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大学・研究所にある論文を検索できる 「孤発性聴神経腫瘍に対するガンマナイフを用いた定位手術的照射の長期成績に関する検討」の論文概要。リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。

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孤発性聴神経腫瘍に対するガンマナイフを用いた定位手術的照射の長期成績に関する検討

河島, 真理子 東京大学 DOI:10.15083/0002008275

2023.12.27

概要

審査の結果の要旨

氏名

河島 真理子

本研究は孤発性聴神経腫瘍に対する定位手術的照射(SRS)において、若年患者の成績と、低
線量治療の長期成績の解析を試みたものであり、下記の結果を得ている。

1.

治療時 40 歳以下の若年聴神経腫瘍に対する SRS の腫瘍制御は、非若年者と比較し遜色

ないことを示した。良性腫瘍である聴神経腫瘍は、治療後長期間にわたる有効性、安全性が求め
られるが、それを担保する長期成績が乏しかったこと、また一般に若年者は高齢者よりも周術期
合併症リスクが低いことから、第一に摘出術が選択されることが多かった。本研究における、既
報との優位点は、より長期の観察期間と、症例マッチングによる非若年者との比較を行った点で
ある。その結果、若年者と非若年者との間に腫瘍制御率の違いを認めず、治療選択の際の判断根
拠の一つになると考えられる。

2.

聴神経腫瘍に対する SRS では、歴史的に線量を減らすことにより顔面神経障害や三叉神

経障害のリスクが低く抑えられるようになったが、一方で線量低減による腫瘍制御への負の影
響も懸念されていた。本研究では、観察期間 5 年以上を有し、一律 12 Gy の低線量にて照射を行
ったコホートにて、5 年・10 年の腫瘍制御率はそれぞれ 96.4%、94.7%と、VS の成長を長期に
わたり停止できることを示した。

3. また、聴神経腫瘍に対する定位手術的照射において、放射線誘発性動脈瘤や悪性転化など
の稀な遅発性合併症が起こりうることを示した。治療後の長期観察と患者への十分な説明の重
要性を再認識させるものであった。

以上、本論文は孤発性聴神経腫瘍に対する SRS の有効性について明らかにした。聴神経腫瘍
の治療管理において、低侵襲かつ安全な治療に貢献するものと考えられる。

よって本論文は博士(

医学

)の学位請求論文として合格と認められる。

1

この論文で使われている画像

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