Neurological Surgery 脳神経外科36巻4号

2008年04月発行

連載 悪性脳腫瘍治療の今とこれから

4．神経膠腫における遺伝子診断と個別化治療

著者： 佐々木光¹ 吉田一成¹ 河瀬斌¹

所属機関： ¹慶應義塾大学医学部脳神経外科

ページ範囲：P.355 - P.369

Ⅰ．はじめに

　神経膠腫に対しては，その浸潤性と脳という臓器特殊性のため，一般に安全域をとっての根治切除は困難である．また，放射線治療に対する感受性も高いとは言えず，長く，治療成績の改善は画像技術の進歩や手術手技の熟練によるものに限られていた ．その中で，近年，患者の機能，生命予後に大きく貢献するいくつかの重要な進歩が認められている．手術の面では，ナビゲーションシステムや術中モニタリングによる摘出率向上，合併症低減などであり，補助療法においては，1p/19q欠失に代表される遺伝子診断に基づく個別化治療および新規経口抗がん剤テモゾロミド（temozolomide）の臨床導入が挙げられる．本稿では，特に遺伝子診断と個別化治療に関して，その歴史，最近の知見を紹介することにより現状を確認した後，遺伝子診断に基づく神経膠腫の個別化治療に向けてのわれわれの治療方針について概説する．

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