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題 名 | 體外及管腔內放射線治療肝門部癌--治療前後膽道鏡影像之變化 |
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作 者 | 詹益銀; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 21:4 1988.07[民77.07] |
頁 次 | 頁427-434 |
分類號 | 416.246 |
關鍵詞 | 體外及管腔內放射線治療; 肝門部癌; 膽道鏡影像; |
語 文 | 中文(Chinese) |
中文摘要 | 長庚紀念醫院一般外科自1985年1月至1985年12月間共有5位肝門部癌病人接受體外放射及管腔內放射治療,1男4女,年齡最小53歲最大68歲。3位是肝門部及肝內肝管癌因無法切除經置放T形 管引流後給予放射線輔助治療,1例是肝門及右側肝管腫瘤經術後膽道鏡生檢證實腺癌後給予放射線治療,另1例是再發性左側肝管癌接受放射線治療。5位病人接受體外放射30格雷,另外4位病人又接受管腔內放射15至24格雷。放射線治療後2位病人臨床症狀即膽管內黏液物質明顯消失,膽道攝影檢查60%(3/5)有明顯進步,而膽道鏡檢查80克(4/5)均可發現管腔內腫瘤壞死、變小甚至完全消失。除了一位病人接受放射線治療後發生局部皮膚炎外並無明顯的企身反應。 對于無法切除,再發性或術後殘留為組織之肝門部癌,體外放射及管腔內放射是一種適當的輔助性治療,經由臨床症狀,膽道攝影及膽道鏡追蹤撿查證實有效,至于最適當的放射劑量及能否延長活存時間則有賴更多病例及更長時間的追蹤及分析。 |
英文摘要 | Five patients with proximal bile duct cancer were treated with radiation therapy-teletherapy and intra-luminal radiotherapy (ILRT) from J an. to Dec. 1986 at Chang Gung Memorial Hospital. There was one man and four women, age ranged from 53 to 63 years. The location of the tumors were porta hepatis and right hepatic duct in 3, porta hepatis and left hepatic duct in 1 and another recurrent tumor in the left main hepatic duct. All received 30 Grays teletherapy to the porta hepatisand ILRT by high dose rate Co-60 remote afterloading technique 15-24 Grays in 4 out of 5 patients. Treatment response was assessed on the basis of choledochoscopic findings, cholangiographic response, improvement of clinical symptoms, and survival time. Choledochoscopic examination showed regression of the the tumor in 80% (4/5). One patient had complete regression of the tumor. Follow up cholangiogram showed adequate patency of the biliary tree or a decrease in size of the filling defect in 60% (3/5) of the patients. Two patients became of cholangitis free with mucinous substance subsiding from the T-tube after radiation therapy was completed. Survival time after radiation therapy ranged from 6 months to 16 months. One patient died 9 months after radiation due to cachexia and massive ascites. External radiation and intra-luminal radiation therapy is suitable and effective adjunctive therapy for unresectable, recurrent or post-operative residual tumor in the patient with proximal bile duct cancer. Choledochoscopy is an effective method for assessing raddiation effects. |
本系統中英文摘要資訊取自各篇刊載內容。