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題名 | Preoperative Corticosteroid Therapy for Chemoresistant Invasive Thymoma: A Case Report=對化學治療抗性之侵襲性胸腺瘤使用手術前類固醇治療--成功病例報告 |
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作者 | 陸希平; 張逸良; 李元麒; 李俊仁; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 30:6 民86.11-12 |
頁次 | 頁429-433 |
分類號 | 416.226 |
關鍵詞 | 化學治療; 胸腺瘤; 類固醇治療; Thymoma; Neoadjuvant therapy; Corticosteroid; |
語文 | 英文(English) |
中文摘要 | 由於胸腺瘤常侵犯縱隔腔附近重要的結構,故常影響根治性切除手術的施行,直至目前仍是深具挑戰的課題。術前化學治療合併外科切除目前相當受到注意並有不錯的初步結果。以Cisplatin為主的合併化療法是目前最常使用的方式。類固醇常合併其它藥物,但極少單獨使用以為術前之化學治療。在本篇報告一27歲男性病人罹患原本無切險的侵襲性胸腺瘤,經兩次合併化療法失敗且產生極大副作用嘗試使用類固醇單一治療,結果腫瘤明顯縮小並成功切除腫瘤。經術後電療及一年追蹤情況穩定。對於侵襲性胸腺瘤嘗試使用化學治療,但無效的病人,或許可嘗試類固醇治療的方法。 |
英文摘要 | Treatment for invasive thymoma still faces difficulities if the tumor pervades to vital structures or spreads to the pleura and hampers resection. Neoadjuvant chemotherapy followed by surgical resection is a new trial and has had positive results. Cisplatin-based combination therapy is the most common regimen used for neoadjuvant therapy at present. Corti-costeroid was often used as a component, but rarely as a single agent for neoadjvant therapy. Here we describe a 27 year-old patient with primarily unresectable thymoma due to tumor compression and encasement of the great vessels. After the failure of two courses of combination chemotherapy, prednisolone 60mg per day was used for three weeks and obtained partial remission. Subsequent surgical resection and postoperative irradiation were successfully undertaken. No tumor recurrence or distant metastasis has been found within 40 months of follow-up. It is concluded that for patients with advanced thymoma which is refractory to conventional regimen of chemotherapy, corticosteroid can be used as an alternative. |
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