u306f\uff0c\u661f\u7d30\u80de\u816b\u3088\u308a\u4e4f\u7a81\u8d77\u81a0\u816b\u306e\u65b9\u304c\u826f\u304f\uff0c5cm\u672a\u6e80\uff0cMMSE 27\u4ee5\u4e0a\uff0c\u5168\u6458\u51fa\u3067\u304d\u305f\u4f8b\u3067\u826f\u597d\u3067\u3057\u305f\u3002baseline MMSE\u304c\u6b63\u5e38\u3067\u3042\u3063\u305f\u60a3\u8005\u3055\u3093\u3067\u306f\uff0c7\u5e74\u5f8c\u306b1\u4f8b (5%) \u3067\u6709\u610f\u306aMMSE\u306e\u4f4e\u4e0b\u304c\u3042\u308a\u307e\u3057\u305f\u3002<br \/>\n\u300c\u7d50\u8ad6\u300d\u9ad8\u7dda\u91cf\u7167\u5c04\u306b\u5229\u70b9\u306f\u3042\u308a\u307e\u305b\u3093\u3002MMSE\u3067\u898b\u308b\u9650\u308a\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u5f8c\u306e\u8a8d\u77e5\u6a5f\u80fd\u306fstable \uff08\u3042\u307e\u308a\u843d\u3061\u306a\u3044\u3068\u3067\u3082\u8a33\u3057\u307e\u3057\u3087\u3046\u304b\uff09\u3067\u3057\u305f\u3002<\/p>\n<h4>\u30b0\u30ec\u30fc\u30c92\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u4f7f\u7528\u3059\u308b\u3068\u60aa\u6027\u5316\u3059\u308b\uff1f<\/h4>\n<p><span class=\"highlight\">Choi S: Temozolomide<\/span>&#8211;<span class=\"highlight\">associated<\/span> <span class=\"highlight\">hypermutation<\/span> in <span class=\"highlight\">gliomas<\/span>.\u00a0<span role=\"menubar\">Neuro Oncol.<\/span> 2018<br \/>\n\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306f\uff0c\u30b0\u30ec\u30fc\u30c93\u306e\u9000\u5f62\u6210\u6027\u661f\u7d30\u80de\u816b\u3084\u30b0\u30ec\u30fc\u30c94\u306e\u81a0\u82bd\u816b\u3078\u3068\u5909\u308f\u308b\u3053\u3068\u304c\u3042\u308a\u307e\u3059\u3002\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306f\u58ca\u308c\u305f\u907a\u4f1d\u5b50\u3092\u4fee\u5fa9\u3059\u308b\u4f5c\u7528\u3092\u6291\u5236\u3059\u308b\u306e\u3067\uff0c\u907a\u4f1d\u5b50\u5909\u7570\u3092\u62db\u304d\u3084\u3059\u3044\u3068\u3044\u3046\u6b20\u70b9\u304c\u3042\u308a\u307e\u3059\u3002\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3067\u6cbb\u7642\u3055\u308c\u305fIDH mutant\u306e\u30b0\u30ec\u30fc\u30c92\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u304c\uff0c\u591a\u6570\u306e\u907a\u4f1d\u5b50\u5909\u7570\u3092\u6709\u3059\u308b\u3088\u308a\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u30b0\u30ea\u30aa\u30fc\u30de hypermutated phenotype \u3078\u3068\u9032\u884c\u3059\u308b\u3068\u3044\u3046\u7591\u3044\u304c\u3082\u305f\u308c\u3066\u3044\u307e\u3059\u3002\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u3092\u78ba\u8a8d\u3057\u306a\u3044\u3067\u5b89\u6613\u306b\u30b0\u30ec\u30fc\u30c92 \u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u4f7f\u7528\u3057\u306a\u3044\u307b\u3046\u304c\u826f\u3044\u3068\u3044\u3046\u610f\u898b\u306b\u3064\u306a\u304c\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n<div class=\"setumei\">\n<h4>MGMT\u30d7\u30ed\u30e2\u30fc\u30bf\u30fc\u30fb\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u3092\u898b\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u6642<\/h4>\n<ul>\n<li style=\"list-style-type: none;\"><span style=\"color: #000080;\"><strong>2017\u5e74 EANO\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\uff0c\u30a8\u30d3\u30c7\u30f3\u30b9\u30af\u30e9\u30b91\uff0c\u63a8\u5968\u5ea6B\u3067\u3059\u3002<\/strong><\/span><span style=\"color: #000080;\"><strong>IDH\u91ce\u751f\u578b\u306e\u30b0\u30ec\u30fc\u30c92\u30683\u306e\u30b0\u30ea\u30aa\u30fc\u30de<\/strong><\/span>\u3067\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3092\u4f75\u7528\u3059\u308b\u6642\uff0c\u3042\u308b\u3044\u306f\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5358\u72ec\u4f7f\u7528\u3059\u308b\u5834\u5408\u306b\u306f\uff0c\u30e1\u30c1\u30ec\u30fc\u30b7\u30e7\u30f3\u306e\u3042\u308b\u6642\u306e\u307f\u306b\u4f7f\u7528\u3057\u307e\u3059\u3002<\/li>\n<\/ul>\n<\/div>\n<h4>IDH\u91ce\u751f\u578b\u306e\u6642\u306b\u3055\u3089\u306b\u898b\u308b\u3079\u304d\u907a\u4f1d\u5b50<\/h4>\n<p>Brat DJ: cIMPACT-NOW\u00a0update\u00a03:\u00a0recommended\u00a0diagnostic\u00a0criteria\u00a0for &#8220;Diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade IV&#8221;.\u00a0Acta Neuropathol.\u00a02018<br \/>\nIDH\u5909\u7570\u306e\u306a\u3044 IDH wild-type \u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u7cfb\u816b\u760d\u3067\uff0chigh level EGFR amplification\u304c\u3042\u308b\u304b\uff0cwhole chromosome 7 gain in combination with whole chromosome 10 loss\u3082\u3057\u304f\u306f TERT promoter mutation\u304c\u3042\u308b\u3068\uff0c\u30b0\u30ec\u30fc\u30c94\u3068\u306a\u308b\u3068\u306e\u5831\u544a\u3067\u3059\u3002<\/p>\n<h4>2017\u5e74\u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3<\/h4>\n<p>Weller M, et al.: European Association for Neuro-Oncology (EANO) guideline on the diagnosis and treatment of adult astrocytic and oligodendroglial gliomas. Lancet Oncol 2017<br \/>\n\u3053\u306e\u30da\u30fc\u30b8\u306e\u4e0a\u306e\u65b9\u306b\u3060\u3044\u305f\u3044\u53d6\u308a\u5165\u308c\u3066\u66f8\u3044\u3066\u3042\u308a\u307e\u3059\u3002<\/p>\n<h4>\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u5f8c\u3067PCV\u5316\u5b66\u7642\u6cd5\u3092\u884c\u3046: RTOG 9802\u306e\u9577\u671f\u6210\u7e3e<\/h4>\n<p>Buckner JC, et al: Radiation\u00a0plus\u00a0Procarbazine,\u00a0CCNU, and Vincristine in Low-Grade Glioma. N Engl J Med.\u00a02016<br \/>\n\u3068\u3066\u3082\u6a29\u5a01\u306e\u9ad8\u3044\u96d1\u8a8c\u306b\u767a\u8868\u3055\u308c\u305f\u6cbb\u7642\u6210\u7e3e\u3067\u3059\u30021998\u5e74\u304b\u30892002\u5e74\u306e\u9593\u306b\u30b0\u30ec\u30fc\u30c9\uff12\u306e\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u3042\u308b\u3044\u306f\u4e4f\u7a81\u8d77\u81a0\u816b\u306e251\u4eba\u306e\u60a3\u8005\u3055\u3093\u304c\u6cbb\u7642\u3055\u308c\u307e\u3057\u305f\u3002\u8ffd\u8de1\u671f\u9593\u4e2d\u592e\u5024 12\u5e74\u3068\u3044\u3046\u6c17\u306e\u9060\u304f\u306a\u308b\u307b\u3069\u306e\u9577\u3044\u89b3\u5bdf\u7d50\u679c\u3067\u3059\u300218\u6b73\u304b\u308939\u6b73\u3067\u751f\u691c\u8853\u3042\u308b\u3044\u306f\u90e8\u5206\u6458\u51fa subtotal resection\u3092\u53d7\u3051\u305f\u60a3\u8005\u3055\u3093\uff0c\u3042\u308b\u3044\u306f\u3069\u306e\u3088\u3046\u306a\u624b\u8853\u7d50\u679c\u3067\u308240\u6b73\u4ee5\u4e0a\u306e\u60a3\u8005\u3055\u3093\u306b\uff0c\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u5f8c\u3067PCV\u5316\u5b66\u7642\u6cd5\u304c\u52a0\u3048\u3089\u308c\u307e\u3057\u305f\u3002<span style=\"color: #000080;\"><strong>\u653e\u5c04\u7dda\u5358\u72ec\u3067\u306f\u5168\u751f\u5b58\u671f\u9593\u306f7.8\u5e74\uff0cPCV\u3092\u52a0\u3048\u308b\u306813.3\u5e74\u3068\u3044\u3046\u5927\u304d\u306a\u5dee<\/strong><\/span>\u304c\u51fa\u307e\u3057\u305f\u300210\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f\uff0c\u305d\u308c\u305e\u308c21%\u306851%\u3067\u3059\u3002\u4e4f\u7a81\u8d77\u81a0\u816b\u306e\u7d44\u7e54\u578b\u3067\u7121\u5897\u60aa\u751f\u5b58\u3082\u5168\u751f\u5b58\u5272\u5408\u3082\u9ad8\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002\u3053\u306e\u5927\u898f\u6a21\u81e8\u5e8a\u8a66\u9a13\u306f1998\u5e74\u306b\u958b\u59cb\u3055\u308c\u3066\u304a\u308a\uff0c\u304b\u306a\u308a\u306e\u4e4f\u7a81\u8d77\u81a0\u816b\u306e\u6df7\u5728\u304c\u3042\u308a\u307e\u3059\u3002\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b 1p\/19q non-deleted\u3067\u771f\u3067\u3042\u308b\u304b\u3069\u3046\u304b\uff0c\u8b0e\u306e\u307e\u307e\u3067\u3057\u3087\u3046\u3002\u3067\u3082\u4e4f\u7a81\u8d77\u81a0\u816b\u306b\u304a\u3044\u3066\u306f\u771f\u306e\u7d50\u679c\u3068\u8a00\u3048\u307e\u3059\u3002<\/p>\n<h4>\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u3069\u3061\u3089\u3092\u9078\u629e\u3059\u308b\u304b<\/h4>\n<p>Baumert BG: Temozolomide chemotherapy versus radiotherapy in high-risk low-grade glioma (EORTC 22033-26033): a randomised, open-label, phase 3 intergroup study. Lancet Oncol, 2016<br \/>\nReijneveld JC: Health-related quality of life in patients with high-risk low-grade glioma (EORTC 22033-26033): a randomised, open-label, phase 3 intergroup study. Lancet Oncol, 2016<br \/>\n477\u4eba\u306e\u30b0\u30ec\u30fc\u30c9II\u30b0\u30ea\u30aa\u30fc\u30de\u00a0(astrocytoma, oligoastrocytoma, or oligodendroglioma)\u306e\u60a3\u8005\u3055\u3093\u3092\u5bfe\u8c61\u3068\u3057\u305f\u81e8\u5e8a\u7b2c\uff13\u76f8\u8a66\u9a13\u3067\u3059\u3002\u6cbb\u7642\u3092\u884c\u3063\u305f\u57fa\u6e96\u306f\u4e88\u5f8c\u304c\u60aa\u305d\u3046\u306b\u601d\u3048\u308b\u4f8b\u3067\uff0c40\u6b73\u4ee5\u4e0a\uff0c\u9032\u884c\u6027\u75c5\u5de3\uff0c\u816b\u760d\u30b5\u30a4\u30ba\u304c5cm\u4ee5\u4e0a\uff0c\u6b63\u4e2d\u3092\u8d85\u3048\u308b\u75c5\u5909\uff0c\u795e\u7d4c\u75c7\u72b6\u304c\u3042\u3063\u305f\u3068\u3044\u3046\u57fa\u6e96\u3067\u3059\u3002\u7121\u4f5c\u70ba\u306b\uff0c\u653e\u5c04\u7dda\u6cbb\u7642 (conformal radiotherapy; up to 50.4 Gy; 28 doses of 1.8 Gy once daily)\u00a0\u3042\u308b\u3044\u306f\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5316\u5b66\u7642\u6cd5\u00a0(75 mg\/m2 for 21 days, every 28 days, maximum of 12 cycles)\u304c\u306a\u3055\u308c\u307e\u3057\u305f\u3002<br \/>\nPFS \u7121\u5897\u60aa\u751f\u5b58\u671f\u9593\u306f\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u7fa4\u306739\u30f6\u6708\uff0c\u653e\u5c04\u7dda\u306746\u30f6\u6708\u3068\u6709\u610f\u5dee\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u307e\u305f\uff0c\u751f\u5b58\u306e\u8cea\u00a0health-related quality of life (HRQOL)\u306b\u3082\u5dee\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u6709\u5bb3\u4e8b\u8c61\u306f\u5168\u822c\u7684\u306b\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u6cbb\u7642\u7fa4\u3067\u591a\u3044\u3067\u3059\u3002<br \/>\n\u305f\u3060\u3057\uff0c<span style=\"color: #000080;\"><strong>IDH\u5909\u7570\u304c\u3042\u308a1p\/19q\u6b20\u5931\u304c\u306a\u3044\u3082\u306e\uff08\u3044\u308f\u3086\u308b\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\uff09\u3067\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u306ePFS\u304c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u3088\u308a\u3082\u9577\u304b\u3063\u305f<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002IDH\u5909\u7570\u304c\u3042\u308a1p\/19q\u6b20\u5931\u304c\u3042\u308b\u3082\u306e\uff08\u4e4f\u7a81\u8d77\u81a0\u816b\uff09\u3068IDH\u5909\u7570\u304c\u306a\u3044\u3082\u306e\u3067\u306f\u4e21\u7fa4\u306e\u9593\u306b\u5dee\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n<h4>\u9ad8\u30ea\u30b9\u30af\u4f4e\u60aa\u5236\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de\u306b\uff0c\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u306e\u4f75\u7528\u30673\u5e74\u751f\u5b58\u5272\u5408\u304c73%<\/h4>\n<p class=\"heading-title\"><span class=\"authors-list-item \">Fisher BJ:\u00a0<\/span>Phase 2 study of temozolomide-based chemoradiation therapy for high-risk low-grade gliomas: preliminary results of Radiation Therapy Oncology Group 0424. Int J Radiat Oncol Biol Phys 2015<br \/>\nRTOG\u304c\u4e88\u5f8c\u304c\u60aa\u3044\u3068\u5224\u65ad\u3055\u308c\u308blow-grade glioma\u306e\u6cbb\u7642\u6210\u7e3e\u3092\u5831\u544a\u3057\u307e\u3057\u305f\u3002\u4e88\u5f8c\u60aa\u5316\u56e0\u5b50\u306f\uff0c<span style=\"color: #000080;\"><strong>\u661f\u7d30\u80de\u816b\u3067\u3042\u308b\uff0c40\u6b73\u4ee5\u4e0a\uff0c\u4e21\u5074\u5927\u8133\u534a\u7403\u3078\u306e\u4f38\u5c55\uff0c6cm\u4ee5\u4e0a\u306e\u5927\u304d\u306a\u816b\u760d\uff0cPS\u304c\uff12\u4ee5\u4e0a<\/strong><\/span>\u3068\u3044\u3046\u56e0\u5b50\u306e\u4e2d\u3067\uff13\u9805\u76ee\u4ee5\u4e0a\u3092\u307f\u305f\u3059129\u4f8b\u3067\u3059\u3002\u653e\u5c04\u7dda\u6cbb\u7642\u3068\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9 54\u00a0Gy in 30 fractions and concurrent and adjuvant TMZ\u306e\u6cbb\u7642\u304c\u3055\u308c\u307e\u3057\u305f\u30023\u5e74\u5168\u751f\u5b58\u5272\u5408\u306f73%\uff0c3\u5e74\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408\u306f59%\u3067\u3057\u305f\u3002\u3053\u306e\u5831\u544a\u306b\u306f\u82e5\u5e72\u306e\u4e4f\u7a81\u8d77\u81a0\u7d30\u80de\u7cfb\u816b\u760d\u30b0\u30ec\u30fc\u30c92\u304c\u542b\u307e\u308c\u3066\u3044\u307e\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300d<span style=\"color: #000080;\"><strong>\u6cbb\u308a\u306b\u304f\u3044\u3068\u5224\u65ad\u3055\u308c\u308b\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306e\uff13\u5e74\u751f\u5b58\u5272\u5408\u306f7\u5272\u304f\u3089\u3044\uff0c\u624b\u8853\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3092\u3057\u3066\u30826\u5272\u3067\u518d\u767a\u3059\u308b<\/strong><\/span>\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n<h4>\u5206\u5b50\u8a3a\u65ad\u3088\u308a\u753b\u50cf\u8a3a\u65ad\u306e\u65b9\u304c\u4e88\u5f8c\u304c\u826f\u304f\u308f\u304b\u308b<\/h4>\n<p><span class=\"refAuthors\">Goz\u00e9, C, \u00a0<\/span><span class=\"refTitle\">Imaging growth and isocitrate dehydrogenase 1 mutation are independent predictors for diffuse low-grade gliomas. <\/span><span class=\"refSeriesTitle\">Neuro Oncol 16,<\/span>\u00a0<span class=\"refSeriesDate\">2014<br \/>\n131\u4eba\u306e\u7d44\u7e54\u5b66\u7684\u4f4e\u60aa\u6027\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de\u306e\u60a3\u8005\u3055\u3093\u306e\u4e88\u5f8c\u89e3\u6790\u3067\u3059\u3002107\u4eba\u306bIDH1\u306e\u5909\u7570\u304c\u3042\u308a\u307e\u3057\u305f\u3002\u753b\u50cf\u8a3a\u65ad\u3067\u306f5.4mm\/\u5e74\u306e\u5e73\u5747\u5897\u5927\u901f\u5ea6\u3067\u3057\u305f\u3002\u7121\u5897\u60aa\u751f\u5b58\u671f\u9593 PFS\u306f\uff0c<br \/>\nIDH1\u5909\u7570\u304c\u3042\u308b\u3068\u4e88\u5f8c\u304c\u826f\u3044\u3053\u3068\u304c\u77e5\u3089\u308c\u3066\u3044\u307e\u3059\u3002\u5168\u4f53\u3067\u898b\u308b\u3068\uff0c\u60aa\u6027\u9032\u884c\u306e\u306a\u3044PFS\u306f\u753b\u50cf\u4e0a\u3067\u3086\u3063\u304f\u308a\u3057\u305f\u5897\u5927\u901f\u5ea6\u3092\u793a\u3057\u305f\u3082\u306e\u3067149\u30f6\u6708\uff0cIDH1\u5909\u7570\u306e\u3042\u3063\u305f\u3082\u306e\u3067100\u30f6\u6708\u3067\u3059\u3002IDH1\u306e\u5909\u7570\u306e\u6709\u7121\u306b\u95a2\u308f\u3089\u305a\uff0c\u753b\u50cf\u4e0a\u3067\u5897\u5927\u901f\u5ea6\u306e\u9045\u3044\u4f4e\u60aa\u6027\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de\u306e\u4e88\u5f8c\u306f\u826f\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<br \/>\n\u300c\u89e3\u8aac\u300dIDH1\u5909\u7570\u304c\u306a\u3044\u3068\u81a0\u82bd\u816b\u306e\u53ef\u80fd\u6027\u304c\u3042\u308a\uff0c\u304b\u306a\u308a\u7a4d\u6975\u7684\u306a\u6cbb\u7642\u3092\u884c\u3046\u3068\u3044\u3046\u98a8\u6f6e\u306b\u3042\u308a\u307e\u3059\u3002\u3057\u304b\u3057\uff0c\u3057\u3070\u3089\u304f\u7d4c\u904e\u3092\u898b\u3066\u3044\u3066MRI\u3067\u304b\u306a\u308a\u3086\u3063\u304f\u308a\u3057\u304b\u5897\u5927\u3057\u306a\u3044\u3082\u306e\u306e\u4e88\u5f8c\u306f\uff0c\u5206\u5b50\u8a3a\u65ad\u3067\u4e88\u60f3\u3059\u308b\u3088\u308a\u3082\u306f\u308b\u304b\u306b\u826f\u3044\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/span><\/p>\n<h4>IDH\u5909\u7570\u306e\u3042\u308b\u661f\u7d30\u80de\u816b\u306f\u5e83\u7bc4\u56f2\u4f38\u5c55\u304c\u5c11\u306a\u3044<\/h4>\n<p>Qi S, et al.: Isocitrate dehydrogenase mutation is associated with tumor location and magnetic resonance imaging characteristics in astrocytic neoplasms. Oncol Lett 7, 2014<br \/>\n\u30b0\u30ec\u30fc\u30c92\u30683\u306e\u661f\u7d30\u80de\u816b193\u4f8b\u306e\u753b\u50cf\u8a3a\u65ad\u3068IDH\u907a\u4f1d\u5b50\u89e3\u6790\u3067\u3059\u3002IDH1\/2\u306e\u907a\u4f1d\u5b50\u5909\u7570\u3092\u793a\u3057\u305f\u3082\u306e\u306f\uff0c\u5358\u4e00\u8133\u8449\u306b\u9650\u5c40\u3057\u9593\u8133\u3084\u8133\u5e79\u90e8\u306b\u5c11\u306a\u304b\u3063\u305f\uff0c\u4e21\u5074\u5927\u8133\u306b\u307e\u305f\u304c\u308b\u3053\u3068\u304c\u5c11\u306a\u304f\uff0c\u5883\u754c\u304c\u660e\u77ad\u3067MRI\u3067\u306e\u4fe1\u53f7\u3082\u5747\u4e00\u6027\u304c\u3042\u308a\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u50cf\u3082\u5747\u4e00\u6027\u304c\u9ad8\u304b\u3063\u305f\u3068\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n<h4>IDH\u5909\u7570\u306e\u306a\u3044\u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306e\u4e88\u5f8c\u306f\u3068\u3066\u3082\u60aa\u3044<\/h4>\n<p>Metellus P, Absence of\u00a0IDH\u00a0mutation identifies a novel radiologic and molecular subtype of WHO grade II gliomas with dismal prognosis.\u00a0Acta Neuropathol.\u00a02010<br \/>\n\u30aa\u30ea\u30b4\u3082\u542b\u3081\u3066\u306e\u89e3\u6790\u3067\u3059\u304b\u3089\u661f\u7d30\u80de\u816b\u3060\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002IDH\u5909\u7570\u304c\u3042\u308b\u3082\u306e\u30675\u5e74\u751f\u5b58\u5272\u5408\u306f93%\uff0cIDH\u5909\u7570\u306e\u306a\u3044\u3082\u306e\u3067\u306f51%\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002IDH\u5909\u7570\u306e\u306a\u3044\u30b0\u30ec\u30fc\u30c92\u30b0\u30ea\u30aa\u30fc\u30de\u306f\uff0c\u5e74\u9f62\u5c64\u304c\u9ad8\u3044\uff0c\u5cf6 insula\u306b\u767a\u751f\u7387\u304c\u9ad8\u3044\uff0c6cm\u3092\u8d85\u3048\u308b\u3082\u306e\u304c\u591a\u3044\uff0cMRI\u3067\u6d78\u6f64\u6027\uff0cp53\u9670\u6027\uff0c1p\/19\u6b20\u5931\u304c\u306a\u3044\u50be\u5411\u3067\u3059\u3002<\/p>\n<h4>\u30b0\u30ec\u30fc\u30c9\uff12\u306e\u3073\u307e\u3093\u6027\u30b0\u30ea\u30aa\u30fc\u30de\u306b\u9ad8\u7dda\u91cf\u7167\u5c04\u3092\u4f7f\u3063\u3066\u3082\u751f\u5b58\u671f\u9593\u306f\u4f38\u3073\u306a\u3044<\/h4>\n<p>Shaw E, et al.:\u00a0Prospective randomized trial of low- versus high-dose radiation therapy in adults with supratentorial low-grade glioma: initial report of a North Central Cancer Treatment Group\/Radiation Therapy Oncology Group\/Eastern Cooperative Oncology Group study.\u00a0J Clin Oncol. 2002<br \/>\n\u4e4f\u7a81\u8d77\u81a0\u816b\u3092\u542b\u3080203\u4f8b\u306e\u30b0\u30ec\u30fc\u30c9\uff12\u30b0\u30ea\u30aa\u30fc\u30de\u306b\u7121\u4f5c\u70ba\u524d\u5411\u304d\u8a66\u9a13\u304c\u884c\u308f\u308c\u307e\u3057\u305f\u3002<strong>64.8\u30b0\u30ec\u30a4\/<\/strong>36\u5206\u5272\u3068<span style=\"color: #000080;\"><strong>50.4 \u30b0\u30ec\u30a4\/<\/strong><\/span>28\u5206\u5272\u306e2\u7fa4\u3067\u6cbb\u7642\u304c\u884c\u308f\u308c\u307e\u3057\u305f\u3002\u9ad8\u7dda\u91cf\u30675\u5e74\u751f\u5b58\u5272\u5408\u306f64%\uff0c\u4f4e\u7dda\u91cf\u306772%\u3068\u306a\u308a\uff0c\u7dda\u91cf\u304c\u4f4e\u3044\u65b9\u304c\u82e5\u5e725\u5e74\u751f\u5b58\u5272\u5408\u304c\u9ad8\u304f\u306a\u3063\u3066\u3044\u307e\u3059\u3002\u9ad8\u7dda\u91cf\u306e\u65b9\u304c\u653e\u5c04\u7dda\u58ca\u6b7b\u306e\u5408\u4f75\u7387\u306f\u9ad8\u304f\u306a\u308a\u307e\u3057\u305f\u3002<\/p>\n<h4>\u306a\u305c60\u30b0\u30ec\u30a4\u3092\u7528\u3044\u306a\u3044\u306e\u304b<\/h4>\n<p>Karim AB, et al.: A randomized trial on dose-response in radiation therapy of low-grade cerebral glioma: European Organization for Research and Treatment of Cancer (EORTC) Study 22844. Int J Radiat Oncol Biol Phys 36, 1996<br \/>\n\u53e4\u3044\u6587\u732e\u306a\u306e\u3067\u3059\u304c\uff0c\u30e8\u30fc\u30ed\u30c3\u30d1\u3067\u4f4e\u60aa\u6027\u5ea6\u30b0\u30ea\u30aa\u30fc\u30de LGG 343\u4f8b\u3067\u524d\u5411\u304d\u8a66\u9a13\u304c\u306a\u3055\u308c\u307e\u3057\u305f\u3002\u00a045 Gy (5 weeks) \u3082\u3057\u304f\u306f59.4 Gy (6.6 weeks)\u306e\u7167\u5c04\u304c\u3055\u308c\u307e\u3057\u305f\u304c\uff0c74\u30f6\u6708\u306e\u8ffd\u8de1\u671f\u9593\u3067\uff0c\u5168\u751f\u5b58\u5272\u5408 OS \u306b\u3082\u7121\u5897\u60aa\u751f\u5b58\u5272\u5408 (PFS 47% vs. 50%) \u306b\u3082\u6709\u610f\u306a\u5dee\u306f\u3042\u308a\u307e\u305b\u3093\u3067\u3057\u305f\u3002<\/p>\n<h5>\u5b9f\u4f8b\u3067\u306e\u6cbb\u7642\u65b9\u6cd5\u306e\u8003\u3048\u65b9\uff1a30\u4ee3\u7537\u6027\u306e\u9650\u5c40\u6027\u661f\u7d30\u80de\u816b<\/h5>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-8360 alignnone\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm992-1-200x200.jpg\" alt=\"astromm992\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm992-1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm992-1-298x300.jpg 298w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm992-1-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm992-1.jpg 313w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-8361 alignnone\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm991-1-200x200.jpg\" alt=\"astromm991\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm991-1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm991-1-144x144.jpg 144w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><img loading=\"lazy\" decoding=\"async\" class=\"size-thumbnail wp-image-8362 alignnone\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm994-1-200x200.jpg\" alt=\"astromm994\" width=\"200\" height=\"200\" srcset=\"https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm994-1-200x200.jpg 200w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm994-1-300x300.jpg 300w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm994-1-144x144.jpg 144w, https:\/\/plaza.umin.ac.jp\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm994-1.jpg 438w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/><br \/>\n2001\u5e74\u306b\u7121\u75c7\u72b6\u3067\u5076\u7136\u767a\u898b\u3055\u308c\u305f\u53f3\u8fba\u7e01\u56de\u306e<span style=\"color: #000080;\"><strong>\u9650\u5c40\u6027\u661f\u7d30\u80de\u816b well-deliniated or localized astrocytoma<\/strong><\/span>\u3068\u547c\u3070\u308c\u308b\u3082\u306e\u3067\u3059\u3002\u975e\u5e38\u306b\u9650\u5c40\u6027\u3067\uff0cT2\u3067\u5f37\u3044\u9ad8\u4fe1\u53f7\u306b\u306a\u308aT2-FLAIR mismatch sign\u304c\u3042\u308a\uff0cT1\u3067\u306f\u4f4e\u4fe1\u53f7\u3067\u30ac\u30c9\u30ea\u30cb\u30a6\u30e0\u5897\u5f37\u3055\u308c\u306a\u3044\u5178\u578b\u7684\u753b\u50cf\u3067\u3059\u3002<\/p>\n<p><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm0110.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"astromm0110\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm0110-300x294.jpg\" alt=\"\" width=\"252\" height=\"256\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm0110cor1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"astromm0110cor\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm0110cor1-298x300.jpg\" alt=\"\" width=\"242\" height=\"253\" \/><\/a><\/p>\n<p>\u816b\u760d\u304c\u767a\u898b\u3055\u308c\u3066\u304b\u30892\u5e74\u534a\u3067\u5c11\u3057\u5897\u5927\u3057\u305f\u306e\u3067\uff0c\u958b\u982d\u624b\u8853\u3067\u5168\u6458\u51fa gross total removal \u3057\u307e\u3057\u305f\u3002\u30c9\u30ed\u30c9\u30ed\u306e\u67d4\u3089\u304b\u3044\u816b\u760d\u3067\u3057\u305f\u304b\u3089\uff0c\u305d\u306e\u90e8\u5206\u306e\u307f\u3092\u6458\u51fa\u3057\u3066\uff0c\u5468\u56f2\u306e\u8133\u306b\u306f\u624b\u3092\u4ed8\u3051\u307e\u305b\u3093\u3067\u3057\u305f\u3002<br \/>\n<a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm045ax.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"astromm045ax\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm045ax-297x300.jpg\" alt=\"\" width=\"248\" height=\"255\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm045cor.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"astromm045cor\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm045cor-300x298.jpg\" alt=\"\" width=\"250\" height=\"257\" \/><\/a><\/p>\n<p>\u767a\u75c5\u5f8c\uff0c5\u5e74\u76ee\u3067\u3059\u3002\u4eca\u5ea6\u306f\uff0c\u53f3\u524d\u982d\u8449\u306e\u6df1\u90e8\u767d\u8cea\u306b\u6ef2\u307f\u8fbc\u3080\u3088\u3046\u306b\u816b\u760d\u518d\u767a\u3057\u307e\u3057\u305f\u3002\u3053\u308c\u3092\u958b\u982d\u624b\u8853\u3067\u307e\u305f\u6458\u51fa\u3057\u3066\u304b\u3089\uff0c46\u30b0\u30ec\u30a423\u5206\u5272\u306e\u653e\u5c04\u7dda\u6cbb\u7642\u3092\u3057\u307e\u3057\u305f\u3002<br \/>\n<a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm0411.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"astromm0411\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm0411-295x300.jpg\" alt=\"\" width=\"244\" height=\"252\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm0411cor.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"astromm0411cor\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm0411cor.jpg\" alt=\"\" width=\"244\" height=\"257\" \/><br \/>\n<\/a>\u305d\u306e\u5f8c\u306b\u306f\uff0c\u5916\u6765\u3067\u30c6\u30e2\u30be\u30ed\u30de\u30a4\u30c9\u5185\u670d\u6cbb\u7642\u309224\u30b3\u30fc\u30b9\uff082\u5e74\u9593\uff09\u884c\u306a\u3044\u307e\u3057\u305f\u3002<br \/>\n<a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm0712cor1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"astromm0712cor\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm0712cor1-300x298.jpg\" alt=\"\" width=\"247\" height=\"249\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm12.4.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"astromm12.4\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm12.4-289x300.jpg\" alt=\"\" width=\"233\" height=\"255\" \/><br \/>\n<\/a>\u5de6\u304c\u518d\u767a\u304b\u30892\u5e74\u5f8c\uff0c\u53f3\u304c\u518d\u767a\u304b\u3089\uff18\u5e74\u5f8c\u3067\u3059\u3002\u816b\u760d\u306e\u518d\u5897\u5927\u306f\u3042\u308a\u307e\u305b\u3093\u3002FLLIR\u3067\u9ad8\u4fe1\u53f7\u306b\u898b\u3048\u308b\u306e\u306f\u653e\u5c04\u7dda\u6cbb\u7642\u306e\u5f71\u97ff\u3067\u3059\u3002\u767a\u898b\u5f8c\u3059\u3067\u306b20\u5e74\u304c\u7d4c\u904e\u3057\u305f\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u73fe\u5728\u3082\u7121\u75c7\u72b6\u3067\u816b\u760d\u5897\u60aa\u306a\u304f\u6280\u5e2b\u3068\u3057\u3066\u666e\u901a\u306b\u793e\u4f1a\u4eba\u3068\u3057\u3066\u751f\u6d3b\u3057\u3066\u3044\u307e\u3059\u3002\uff08\u3053\u306e\u4e00\u9023\u306e\u753b\u50cf\u306f\u60a3\u8005\u3055\u3093\u306e\u8a31\u53ef\u3092\u5f97\u3066\u63b2\u8f09\u3057\u307e\u3057\u305f\u3002\uff09<\/p>\n<p><span style=\"color: #000000;\">\u300c\u30b3\u30e1\u30f3\u30c8\u300d<\/span>\u53f3\u524d\u982d\u8449\u306e\u661f\u7d30\u80de\u816b\u3068\u3044\u3048\u3069\u3082\uff0c\u8133\u6881\u3084\u524d\u982d\u8449\u6df1\u90e8\u767d\u8cea\u306b\u304b\u304b\u3063\u3066\u3044\u308b\u3082\u306e\u306f\uff0c\u816b\u760d\u306e\u5468\u308a\u306e\u8133\u3082\u542b\u3081\u3066\u6458\u51fa\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u306f\u3067\u304d\u307e\u305b\u3093\u3002\u4e0b\u306b\u3042\u308b\u753b\u50cf\u306f\u540c\u3058\u60a3\u8005\u3055\u3093\u306e2020\u5e74\u306e\u3082\u306e\u3067\u3059\u3002\u4e0a\u306e\u65b9\u306e\u753b\u50cf\u306f\u816b\u760d\u306e\u3068\u3053\u308d\u3070\u304b\u308a\u5f37\u8abf\u3057\u3066\u307f\u305b\u305f\u306e\u3067\u3059\u304c\uff0c\u524d\u982d\u8449\u306e\u6df1\u90e8\u767d\u8cea\u3068\u8133\u6881\u819d\u90e8\u304c\u6e29\u5b58\u3055\u308c\u305f\u72b6\u614b\u3067\u6cbb\u7642\u304c\u7d42\u4e86\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u89e3\u308b\u3068\u601d\u3044\u307e\u3059\u3002\u3060\u304b\u3089\u793e\u4f1a\u751f\u6d3b\u304c\u3067\u304d\u308b\u306e\u3067\u3059\u3002<br \/>\n<a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm2013t1.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"astromm2013t1\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm2013t1-291x300.jpg\" alt=\"\" width=\"239\" height=\"255\" \/><\/a><a href=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm2013flair.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"\" title=\"astromm2013flair\" src=\"\/sawamura\/wp\/wp-content\/uploads\/2013\/08\/astromm2013flair-294x300.jpg\" alt=\"\" width=\"240\" height=\"253\" \/><br \/>\n<\/a>\u30ca\u30d3\u30b2\u30fc\u30b7\u30e7\u30f3\uff0c\u624b\u8853\u4e2dMRI\uff0c\u899a\u9192\u4e0b\u624b\u8853\uff0cALA\u306b\u3088\u308b\u53ef\u8996\u5316\u306a\u3069\u306e\u6280\u8853\u3092\u4f7f\u3063\u3066\uff0c\u3082\u3063\u3068\u5e83\u7bc4\u56f2\u306b\u8133\u3092\u5207\u9664\u3059\u308c\u3070\uff0c\u3082\u3057\u304b\u3059\u308b\u3068\u624b\u8853\u3060\u3051\u3067\u6cbb\u3063\u305f\u9650\u5c40\u6027\u661f\u7d30\u80de\u816b\u3060\u3063\u305f\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u3067\u3082\u3053\u306e\u816b\u760d\u3067\u306f\uff0c\u899a\u9192\u4e0b\u624b\u8853\u3067\u8853\u4e2d\u6240\u898b\u304c\u51fa\u308b\u3053\u3068\u306f\u306a\u3044\u3067\u3057\u3087\u3046\u3057\uff0cALA\u3067\u306f\u6d78\u6f64\u90e8\u4f4d\u306e\u816b\u760d\u304c\u8d64\u304f\u5149\u3089\u306a\u304b\u3063\u305f\u3067\u3057\u3087\u3046\u3057\uff0c\u8853\u4e2dMRI\u3092\u3059\u308c\u3070\u6458\u51fa\u7bc4\u56f2\u3092\u3082\u30461cm\u304f\u3089\u3044\u5e83\u3052\u308b\u3079\u304d\u3060\u3068\u8003\u3048\u305f\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u3057\u304b\u3057\uff0c\u305d\u308c\u3067\u306f\uff0c\u524d\u982d\u8449\u6df1\u90e8\u767d\u8cea\u3068\u8133\u6881\u819d\u90e8\u306e\u640d\u50b7\u304c\u751f\u3058\u3066\u3044\u305f\u306e\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u8133\u6881\u819d\u90e8\u3092\u542b\u3081\u305f\u5e83\u7bc4\u56f2\u5207\u9664\u306f\u8133\u6a5f\u80fd\u306e\u4f4e\u4e0b\u3092\u62db\u304f\u306e\u3067\uff0c\u5207\u9664\u305b\u305a\u306b\u653e\u5c04\u7dda\u3068\u5316\u5b66\u7642\u6cd5\u3067\u6291\u3048\u8fbc\u307e\u306a\u3051\u308c\u3070\u60a3\u8005\u3055\u3093\u306f\u793e\u4f1a\u751f\u6d3b\u3092\u5931\u3044\u307e\u3059\u3002<\/p>\n<p><span style=\"color: #ff0000;\"><strong>\u89e3\u5256\u5b66\u7684\u306b\u6458\u51fa\u3067\u304d\u306a\u3044\u4f4d\u7f6e\u306b\u3042\u308b\u30b0\u30ea\u30aa\u30fc\u30de\u306f\uff0c\u899a\u9192\u4e0b\u624b\u8853\uff0cALA, \u8853\u4e2dMRI\u306a\u3069\u3092\u4f7f\u3063\u3066\u3082\u6458\u51fa\u3067\u304d\u306a\u3044\u3067\u3059\u3002<\/strong><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u304a\u304a\u307e\u304b\u306a\u3053\u3068 \u3073\u307e\u3093\u6027\u661f\u7d30\u80de\u816b\u306f\uff0c\u75c5\u7406\u7d44\u7e54\u8a3a\u65ad\u540d\u3067\u3059 2021\u5e74\u304b\u3089\u306f\u907a\u4f1d\u5b50\u8a3a\u65ad\u3068\u306a\u308a\uff0c\u661f\u7d30\u80de\u816bIDH\u5909\u7570\u578b\u3068\u3088\u3070\u308c\uff0c\u30b0\u30ec\u30fc\u30c9\u304c2\u304b\u30894\u306b\u5206\u985e\u3055\u308c\u307e\u3059 \u307b\u3068\u3093\u3069\u304c\u30b0\u30ec\u30fc\u30c92\u3067\u3059 \u82e5\u3044\u6210\u4eba30\u6b73\u4ee3\u306b\u3082\u3063\u3068\u3082\u591a\u3044\u3067\u3059 \u5c0f\u5150 [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16],"tags":[],"class_list":["post-3607","post","type-post","status-publish","format-standard","hentry","category-glioma"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/3607","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\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/comments?post=3607"}],"version-history":[{"count":257,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/3607\/revisions"}],"predecessor-version":[{"id":23758,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/posts\/3607\/revisions\/23758"}],"wp:attachment":[{"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/media?parent=3607"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/categories?post=3607"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/plaza.umin.ac.jp\/sawamura\/wp-json\/wp\/v2\/tags?post=3607"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}