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1 ICD-11 . 2013 .. 3 2007 . 1994 . 1993 . 1997 .. cachexia .. 50 .. NSAID .. 1 .. 1 . ,32(6):743-749,2005. 2 Robert Twycross Andrew Wilcock .. apoptosis . Programmed cell death .. DNA .. necrosis . antisense . mRNA ( ) mRNA .. DNA . RNA RNaseH hnRNA, mRNA .. duration of stable disease .. dysplasia .. -1- .. intraepitherial neoplasia . intraepitherial neoplasia high grade low grade .. atypia . , 112 1996 . 2 1997 . 9 1999 .. prim ary debulking surgery .. 2007.. en bloc resection . En bloc .. genetic counseling .. gene . DNA 1 DNA . DNA RNA . DNA .. genotype gene cloning gene duplication gene amplification genetic map gene recombination -2- oncogene tumor suppressor gene 1992 .. genetic diagnosis .. polymerase chain reaction (PCR) DNA.. HLA .. clone minimum residual disease MRD .. DNA 1995 . Pennisi E From genes to genome biology.

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3 -3- .. GCP . (inform ed choice). (informed consent) .. informed choice . Virotherapy .. 1 .. juxta-regional lym ph nodes .. odds odds ratio .. = .. 4 4 2 .. = .. 1 .. opioid .. -4- ( ) .. Oncologic em ergency .. before-after study .. external (beam ) irradiation intracavitary irradiation .. 3D-CRT(3 ) IMRT .. chem otherapy .. chem oradiotherapy .. concurrent chemoradiotherapy CCRT . accelerated fractionation . 2 .. -5- .. von Hippel-Lindou Li-Fraumeni . perform ance status (PS) . PS .. Grade . Grade .. Grade 50 .. Grade 50 . Grade . Toxicity and response criteria of the Eastern Cooperative Oncology Group:Am J Clin Oncol 5:649-655,1982. hyperfractionation . 1920 30 . 1 . 1 2Gy . 50Gy 1970. 80 1 2Gy . 1 2Gy . 1 .. 1 1 .. 1 1 2 2 . 6 1980 1 2Gy . 1 1 2 60Gy 72Gy 1 .. Carcinoid . carcinoid . Carcinoid .. Carcinoid . -6- 5-HIAA 5-hydroxyindole acetic acid.

4 Cancer . cancer carcinoma . cancer carcinoma .. oncogene .. v-onc proto-onc . c-onc .. tumor suppressor gene( ) . Cancer stem cells .. 1997 . 2000 .. 1.. 25 . 2.. 65 . 65 74 . 75 84 . 85 . screening for cancer .. 19 2 .. high risk group . -7- UICC (1) . (2) (3) (4) (5) .. 50 HBV HCV .. lim b salvage surgery .. 1 3 . 1 3 .. 1 . 2 . 3 . natural history . Natural history .. spontaneous regression .. palliative m edicine palliative care . -8- QOL . terminal . Oxford Textbook of Palliative Medicine . palliative care team .. 2008 . 1976 St. Thomas Hospital 80 90 .. - .. Cintron, A. and Meier, : The palliative care consult team. In: (eds), Bruera, E., Higginson, , Ripamonti, C. et al. Textbook of Palliativ Medicine. Hodder Arnold, London, , 2006.. 1.. 2.. 3.. 2 . GIST gastrointestinal strom al tum or . KIT KIT . interstitial cells of Cajal(ICCs).

5 KIT KIT GIST . GIST .. Pseudo . 1978 pseudomucinous 3 . cystadenoma . -9- intensification therapy .. consolidation therapy . IM RT intensity m odulated radiation therapy . IMRT . * . IMRT . IMRT .. * .. local recurrence .. palliative sedation therapy .. clustering .. DNA , .. nd 1 .Knudsen S. Guide to analysis DNA microarray data. 2 ed. 2004, John Wiley & Sons, Hobson, New Jersey, -10- USA. 2. 2001, , . (clinical research coordinator: CRC).. 19. 5 .. SMO SoCRA . AACR .. Kur course cycle . (Kur). (course) (cycle) .. Krukenberg tum or . Krukenberg(1896 ) fibrosarcoma ovarii mucocellulare(carcinomatodes) . Krukenberg .. 2008. care . Cure . Cure .. angiogenesis . vasculogenesis .. VEGF(Vascular Endothelial Growth Factor) . EGF(Epidermal Growth Factor) .. -11- (data and safety m onitoring com m ittee independent data m onitoring com m ittee ).

6 GCP .. data monitoring committee .. independent data monitoring committee . high low dose therapy . 2 1/2 large small dose therapy . wide m argin . Curative margin . 2 1990.. etc.. prognostic factor .. PS0/1 PS2/3 . PS0/1 PS2/3 PS . Cox .. confounding .. interaction . predictive factor HER2/neu . HER2/neu . HER2/neu .. solid tum or .. -12- personal inform ation .. 14 6 17 . 50 .. radical surgery palliative surgery .. reduction surgery .. Radical surgery curative surgery Curative surgery . surgical curability comprehensive curability . A(pA) R0 Dnumber N pN number . B pB A(pA) C(pC) . C(pC) R1 R2 . A,B,C . A,pB,pC . D D0 ; D1; 1 D2; 1 . 2 D3; 1 2 3 . R0 R1 R2; . definitive radiation therapy . gross tumor volume;GTV (clinical target volume;CTV) .. (planning target volume;PTV) . -13- .. com partm ent . (barrier) 1 . 1 Enneking.

7 Intracompartmental(T1) . extracompartmental(T2) . curative margin . Enneking WF A System of staging musculoskeletal neoplasms 204 9-24,1986 . com pliance .. reconstructive surgery .. psycho-oncology . (oncology) . Quality of life (QOL) .. 2002 .. m inim ally invasive therapy M IT . interventional radiology . nadir .. cytokine .. ( ) . 1 . -14- .. recurrent cancer .. relapsing relapsing .. relapse .. recurrence and m etastasis .. cell adhesion m olecules .. (Southern blotting & northen blotting). DNA . Southern . RNA . DNA RNA .. Salvage chem otherapy , , . -15- . , BEP (bleomycin, etoposide, cisplatin) . 70-80% , 20-30% etoposide, ifosfamyde, cisplatin VIP . , gemcitabine salvage chemotherapy .. exploratory laparotom y .. 2008.. 2 3 3 . 1 2 MAP FFP . MAP FFP 3 . FFP . 2 3 1 .. 800ml 2 3 1 400ml 4-6 . Hb 11g/dl . MAP 42.

8 3 1 . 1,000ml . 2 .. 3 2 3 .. -16- 1 2 3 . 1 2 . suicide .. 1998 3 .. 2 .. supportive therapy . , . , G-CSF .. spontaneous carcinom a .. Tum or Im m unity .. m ultidisciplinary m ultim odal therapy . multidisciplinary multimodal .. -17- multidisciplinary . multimodal . heavy particle radiation therapy .. ( ) .. X .. 1/3 1/4 . (charged particle beam radiation therapy, particle beam radiation therapy), . (heavy ion particle radiation therapy).. standard surgery . extended surgery . modified surgery .. function preserving surgery .. (dendritic cell). (dendritic cell: DC) . ( ) ( ) . (major histocompatibility complex: MHC) . T .. preoperative chem otherapy induction chem otherapy . neoadjuvant chem otherapy . -18- down staging .. debulking (cytoreductive) surgery . primary debulking surgery interval debulking surgery.

9 Secondary debulking surgery . 2007. intralesional m argin . 100 .. 2 1990 .. 5 . proliferation ( proliferation hyperplasia multiplication . cell proliferation number . growth tumor growth size . invasion infiltration . extension progress progress .. doubling time 2 .. m arginal m argin .. intralesional margin . 60 . 2 1990. tum or m arker . , .. (brachytherapy). -19- mm . 60 137 198 192 125 . (1) . (2) (3) .. 100 .. 1cm 100% 2cm 25% 3cm 11% .. remote controlled afterloading system .. remote controlled afterloading system RALS.. adenocarcinoma in situ . 1996. intraepithelial neoplasia .. 3 .. regional lym ph nodes .. advanced cancer . advanced cancer .. -20- physical finding .. 43 30 1981 . GCP GPM SP. GCP Good Clinical Practice 28 9 3 27 . GPMSP Good Post-Marketing Surveillance Practice 10 9 3 10 . GCP GCP 1997 . skip m etastasis.)

10 3 2000. Squam ous cell carcinom a epiderm oid carcinom a Squamous cell carcinoma . epidermoid .. Staging laparotom y . 2007. spiritualty . WHO .. DSM IV TR . "Religious or Spiritual Problem" ( ) .. -21- restriction fragm ent length polym orphism RFLP . DNA .. neurological m anifestation screening . 3 12% . 4 35 . QOL .. National Comprehensive Cancer Network Guideline .. overall survival OS .. survival tim e .. survival rate .. (second opinion).. 1970 .. -22- .. second look operation .. interval cytoreductive surgery 2 second look operation . incisional biopsy excisional biopsy .. Sensitive relapse , , , . , , . ,sensitive relapse , .. Barrett .. dysplasia .. preinvasive cancer carcinoma in situ . occult carcinoma latent carcinoma . occult latent occult carcinoma cancer of unknown primary latent carcinoma .. 4 . 2010.