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臺腺腾腰膀腷膈膔膝臎臓 Vol. 37, pp. 447452, 2009 腁腈腆腂腍腅腀腇腋腄腌腀腃腊腉 腋腆腌腊 腈腅 腏腆 腐腭 腍腇腎腄 : 22 2 17 腁 腈腄腉腆 臱膾 10 腓腪 1012 臱腝臹腮腢腫腌腝腃腔25腞臮膱glioma膂膐至膐臲腎腃臮膱臙腝 臣腙腛腕腗腂腫臙腛腚腂腭腧腫臵臙腊腞膖腛腩腟腜膵膫臗臠腝臰腂臔臶臻腇腎腊膿自腎10 腌膛90膂自腘腁 glioma 腘腥臉腥膁臵腝臅腂臮膱glioblastoma GBM, WHO grade IV腅腨腟膰臶臷臊anaplastic astrocytoma, WHO grade III῍ῌ膂膐膁臵臮膱malignant glioma膚膔 臗臠膑膝膜膃腛腚臜膝臄腕腗腥腸膝腝臕膟腘腛腆腘腥 GBM 膔膌臧腆腩1 腙腈腭腤腗腸膝腘腁 腒腝膋腞臛膃腝腜腎腢臆腣腨腃腜臀腇腫臭 臢臵膉腘腁腪臸臫腙腝膩膙腇腸腄膍臗臠 腇腟腏腫腌腙腇臇腘腁腫malignant glioma 腝臧臬腇臟膸腎腓腙腈腜腞腏腘腜腝臀膃腜臙腇臀腇腕腗腂腫腌腙腘腁腫腒腬腜膒腄腗膑膝 膜膃膽臵腜腨腫腒腝膚膑膳膌臌腎 malignant glioma 腠腝腦腔腝臩腙腛 腫腌腙臵腇臌腏腫腌腙腛腚腇 腁腋腩腬腫腨腪malignant glioma 腇腒腝臔 腝臞膺膋臐腘腁腫腌腙腇腩腬腗腂腫腝臗臠腞腷腹腲腀腳腽膀腳腴腶腻臮膱臹 腼腸腵腾膀腱膲膼臯MRI 腚腮膯臏腎腮膏腎腖腖膓膨腜臙臟腎臠膺臦臖臁膣臋腝臔腙腛腪腖腖腁腫膔腜腅腂腗腥腝臗臠臑膎 腊腚腮膯臏腎腝膏腎腖腖腮膿自腍 腑腫腌腙腜腣膞腎腗腂腫腡腓膑膝 膜膃 腙腎腗2005 temozolomide TMZ腻膕膜膃臦臖腕腨膜膃膜腎 腗臹腌膓膺腮膘腏腫腙腂腃臍膄臥臒膶腇腰腷 腍腬膇膅腘腥臙膡腟臟膺腜臦臖臁膣臋腝 TMZ 腙腎腗臄腭腬腗腂腫腎腆腎臹 膤膡腞腭腐腆 2.5 腆膴膍腎腗腂腫腜膕腉 臈臔腜腊臔膜膃臌腎腗腂腛腂腝腇膸臬腘 腁腫臂腘腞 malignant glioma 腝膖腀腖腝膚膔腅腨腟膺膜膃腜腖腂膛臼腏腫glioma 腆腂腃腊腖腍腔腕腏腙腐 anaplastic astrocytoma腀 腒腎腚腌腐 glioblastoma GBM腇腋腗腅腃 glioma 腙腞臮膱自腝腃腔臷臊膆腩 自膆臊膊膙腈腆腩臹腏腫 臨腘25 腤腫臷臊膄膑膘腝臙腙腎腗臷臊astrocytomalow grade astrocytoma 臨腙腎腗腩腬腗腈腓腇2000 WHO 腺膠腆腩 low grade astrocytoma 腞腟腡腯臵臷臊di#use astrocy- toma 腈膠腄腩腬腓2007 WHO 腺膠腞臷臊膄膑膘腝臙腟腡腯臵臭臢臵臷臊di#usely infiltrating astrocytoma 腙膹膬臵臷臊circumscribed astrocytoma 腒腾腍腬腍腩腜 gli- omatosis cerebri 膒腍腬腓 1di#usely infi- ltrating astrocytoma 2000 WHO 腺膠腘臤腤 腗臏腍腬腓膻腘腁腫腇腟腡腯臵臷臊膰臶臷臊膗臙腝臨腘腁腫腌腬腩腝臙腞腂腊腖腆腝腇腯致膇臐腝膅臫腦腇腯膇臐腝 膞臵膑腜腨腪臹腏腫腙臃腄腩腬腫臝腕腗膁臵膑 臺腺腾腰膀腷膈膔臮膱膚膔 447 31

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�������� ��������� ������ ADC ����������������1H-MRS �� anaplastic astrocytoma �����NAA � � Choline !"��#� NAA�Cho �� � creatine �� ���$%�&'�� lipid,lactate �!"�()*$%��+���, �-��� 2��.!�/� anaplastic astrocytoma, GBM�

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���� malignant glioma ������� ��� ����� �Brain Labo� ���������� �� 3�� ������������������ ���!" �motor evoked potential: MEP��#$%&��!" �somatosensory evoked poten-tial: SEP�� '&���(!" �auditory brainstemevoked potential: ABR�� )&��!" �visualevoked potential: VEP� *+�!,-./01���2����34�� 5-�5678��9 �5-ALA�:�;<��=>?@AB���CD./4�:CEFGH� I J�*;K�LM:�NOP;���� malignant glioma �Q;P�� �RSTU�":�VS�!,-./01���2���34��W��X�� Y<&Z����34�:[\S�]^_��U����� `�LMab�cdeP;<fg��*+ eloquent area �LM�ahiOPQj� klmno�pqc*rs���� ������t�uv����w6

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����TMZ ������������ ����

��� ���������� �� TMZ������������ ������ �Cisplatin,BCNU, Thalidomide, Interferon ��� ���� ����� !"#�$�����malignant glioma %& '(������)

� �*��+,�- ACNU � Cisplatine ��%������ �+,�.�/0��1��23� �456���78��9$� :�����;<%#�$���� �=��>���%?@$���� malignant glioma���� TMZ�����$���� ���AB��CD����

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malignant glioma �� ��EF� �%8GH�$�>� �I!�JK��A� �L?M*"N�O># ���$%��� $P$$QR&F� STUVWXYZ� [Y\]^_`aTbc^��� ��'d�ef�g(��*F$%�hi��� STUI)%jD�� k*+� ��$�� l�,m�$Qnop'��q-' � r �st�H �� �Duv.Q �� w/�� x0�� yazY�� {WpZ�� |^}^~W��� L?�R������13��

� �

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