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題名 | Concurrent Chemoradiotherapy for Unresectable Thymic Carcinoma=對於無法手術切除之胸腺癌以同步化學及放射線治療之效果 |
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作者 | 陳彥仰; 黃承華; 唐曄; 刑福柳; | 書刊名 | 長庚醫學 |
卷期 | 27:7 民93.07 |
頁次 | 頁515-522 |
分類號 | 416.226 |
關鍵詞 | 胸腺癌; 同步化學及放射線治療; 放射線治療; 化學治療; Thymuic; Carcinoma; Chemotherapy; Radiotherapy; Concurrent chemoradiotherapy; |
語文 | 英文(English) |
中文摘要 | 背景:胸腺癌是一種罕見的前縱隔腔腫瘤,相較於傳統之胸腺瘤,其較具侵襲性,預後較差,由於診斷時常廣的侵犯周邊器官或達端移轉,往往無法做根性的手術切除,然而化治療的角色及最適當的治療模式目前尚未有定論,我們分享以同步化學及放射線治療來處理無法手術初除之胸腺癌的經驗。 方法:於1989年7月至2003年7月共收集了29例於高雄長庚醫院斷為無法手術切除之胸癌作回朔性的分析,共有16人托受同步化學及放射線治療,其中10位男性6位女性,中位年齡53歲。 結果:共有4人達到完全緩解,4人部份緩解,反應率為50%,中位存活期為82個月,第1年、第2年、第3年、及第5年存活率分吸為93.8%、81.3%、74.5%、67.7%,放性肺炎是最常見的副作用,但沒有第三級和第四級的毒性危及生命副作用。 結論:同步化學及放射線治療對無炸法手術初除之胸腺癌似乎是有效的治療模式可延長病人的存活期,但是仍需要大規模研究來證實之。 |
英文摘要 | Backgroud: Thymic carcinoma is a rare anterior mediastinal neoplasm. It is more invasive and has a poorer prognosis than ordinary thymoma. Complete curative resection is requently impossible to achieve because of extensive invasion or metastasis at diagnosis. The role of systemic chemotherapy and the optimal regimen in thymic carcinoma remain uncertain. We report our experience with 16 patients with unresentable thymic carcinoma who underwent concurrent chemoradiotherapy. Methods: Between July 1989 and July 2003, 29 patients were diagnosed with unresectale thymic carcinoma at oru hospital. Sixteen of the 29 patients were treated with concurrent chemoradiotherapy. There were 10men and 6 women whose ages ranged from 45 to 66 years old. Chemotherapy regimens consisted of either (A) cisplatin plus 5-fluorouracil or (B) doxorubicin, cist-platin, vincristine and cyclophosphamide every 4 weeks for at least 5 cycles. Radiotherapy was given concurrently and ranged from 34.2 to 70 Gy. Results: There were 4 (25.0%) patients with complete responses , 4 (25.0%) with partial responses, 6 (37.5%) with stable disease and 2 (12.5%) with progressive disease. The overall response rate was 50%. The median follow-up was 64 months, and the median survival was 82 months. The overall cumulative survival rates at 1, 2, 3, and 5years were 93.8%, 81.3%, 74.5%, and 67.7%, respectively. The most common side effects were Grade I/II toxicity, including vomiting, fatigue, and espohagitis. Were noted. Conclusions: Concurrent chemoradiotheraphy seems effective for unresectable thymic carcinoma. Oru experience, although preliminary, is ec ouraging and merits conducting a randomized trial to determine the impact of concurrent chemoradiotherapy on unresectable thymic carcinoma. |
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