ムラガキ　ヨシヒロ   MURAGAKI Yoshihiro   村垣　善浩    所属   医学部 医学科（東京女子医科大学病院）    職種   客員教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Patterns of intracranial glioblastoma recurrence after aggressive surgical resection and adjuvant management: retrospective analysis of 43 cases.
掲載誌名	正式名：Neurologia medico-chirurgica 略　 称：Neurol Med Chir (Tokyo) ISSNコード：13498029(Electronic)04708105(Linking)
巻・号・頁	52(8),pp.577-586
著者・共著者	KONISHIi Yoshiyuki†, MURAGAKI Yoshihiro, ISEKI Hiroshi, MITSUHASHI Norio, OKADA Yoshikazu
担当区分	2nd著者
発行年月	2012/08
概要	The present retrospective study evaluated the recurrence patterns after aggressive surgical removal of intracranial glioblastomas in 43 consecutive adult patients. The resection rate of the enhanced lesion on magnetic resonance imaging was 100% and 95-99% in 22 and 21 cases, respectively. All patients received postoperative fractionated radiotherapy (60 Gy in 30 fractions) with additional chemotherapy (25 cases) or vaccine therapy (18 cases). During follow-up (median 17 months), tumor recurrence was identified in 33 patients, most frequently regional within the wall of the resection cavity (20 cases). No clinical factor differed significantly between the groups of patients with regional or marginal tumor progression (N = 22) and patients with distantor multiple recurrences (N = 8). Progression-free survival did not differ significantly between these two groups (p = 0.27). However, overall survival was significantly longer (p = 0.04) in patients with regional or marginal tumor progression, and constituted 90% and 54% at 1 and 2 years after surgery, respectively, compared to 75% and 0% in patients with distant or multiple recurrences. Aggressive surgical resection and adjuvant management of intracranial glioblastoma may change its recurrence pattern. Tumor progression appears in the wall of the resection cavity or within 2 cm from its margin in approximately half of patients.
DOI	10.2176/nmc.52.577
文献番号	22976141