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題名 | 子宮頸癌接受單獨放射治療後發生遠處轉移的分佈與結果 |
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作者姓名(中文) | 方富民; 梁雲; 張簡展照; 王重榮; 陳惠君; 孫立民; 許軒之; | 書刊名 | 長庚醫學 |
卷期 | 18:4 1995.12[民84.12] |
頁次 | 頁347-352 |
分類號 | 417.2832 |
關鍵詞 | 子宮頸癌; 放射線治療; 遠處轉移; Carcinoma of uterine cervix; Radiotherapy; Distant metastasis; |
語文 | 中文(Chinese) |
中文摘要 | 從1988年至1992年5月,共有286位子宮頸癌病患至本院接受單獨放射線治療。經過至少兩年的追縱檢查,共有61位(21%)病患發生遠處轉移。依FIGO分期,其發生率分別是I:2/39,IIa:1/19,IIb:20//118,III:34/101,IVa:4/9。85%(52/61)的病患開始產生遠處轉移,是在治療後2年內發生的。61位病患中,23位只發生一器官轉移;38位發生多處器官轉移。轉移部位的分佈主要在淋巴腺(38位)、肺臟(28位)、骨骼(27位)、腹部(20位)。淋巴腺的轉移處狂要在左側鎖骨上寫(15位)、主動脈旁(18位)及腹股溝(5位)。骨骼轉移部位,主要在脊椎骨(23位),尤其是腰椎(20位)。腹部的轉移以腹腔內(15位)、肝臟(5位)為主。各種器官轉移的發生是在治療後2年內的機率分別是:肺:75%(21/28),骨骼:62%(18/29),左側銷骨上淋巴腺:60%(9/15),主動脈旁淋巴腺:72%(13/18),腹腔內:86% (13/15),肝臟:66%(2/3),腦:0%(0/4)。 六十一位病患發生遠處轉移後,其中值存活時間為6.4個月。2年的存活率(actuarial survival)為14%。單一器官轉移比多?器官史移,或單獨遠處轉移比伴隨局部復發者,經單一雙數分析,在存活率上並無統計上的差異(p>0.05)。而發生轉移後,曾接受過化學治療或放射治療的23位病患,其存活率明顯高於只接受支持性療性的38位病患(1年存活率34% vs. 2.4%,p<0.05)。 |
英文摘要 | From 1988 to May, 1992, there were 286 patients with pathology-proved carcinoma of the uterine cervis referred to Chang Gung Memorial Hospital, Kaohsiung to receive definite radiotherapy. Sixty-one (21%) patients were found to develop distant metastasis after radiotherapy for at least 2 years follow-up. By FIGO stage, the incidence of distant metastasis was as follows: I :2/29, II a:1/19, II b:20/118, III :30/101, IV a:4/9. Eighty-five percent patients (52/61) began to develop distant metastasis within the first 2 years after radiotherapy. Twenty-three patients developed single organ metastasis, an 38 patients developed multiple organ metastasis. Lymph nodes (38 patients), lung (28 patients), bone (27 patients), and abdomen (20 patients) were the common sites of distant metastasis. Lymph nodes metastasis occurred most often at supreaclavicular lymph nodes (15 patients), para-aortic lymph nodes (18 patients), and inguinal lymph nodes (5 patients). Spine (23 patents), especially the lumbar spine (20 patients) was the most common site of bony metastasis. Abdominal metastasis occurred in abdominal cavity (15 patients) or liver (5 patients). The incidence of metastasis within the first two years after radiotherapy was lung: 75% (21/28), left supraclavicular lymph nodes: 60% (9/15), para-aortic lymph nodes: 72% (13/18), intra-abdominal cavity: 86% (13/15), liver: 66% (2/3), brain: 0% (0/4). The 2-year actuarial survival rate for the 61 patients after developing distant metastasis was 14%, with a median survival time of 604 months. There was no significant difference in survival when comparing patients with single organ metastasis and with multiple organ metastasis (p<0.05), or patients with distant metastasis along and with distant metastasis alone and with distant metastasis combined with local recurrence (p>0.05). Otherwise, after distant metastasis twenty-three patients receiving chemotherapy or radiotherapy had a significantly higher 2-year survival rate than 38 patients receiving supportive care only after distant metastasis (34% vs. 2.4%, p<0.05). . |
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