{"created":"2023-05-25T05:26:06.080565+00:00","id":4758,"links":{},"metadata":{"_buckets":{"deposit":"10b62192-221d-479d-b1c9-8329fb19bbcf"},"_deposit":{"created_by":17,"id":"4758","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"4758"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:00004758","sets":["29:31:160:162"]},"author_link":["14563","14547","14553","14556","14559","14548","14550","14554","14558","14546","14555","14560","14562","14549","14557","14552","14551","14561"],"item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"The strategy of treatment for skull base meningioma"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"ズガイテイズイマクシュ ノ チリョウ シシン ノ カクリツ"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2019-08-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"55","bibliographicPageStart":"46","bibliographicVolumeNumber":"37","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学"},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"【背景】髄膜腫は頭蓋内原発良性腫瘍のあり、全摘出が治療の原則となるが、特に頭蓋底髄膜腫は重要構造物が周囲にあり、必ずしも機能温存下に全摘出できるわけではない。髄膜腫は良性腫瘍であるため、致命的合併症を生じることは許容できないことである。当科では、1994年から頭蓋底髄膜腫に対して長期腫瘍制御と機能温存を第一として、肉眼的全摘を原則としながらも合併症の危険性が高いと判断した症例では、意図的に腫瘍を残存させ、原則１年以内の定位放射線治療を併用する方針で、現在まで一貫として治療を行ってきた。そこで本治療方針におけるこれまでの20年間のデータを詳細に検討し、頭蓋底髄膜腫の治療指針を確立することを目的として研究を行った。\n【対象と方法】1994年４月から2013年４月までの髄膜腫255例のうち、頭蓋底髄膜腫は125例で摘出術を施行した104例を対象とした。検討項目は腫瘍増大の有無及び時期、腫瘍倍化時間、MRI T2 signal intensity ratio（SIR）、病理所見、腫瘍摘出度の指標であるSimpson grade、細胞増殖能の指標であるMIB－1 Labeling Index（LI）、放射線治療の有無とした。\n【結果】摘出術のみ施行したのは87例（Ｓ群）、術後意図的残存腫瘍に対して１年以内の早期放射線治療施行したのが17例（eRT群）であった。５年および10年腫瘍制御率はSimpsonⅡではそれぞれ91．6％、87．8％、SimpsonⅢでは100％、80％、さらにSimpsonⅣのうちeRT群では93．3％、81．7％である一方、Ｓ群では70．7％、56．6％と、有意に制御率は低かった。またmortalityは０％、morbidityは4．8％と良好な成績であった。有意な腫瘍増大因子はMIB－1 LI、残存腫瘍体積、T2 SIRであり、ROC解析では残存腫瘍体積が最も腫瘍増大に関与していた。\n【結論】本研究では当科での頭蓋底髄膜腫に対する治療指針を検証し、その有用性を実証した。さらに、今回明らかにした腫瘍の生物学的な性質を把握して治療及び経過観察を行っていくことが重要であることを明らかにした。","subitem_description_type":"Other"}]},"item_3_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"14552","nameIdentifierScheme":"WEKO"}],"names":[{"name":"サイトウ, ユウキ"}]},{"nameIdentifiers":[{"nameIdentifier":"14553","nameIdentifierScheme":"WEKO"}],"names":[{"name":"コクボ, ヤスアキ"}]},{"nameIdentifiers":[{"nameIdentifier":"14554","nameIdentifierScheme":"WEKO"}],"names":[{"name":"サトウ, シンヤ"}]},{"nameIdentifiers":[{"nameIdentifier":"14555","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ヤマカワ, 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Yukihiko"}]}]},"item_3_identifier_registration":{"attribute_name":"ID登録","attribute_value_mlt":[{"subitem_identifier_reg_text":"10.15022/00004722","subitem_identifier_reg_type":"JaLC"}]},"item_3_publisher_32":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"山形大学"}]},"item_3_source_id_7":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0288-030X","subitem_source_identifier_type":"ISSN"}]},"item_3_source_id_9":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00067279","subitem_source_identifier_type":"NCID"}]},"item_3_text_33":{"attribute_name":"出版者（ヨミ）","attribute_value_mlt":[{"subitem_text_value":"ヤマガタ ダイガク"}]},"item_3_text_34":{"attribute_name":"別言語の出版者","attribute_value_mlt":[{"subitem_text_value":"Yamagata 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順彦"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-23"}],"displaytype":"detail","filename":"kiyoum-37-2-46to55.pdf","filesize":[{"value":"665.2 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volume","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"Tumor control probability","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"頭蓋底髄膜腫の治療指針の確立","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"頭蓋底髄膜腫の治療指針の確立"}]},"item_type_id":"3","owner":"17","path":["162"],"pubdate":{"attribute_name":"公開日","attribute_value":"2019-08-15"},"publish_date":"2019-08-15","publish_status":"0","recid":"4758","relation_version_is_last":true,"title":["頭蓋底髄膜腫の治療指針の確立"],"weko_creator_id":"17","weko_shared_id":-1},"updated":"2023-05-25T06:19:53.544567+00:00"}