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<title>グリオーマ治療のDecision Making（電子版のみ） | 株式会社文光堂</title>


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<meta name="description" content="今般病理組織学と分子生物学の両面からグリオーマ病態診断が導入されつつあるが，これらの新たな診断によってグリオーマの標準治療が更新されるには少し時間がかかると予想されるので，まずは将来を見据えた視点を持ちながら今の標準治療とその根拠を整理するべきであると考える．本書では，神経上皮性腫瘍全体をグリオーマと定義しているがそのすべてを網羅することはせず，特に標準治療として知っておくべき項目をピックアップし">

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		<h1 class="title">グリオーマ治療のDecision Making（電子版のみ）<span class="version"></span></h1>
		

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				<ul class="property"><li class="disc">B5判・314頁・4色刷</li><li class="disc">ISBN&nbsp;978-4-8306-2407-0</li><li class="disc">2016年5月3日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">今般病理組織学と分子生物学の両面からグリオーマ病態診断が導入されつつあるが，これらの新たな診断によってグリオーマの標準治療が更新されるには少し時間がかかると予想されるので，まずは将来を見据えた視点を持ちながら今の標準治療とその根拠を整理するべきであると考える．本書では，神経上皮性腫瘍全体をグリオーマと定義しているがそのすべてを網羅することはせず，特に標準治療として知っておくべき項目をピックアップした．</section><section class="preface">序文<br><br>　本書のねらいは，一般脳神経外科医向けに，「グリオーマの標準的治療について，腫瘍学と神経科学の観点から知識を整理する」ということにあります．<br>　今般病理組織学と分子生物学の両面からグリオーマ病態診断が導入され，その自然歴や治療介入の効果について新たな知見が報告されています．また，各種脳機能診断方法の発展は神経科学における新知見に寄与するだけではなく，その診断結果の臨床的信頼性向上によって手術適応や術中摘出決定の判断基準となりうることが明らかになってきました．ただし，これらの新たな診断によってグリオーマの標準治療が更新されるには少し時間がかかると予想されます．将来を見据えた視点を持ちながら今の標準治療とその根拠を整理するべく，脳神経外科診療プラクティスシリーズ「グリオーマ治療のDecision Making」を企画することとなりました．<br>　本書では，神経上皮性腫瘍全体をグリオーマと定義していますが，そのすべてを網羅することはせず，特に標準治療を知っておくべき項目をピックアップしています．読者は，脳神経外科研修医から専門医取得後の医師まで広く想定しており，本書を通読するわけではなく，必要な時に必要な部分のみを読むと想定しています．グリオーマが専門ではない脳神経外科医でも理解しやすいように，腫瘍学と神経科学を切り口に，基礎から最新の知識まで整理しています．また，論文を読み書きする際に役立つような知識も扱い，単にグリオーマという疾患だけではなく脳神経外科学すべてに通じる学問的アプローチと臨床知識を学ぶことができるよう編集しました．<br>　執筆は，各分野で著名な先生方に趣旨をご理解いただいたうえでお願いいたしました．以下の点が特徴的といえます．<br>① 教科書的・網羅的記載は必ずしも必要とせず，診断や治療を行ううえで実践的で重要なことを記載し，なぜそうなのかということが理解できる．<br>② 背景となる病理診断や機能解剖の記載を積極的に取り入れて，標準治療の背景を理解することの重要性も理解できる．<br>③「詳細は・・・を参照」といった記載は避けて各項目はそれのみで完結するようにし，その項目のみを読んでも理解できる．<br>④ 図表・写真などをできるだけたくさん用いて視覚的に理解できる．<br>　本書によって読者の先生方の日常診療が一層深厚なものとなり，脳神経外科学のますますの発展につながれば望外の喜びです．<br><br>札幌医科大学　三國信啓</section><section class="indexes">I. グリオーマ診療─OncologyとNeuroscience の観点から─<br>II. グリオーマの基礎知識<br>　1．特殊性<br>　　a．グリオーマの定義，疫学，頻度<br>　　b．グリオーマの増殖様式<br>　2．病理<br>　　a．神経上皮性腫瘍の病理（WHO2007）分類とWHO gradingの臨床的意義<br>　　b．病理診断基準<br>　3．鑑別診断<br>　　a．グリオーマ画像診断の基礎知識<br>　　b．グリオーマの再発，放射線壊死，偽増悪，偽奏効の鑑別診断<br>　　c．脳梗塞・脳膿瘍との鑑別<br>　　d．脱髄性疾患との鑑別<br>　　e．悪性リンパ腫との鑑別<br>　4．集学的治療と予後<br>　　a．組織別治療指針<br>　　　1）星細胞系腫瘍<br>　　　2）乏突起膠細胞系腫瘍と乏突起星細胞系腫瘍<br>　　　3）上衣系腫瘍<br>　　　4）脈絡叢腫瘍<br>　　　5）神経細胞および混合神経細胞・膠細胞系腫瘍<br>　　　6）胎児性腫瘍<br>　　　7）松果体部腫瘍<br>　　b．部位や年齢によって特徴付けられるグリオーマの集学的治療指針<br>　　　1）視神経グリオーマ<br>　　　2）脳幹部グリオーマ<br>　　　3）脊髄髄内グリオーマ<br>　　　4）小児グリオーマ<br>　　　5）高齢者グリオーマ<br>　　【T】WHO gradeⅠに対するてんかん治療指針<br>III. 外科治療のDecision Making<br>　1．手術適応判断や手術アプローチ選択のための術前検査<br>　　a．DTI tractographyによる神経線維路検査<br>　　b．fMRIによる皮質機能局在検査<br>　　c．高次脳機能評価と適切な評価時期<br>　　d．グリオーマ手術に適切なQOL評価<br>　　e．言語と記憶の側方性評価<br>　　f．動静脈還流の画像検査<br>　2．グリオーマ摘出に必要な解剖知識と術中機能検査<br>　　a．運動野<br>　　b．感覚野<br>　　c．言語野<br>　　d．視覚路<br>　　e．頭頂葉<br>　　f．島<br>　　g．側頭葉内側部<br>　　h．第三脳室<br>　　i．脳幹・第四脳室<br>　　j．脊髄<br>　3．術中病態診断によるDecision Making<br>　　a．術中迅速病理診断<br>　　b．覚醒下手術<br>　　c．蛍光診断<br>　　d．光線力学的治療<br>　　e．BCNU wafer<br>　　f．皮質脳波<br>　4．手術支援機器の効果的使用<br>　　a．グリオーマ手術に対する神経内視鏡の応用<br>　　b．術中情報統合の有効利用<br>　【O】将来のグリオーマ手術室<br>IV. 最新の術後治療と問題点<br>　1．化学療法<br>　2．放射線療法<br>　3．免疫療法<br>　4．ウイルス療法<br>　5．言語ニューロリハビリテーション<br>　6．運動ニューロリハビリテーション<br>V. 将来の標準治療の基盤となる最新脳腫瘍学<br>　1．分子診断からみたグリオーマの発生機序<br>　2．病理・遺伝学的グリオーマ分類<br>　3．脳腫瘍幹細胞研究によるグリオーマ治療戦略<br>　4．脳腫瘍バイオマーカーとしてのmicroRNA<br>　5．R-IHC法による脳腫瘍診断<br>　6．化学療法治療感受性<br>　7．髄芽腫に対する遺伝子診断<br>VI. グリオーマ論文の読み方<br>　1．脳腫瘍全国集計調査結果の変遷<br>　2．グリオーマに対するJCOG（日本臨床腫瘍研究グループ）の役割と臨床試験<br>　3．臨床試験デザインと結果の解釈に必要な生物統計学<br>　4．WHO分類改訂を控えた脳腫瘍臨床研究の方向性<br>索引<br><br>【T】Topics，【O】One point advice</section></article>
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