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題名 | 剖腹產手術中難產的原因和治療=The Etiology and Treatment of Cesarean Dystocia |
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作者 | 李耀泰; 郭宗正; 陳福民; Li, Yiu-tai; Kuo, Tsung-cheng; Chen, Fu-min; |
期刊 | 臺灣醫學 |
出版日期 | 20051100 |
卷期 | 9:6 民94.11 |
頁次 | 頁803-805 |
分類號 | 417.37 |
語文 | chi |
關鍵詞 | 剖腹產手術; 難產; Cesarean section; Dystocia; Impacted fetal head; Unstable lie; |
中文摘要 | 目的:食道癌是一種非常惡性及常常在疾病後期才診斷出來的疾病。即使經過積極的外科手術治療,存活率仍然不盡理想。一些研究機構已經證實同步化學放射線治療可以增加存活率及局部控制。鑑於國外設計的化學藥物劑量對於本國人來說可能副作用太大而不適合,我們設計了一套術後週期性及低劑量的同步化學放射線治療局部進展性的食道癌。除此之外,遠端轉移常是治療失敗的主因之一。因此,除了同步化學放射線治療之外,我們再加上全身性的化學治療當作我們治療食道癌的計畫。 樣料與方法:從1999年6月到2003年2月共有36位局部進展性的病人。經過手術之後,其中18位病人接受同步化學放射線治療及全身性的化學治療,其餘18位病人只單獨接受放射線治療。放射線治療對於兩組的設計劑量相同,為60Gy。同步化學治療為每週一次低劑量的cisplatin (30mg/m2),共6次。間隔3到4週後,給于全身性的化學治療。設計劑量為每月一次,每次cisplatin (20mg/m2)加5-FU(1000mg/m2)D1~D5,共4次。 結果:治療結果在這兩個組別對於中值存活(17.5 months vs. 10 months)及2年存活率 (77% vs. 44%, p=0.02)。血液及非血液性副作用在這兩個組別是相當的。 結論:在這個研究設計之下,術後週期性及低劑量的同步化學放射線治療合併全身性的化學治療,對於局部進展性的食道癌,不但在副作用上是可以接受的,而且在存活率及局部控制上是有幫助的。 |
英文摘要 | Purpose: Carcinoma of the esophagus is a virulent malignancy with poor survival despite aggression resection. This pilot study was conducted to evaluate the efficacy and toxicity of a three-step combination therapy for locally advanced esophageal cancer Material and Methods: We retrospectively reviewed patients with esophageal carcinoma treated at our institution from July 1999 to February 2003. Patients were included in the study if they had T3 to T4, N0/N1, and M0 stage disease. All patients underwent a curative resection with a margin negative for malignant cells. There were 18 patients who then had adjuvant concurrent chemoradiation (CCRT group) and systemic adjuvant chemotherapy and 18 had surgery followed by radiation alone (RT group). Total doses of 60Gy for both groups were giver. In addition to RT, the CCRT group received concurrent chemotherapy consisting of 6 weekly doses of cisplatin (CDDP) (30mg/m2). CCRT was followed by adjuvant chemotherapy consisting of 4 monthly cycles of CDDP (20mg/m2/day) plus 5-fluorouracil (1000mg/m2/day) for 5 consecutive days. This study looked at survival, toxicity, and patterns of failure. Results: The CCRT group had significantly better median survival (17.5 months vs. 10months) and 2-year survival (77% vs. 44%, p=0.02). Hematologic and non-hematologic toxicities were generally comparable in both groups. Conclusion: In this preliminary study, we have demonstrated that surgery followed by CCRT improves survival and locoregional control and decreases distant metastasis in local advanced esophageal cancer with acceptable toxicity. A large-scale, prospective randomized trial of this regimen is warranted. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。