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- Palliative Splenic Irradiation for Splenomegaly: Retrospective Review of Experience at the Mackay Memorial Hospital
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題名 | Palliative Splenic Irradiation for Splenomegaly: Retrospective Review of Experience at the Mackay Memorial Hospital=脾臟腫大的緩和性放射治療 |
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作者 | 蘇文浩; 賴允亮; 陳裕仁; 張國華; Su, Wen-hao; Lai, Yuen-liang; Chen, Yu-jen; Chang, Kou-hwa; |
期刊 | 放射治療與腫瘤學 |
出版日期 | 20051200 |
卷期 | 12:4 民94.12 |
頁次 | 頁277-283 |
分類號 | 416.36 |
語文 | eng |
關鍵詞 | 脾臟放射治療; 脾臟腫大; 緩和性放射治療; Splenic irradiation; Splenomegaly; Palliative radiotherapy; |
中文摘要 | 引言:許多文獻指出脾臟的放射治療可用於治療一些血液腫瘤。脾臟的放射法效果良好且副作用很少,相較於一些內科療法其花費也較低,對於緩和脾臟腫大的症狀有其存在價值。我們回顧本院的脾臟放射治療的經驗並分析及討論其有效程度。 材料與方法:自2000年1月至2004年8月共有12位病患於本科接受脾臟的放射治療。包括4位慢性骨髓性白血病病患、3位肝硬化、2位再生不良性貧血、1位急性淋巴性白血病。1位何杰金氏淋巴瘤及1位自發性骨髓纖維化的病人,總共接受18個療程的放射治療。使用鈷-60、6與15百萬伏特之光子射線,以前後相對照野照射,每天劑量為50-160 cGy,總劑量為500 cGy到2400 cGy。 結果:共有4位病患(3位慢性髓性白血病病患、1位自發性骨髓纖維的病人)及7個療程有良好療效。另外有6位病患(2位肝硬化,慢性骨髓性白血病病患、急性淋巴性白血病、再生不良性貧血及何杰金氏淋巴瘤各1位)及9個療程有部份的療效。有2位病患對於治療沒有療效,其診斷分別為肝硬化及再生不良性貧血。 討論:脾臟的放射治療可以輕因血液腫瘤及自發性骨髓纖維化所造成的脾臟腫大的症狀。在我們的經驗中,對於慢性骨髓性白血病的病患有良好效果。對於非惡性腫瘤造成的脾臟腫大,脾臟的放射治療效果則較差,需要進一步的研究來證明此一觀點。 |
英文摘要 | Introduction: Splenic irradiation had been applied for many years as a treatment for various hematologic diseases. Its excellent effects, minimal side effects and low-cost make it as a reasonable treatment policy for palliation. We reviewed our experience of splenic irradiation and discussed its efficacy. Materials and Methods: Thirteen cases received splenic irradiation at our department from January 2000 to August 2004, and twelve cases were eligible for analysis. Diseases included chronic myelogenous leukemia (4), liver cirrhosis (3), anaplasitc anemia (2), acute lymphocytic leukemia (1), Hodgkin’s lymphoma (1) and idiopathic myelofibrosis (1). Eighteen courses of radiotherapy were delivered. The radiation treatment techniques consisted of two opposed fields of Co60 and 6 or 15 MV photons targeting to the spleen. The cumulative doses ranged from 500 cGy to 2400 cGy with fraction size ranging from 50 to 160 cGy. Results: Good response was observed in four patients (3 cases of CML, 1 case of idiopathic myelofibrosis) and 7 courses of radiotherapy. Partial response was observed in six patients (2 cases were liver cirrhosis, the other 4 cases were CML, ALL, anaplatic anemia and Hodgkin’s lymphoma) and 9 courses of radiotherapy. Two patients were not responsive to the treatment, who were suffering from liver cirrhosis and anaplastic anemia, respectively. Discussion: Splenic irradiation can achieve good palliate effects for splenomegaly resulting from idiopathic myelofibrosis and hematological malignancies, especial CML. In non-malignant diseases, such as liver cirrhosis and anaplastic anemia, the symptom relief provided by splenic irradiation was not as good as for that of the malignant disease. However, it needs further investigation. |
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