{"id":550,"date":"2020-02-19T20:27:00","date_gmt":"2020-02-19T11:27:00","guid":{"rendered":"https:\/\/idsc-gunma.jp\/congress\/jstm\/?p=550"},"modified":"2022-05-26T20:23:45","modified_gmt":"2022-05-26T11:23:45","slug":"%e3%83%8f%e3%82%a4%e3%83%aa%e3%82%b9%e3%82%af%e8%86%80%e8%83%b1%e3%81%8c%e3%82%93ta-tis-t1-t2%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e8%87%93%e5%99%a8%e6%b8%a9%e5%ad%98%e3%81%ab%e9%96%a2%e3%81%99","status":"publish","type":"post","link":"https:\/\/idsc-gunma.jp\/congress\/jstm\/%e3%83%8f%e3%82%a4%e3%83%aa%e3%82%b9%e3%82%af%e8%86%80%e8%83%b1%e3%81%8c%e3%82%93ta-tis-t1-t2%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%e8%87%93%e5%99%a8%e6%b8%a9%e5%ad%98%e3%81%ab%e9%96%a2%e3%81%99\/","title":{"rendered":"\u30cf\u30a4\u30ea\u30b9\u30af\u8180\u80f1\u304c\u3093(Ta, Tis, T1, T2)\u306b\u304a\u3051\u308b\u81d3\u5668\u6e29\u5b58\u306b\u95a2\u3059\u308b\u6df1\u90e8\u9818\u57df\u52a0\u6e29\u3068\u4f75\u7528\u3057\u305f\u5316\u5b66\u653e\u5c04\u7dda\u7642\u6cd5\u306e\u9577\u671f\u6210\u7e3e"},"content":{"rendered":"\n

\u30cf\u30a4\u30d1\u30fc\u30b5\u30fc\u30df\u30a2\u306b\u95a2\u3059\u308b\u6700\u8fd1\u306e\u8a71\u984c40<\/p>\n\n\n\n

\u30cf\u30a4\u30ea\u30b9\u30af\u8180\u80f1\u304c\u3093(Ta, Tis, T1, T2)\u306b\u304a\u3051\u308b\u81d3\u5668\u6e29\u5b58\u306b\u95a2\u3059\u308b\u6df1\u90e8\u9818\u57df\u52a0\u6e29\u3068\u4f75\u7528\u3057\u305f\u5316\u5b66\u653e\u5c04\u7dda\u7642\u6cd5\u306e\u9577\u671f\u6210\u7e3e<\/strong><\/p>\n\n\n\n

\u6cb3\u5408\u3000\u61b2\u5eb7\uff08\u540d\u53e4\u5c4b\u5e02\u7acb\u5927\u5b66\u5927\u5b66\u9662\u533b\u5b66\u7814\u7a76\u79d1\u3000\u814e\u30fb\u6ccc\u5c3f\u5668\u79d1\u5b66\u5206\u91ce\uff09<\/strong><\/p>\n\n\n\n

\u672c\u90a6\u3067\u8180\u80f1\u304c\u3093\u306e\u6cbb\u7642\u306b\u653e\u5c04\u7dda\u5316\u5b66\u7642\u6cd5\u3084\u6e29\u71b1\u7642\u6cd5\u304c\u65bd\u884c\u3055\u308c\u308b\u4f8b\u306f\u591a\u304f\u306f\u306a\u3044\u304c\uff0c\u3053\u3053\u3067\u7d39\u4ecb\u3059\u308b\u6700\u8fd1\u306e\u8ad6\u6587\u306f\u30c9\u30a4\u30c4\u3067\u306e\u9577\u671f\u306b\u308f\u305f\u308b\u81e8\u5e8a\u6210\u7e3e\u306e\u7d50\u679c\u3067\u3042\u308b1)<\/sup>\uff0e\u672c\u7814\u7a76\u306e\u76ee\u7684\u306f\uff0c\u7d4c\u5c3f\u9053\u7684\u8180\u80f1\u816b\u760d\u5207\u9664\u8853(TURBT)\u5f8c\u306e\u9818\u57df\u6df1\u90e8\u52a0\u6e29(RHT)\u3092\u4f75\u7528\u3057\u305f\u5316\u5b66\u653e\u5c04\u7dda\u7642\u6cd5(RCT)\u306e\u81e8\u5e8a\u6210\u7e3e\u3068\u5b89\u5168\u6027\u3092\u8a55\u4fa1\u3059\u308b\u3053\u3068\u3067\u3042\u308b\uff0e1982\u5e74\u304b\u30892016\u5e74\u306b\u308f\u305f\u308a\uff0c\u30cf\u30a4\u30ea\u30b9\u30af369\u540d\u306e\u8180\u80f1\u304c\u3093\u60a3\u8005\uff08\u6df1\u9054\u5ea6\u8a55\u4fa1\u3067\uff0cpTa, pTis, pT1, \u304a\u3088\u3073pT2 cN0-1, cMO(\u6240\u5c5e\u30ea\u30f3\u30d1\u7bc0\u8ee2\u79fb\uff0c\u9060\u9694\u8ee2\u79fb\u7121)\uff09\u306b\u5bfe\u3057\u3066TUR-BT\u5f8c\uff0c\u96c6\u5b66\u7684\u6cbb\u7642\u304c\u884c\u308f\u308c\u305f\uff0e\u5168\u3066\u306e\u60a3\u8005\u306b\u5bfe\u3057\u3066\u8180\u80f1\u3068\u6240\u5c5e\u30ea\u30f3\u30d1\u7bc0\u306b\u653e\u5c04\u7dda\u6cbb\u7642(RT)\u304c\u884c\u308f\u308c\u305f\uff0e\u3053\u306e\u3046\u3061RCT\u304c\u884c\u308f\u308c\u305f\u306e\u306f215\u540d\uff0cRCT+ RHT\u306f79\u540d\u306b\u5b9f\u65bd\u3055\u308c\uff0cRT\u306e\u307f\u306f75\u540d\u3067\u3042\u3063\u305f\uff0e\u6cbb\u7642\u5fdc\u7b54\u306b\u3064\u3044\u3066\u306f\uff0c4-6\u9031\u5f8c\u306b\u8a55\u4fa1\u3055\u308c\u305f\uff0e<\/p>\n\n\n\n

RT,RCT,RCT+RHT\u5f8c\u306e\u8a55\u4fa1\u306e\u305f\u3081\u306e2\u56de\u76ee\u306eTURBT\u306e\u7d50\u679c\u306f\uff0c\u30cf\u30a4\u30ea\u30b9\u30af\u8868\u5728\u764c\uff08Ta,Tis,T1\uff09\u306e\u5b8c\u5168\u6cbb\u7652(comlete remission:CR)\u306f\uff0cRT,RCT,RCT+RHT\u306e\u9806\u3067146\/166(88%),19\/22(86%),87\/99(88%)\u3067\u3042\u3063\u305f\uff0e\u7b4b\u5c64\u6d78\u6f64\u764cT2\u306e\u305d\u308c\u306f\uff0c26\/44(59\uff05)\uff0c91\/109(84\uff05)\uff0c27\/32(84\uff05)\u3067\u3042\u3063\u305f\uff0e\u591a\u5909\u91cf\u89e3\u6790\u3067\u306fRCT\u306fRT\u3088\u308aCR\u7387\u3092\u5411\u4e0a\u3055\u305b\u308b\u304c\uff0cRCT+RHT\u306f\u3055\u3089\u306bCR\u7387\u3092\u5411\u4e0a\u3055\u305b\u308b\u3068\u3044\u3046\u7d50\u679c\u3067\u306f\u306a\u304b\u3063\u305f\uff0e<\/p>\n\n\n\n

5\u5e74\u304a\u3088\u307310\u5e74\u5168\u751f\u5b58\u7387\u306f\u305d\u308c\u305e\u308cRCT\u306764%(95%CI,58%-71%),39%(95%CI,33%-47%),RT\u306745%(95%CI:35%-58%), 19%(95%CI:12%-13%),RCT+RHT\u306787\uff05\uff0895%CI:79%-95%,60%(95%CI:47%-77%)\u3067\u3042\u3063\u305f\uff0e\u591a\u5909\u91cf\u89e3\u6790\u3067RCT\u306fRT\u3088\u308a\u5168\u751f\u5b58\u7387\u306e\u5411\u4e0a\u306b\u5bc4\u4e0e\u3057\u3066\u304a\u308a\uff0c\u3055\u3089\u306bRHT\u306e\u8ffd\u52a0\u306f\uff0c\u3055\u3089\u306b\u305d\u308c\u306e\u5411\u4e0a\u306b\u5bc4\u4e0e\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u305f\uff0e<\/p>\n\n\n\n

5\u5e74\u304a\u3088\u307310\u5e74\u5168\u7121\u75c5\u751f\u5b58\u7387\u306b\u95a2\u3057\u3066\u3082\uff0c\u591a\u5909\u91cf\u89e3\u6790\u3067RCT\u306fRT\u3088\u308a\u7121\u75c5\u751f\u5b58\u7387\u306e\u5411\u4e0a\u306b\u5bc4\u4e0e\u3057\u3066\u304a\u308a\uff0c\u3055\u3089\u306bRHT\u306e\u8ffd\u52a0\u306f\uff0c\u3055\u3089\u306b\u305d\u308c\u306e\u5411\u4e0a\u306b\u5bc4\u4e0e\u3057\u3066\u3044\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u305f\uff0e<\/p>\n\n\n\n

\u89b3\u5bdf\u671f\u9593\u4e2d\u306b55\u4f8b\u306f\u8180\u80f1\u5168\u6458\u9664\u8853\u3068\u306a\u3063\u305f\uff0e5\u5e74\u53ca\u307310\u5e74\u5f8c\u306e\u8180\u80f1\u6e29\u5b58\u7387\u306fRCT+RHT\uff0cRCT\u306e\u9806\u306796% vs 82% ,96% vs 78%\u3067\u3042\u308a\u8180\u80f1\u6458\u9664\u8853\u306b\u306a\u308b\u307e\u3067\u306e\u671f\u9593\u3092RCT+RHT\u3068RCT\u3067\u6bd4\u8f03\u3059\u308b\u3068\uff0cRCT\uff0bRHT\u306e\u307b\u3046\u304c\u9577\u304b\u3063\u305f\uff0e<\/p>\n\n\n\n

\u6cbb\u7642\u6bd2\u6027\u306b\u3064\u3044\u3066\u306f\uff0c\u8180\u80f1\u523a\u6fc0\u75c7\u72b6\uff0c\u80c3\u8178\u75c7\u72b6\uff0c\u5614\u5410\u75c7\u72b6\u306e\u307b\u304b\uff0c\u691c\u67fb\u6240\u898b\u3067\u767d\u8840\u7403\u6e1b\u5c11\uff0c\u8840\u5c0f\u677f\u6e1b\u5c11\u306a\u3069Grade3-4\u306e\u51fa\u73fe\u7387\u3092\u6bd4\u8f03\u3059\u308b\u3068\uff0cRT,RCT,RCT+RHT\u3067\u5dee\u306f\u306a\u304b\u3063\u305f\uff0e<\/p>\n\n\n\n

TUR-BT\u5f8c\u306b\u30d7\u30e9\u30c1\u30ca\u3092\u57fa\u672c\u3068\u3057\u305f\u540c\u6642RCT\u3092RHT\u3068\u4f75\u7528\u3057\u3066\u884c\u3046\u96c6\u5b66\u7684\u6cbb\u7642\u306f\u60aa\u6027\u5ea6\u306e\u9ad8\u3044\u8180\u80f1\u304c\u3093\u60a3\u8005\u306b\u95a2\u3057\u3066\uff0c\u5c40\u6240\u5236\u5fa1\uff0c\u8180\u80f1\u306e\u6e29\u5b58\u7387\uff0c\u304a\u3088\u3073\u5168\u751f\u5b58\u7387\u306b\u304a\u3044\u3066\u6539\u5584\u52b9\u679c\u304c\u8a8d\u3081\u3089\u308c\u305f\uff0e\u672c\u6cd5\u306f\u8180\u80f1\u5168\u6458\u51fa\u8853\u306b\u4ee3\u308f\u308b\u6cbb\u7642\u6cd5\u3068\u3057\u3066\u6709\u7528\u3068\u601d\u308f\u308c\u308b\uff0e\u4f46\u3057\uff0c\u672c\u8ad6\u6587\u3067\u306f\u60a3\u8005\u80cc\u666f\u3067\u5e74\u9f62\uff0c\u60aa\u6027\u5ea6\u3084\u521d\u56deTUR-BT\u306e\u6210\u7e3e\u306b\u3088\u3063\u3066\u6cbb\u7642\u30d0\u30a4\u30a2\u30b9\u304c\u304b\u304b\u3063\u3066\u3044\u308b\u53ef\u80fd\u6027\u3082\u3042\u308a\uff0c\u5185\u5bb9\u8a55\u4fa1\u306b\u306f\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3042\u308b\uff0e\u307e\u305f\uff0c\u4eca\u5f8c\u306f\u60a3\u8005\u306e\u5229\u76ca\u3092\u8003\u616e\u3057\u305f\u96c6\u5b66\u7684\u6cbb\u7642\u3092\u884c\u3046\u969b\u306b\u306f\u3055\u3089\u306a\u308b\u6ccc\u5c3f\u5668\u79d1\u533b\u3068\u653e\u5c04\u7dda\u6cbb\u7642\u533b\u306e\u7dca\u5bc6\u306a\u9023\u643a\u304c\u5fc5\u8981\u3068\u306a\u308d\u3046\uff0e<\/p>\n\n\n\n

\u53c2\u8003\u6587\u732e<\/p>\n\n\n\n

1)  Merten R et al<\/em>. Long-Term Experience of Chemoradiotherapy Combined with Deep Regional Hyperthermia for Organ Preservation in High-Risk Bladder Cancer (Ta, Tis, T1, T2).<\/p>\n\n\n\n

     Oncologist, 24: e1341-e1350, 2019.<\/p>\n\n\n\n

\u7528\u8a9e\u89e3\u8aac<\/p>\n\n\n\n

TUR-BT\uff1aTransurethral resection of bladder tumor, \u7d4c\u5c3f\u9053\u7684\u8180\u80f1\u816b\u760d\u5207\u9664\u8853\uff0c<\/p>\n\n\n\n

RHT: Regional Deep Hyperthermia; \u3053\u3053\u3067\u306f BSD-2000 3D\/PC-Hyperthermia System (BSD Medical Corporation, Salt Lake City, UT)\u3092\u4f7f\u7528\uff0eSigma Eye \u3042\u308b\u3044\u306f Sigma-60 applicator \u3092\u4f7f\u7528\uff0e\u5468\u6ce2\u6570\uff0c90\u2013100 MHz.<\/p>\n\n\n\n

\u539f\u767a\u816b\u760d\u306e\u58c1\u5185\u6df1\u9054\u5ea6<\/p>\n\n\n\n

TX<\/td>\u539f\u767a\u816b\u760d\u306e\u8a55\u4fa1\u304c\u4e0d\u53ef\u80fd<\/td><\/tr>
T0<\/td>\u539f\u767a\u816b\u760d\u306a\u3057<\/td><\/tr>
Ta<\/td>\u4e73\u982d\u72b6\u975e\u6d78\u6f64\u304c\u3093<\/td><\/tr>
Tis<\/td>\u4e0a\u76ae\u5185\u304c\u3093\uff08CIS\uff09<\/td><\/tr>
T1<\/td>\u4e0a\u76ae\u4e0b\u7d50\u5408\u7d44\u7e54\u306b\u6d78\u6f64\u3059\u308b\u816b\u760d<\/td><\/tr>
T2a<\/td>\u7b4b\u5c64\u306e\u534a\u3070\u307e\u3067\u306e\u6d78\u6f64<\/td><\/tr>
T2b<\/td>\u6d78\u6f64\u304c\u7b4b\u5c64\u306e\u534a\u3070\u3092\u8d8a\u3048\u308b\u3082\u306e<\/td><\/tr>
T3a<\/td>\u8180\u80f1\u5468\u56f2\u8102\u80aa\u7d44\u7e54\u3078\u306e\u9855\u5fae\u93e1\u7684\u6d78\u6f64\u304c\u60f3\u5b9a\u3055\u308c\u308b<\/td><\/tr>
T3b<\/td>\u8180\u80f1\u5468\u56f2\u8102\u80aa\u7d44\u7e54\u3078\u306e\u8089\u773c\u7684\u306b\u306f\u3063\u304d\u308a\u3068\u3057\u305f\u58c1\u5916\u6d78\u6f64\u304c\u60f3\u5b9a\u3055\u308c\u308b<\/td><\/tr>
T4a<\/td>\u524d\u7acb\u817a\u203b\uff0c\u7cbe\u56a2\uff0c\u5b50\u5bae\u3042\u308b\u3044\u306f\u815f\u3078\u306e\u6d78\u6f64<\/td><\/tr>
T4b<\/td>\u9aa8\u76e4\u58c1\u3042\u308b\u3044\u306f\u8179\u58c1\u3078\u306e\u6d78\u6f64<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

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