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題名 | Kadish Stage C Olfactory Neuroblastoma Successfully Treated by Chemoradiotherapy: Report of Two Cases=合併化學放射療法可成功治療Kadish氏C期嗅神經母細胞瘤:二例報告 |
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作者 | 賴建宏; 王正旭; 曾雁明; 薛純; | 書刊名 | 長庚醫學 |
卷期 | 21:4 1998.12[民87.12] |
頁次 | 頁487-492 |
分類號 | 415.9 |
關鍵詞 | 嗅神經母細胞瘤; 鼻腔; Kadish氏分期; 化學療法; Olfactory neuroblastoma; Nasal cavity; Kadish stage; Chemotherapy; |
語文 | 英文(English) |
中文摘要 | 嗅神經母細胞瘤是一種少見的腫瘤,病患求診之臨床症狀最常見者為單側性鼻塞, 而於初診時即發現頸部淋巴結轉移者僅佔10-20%。臨床上常用Kadish分期系統將此病分為 A期:腫瘤侷限於鼻腔;B期:腫瘤侷限於鼻腔及副鼻竇;C期:腫瘤侵犯至鼻腔或副鼻竇之 外,包括眼窩,顱底,顱腔,頸部淋巴結轉移或遠端轉移。學者之間對於Kadish分期與病患 預後之關聯性,看法並不一致,但為便於比較彼此研究之結果,Kadish分期系統仍為廣泛地 使用。嗅神經母細胞瘤之病程通常進展緩慢,疾病之復發多在完全緩解的2年內發生,但於5 年之後復發者並不少。復發之部位多在局部,其次為頸部淋巴結轉移,而遠端轉移者並不多 。於疾病復發後若給予積極的治療,常可成功地再次達成完全緩解。由於此種腫瘤之病例稀 少,罕見單一醫院能累積足夠之治療經驗者,故目前也無對此疾病的標準療法。傳統治療方 式以外科切除或放射治療為主,多數醫師偏好合併使用手術治療及放射療法。化學療法多與 放射治療合併,通常用於晚期或是無法手術治療的腫瘤,許多接受化學療法的病患對藥物的 反應迅速而良好。在此我們報告兩例以化學及放射合併療法治療的Kadish氏C期病例,2例對 於前導性化學療法皆有極佳且快速的反應,而且至今2位病人之無病存活期分別已超過5年及 2年。由於病例之稀少,考慮疾病之復發型態,並基於我們對此2病例之觀察,採用化學及放 射合併療法,而將手術治療保留作為腫瘤復發之處理方式,是一項合理的安排,可以考慮選 擇作為另一種治療策略。 |
英文摘要 | Olfactory neuroblastoma is an uncommon tumor. It is usually diagnosed at advanced stages. Most of the patients have an indolent clinical course with slow progression, late recurrence and relative infrequency of distant metastasis. Because of the rarity and lack of a randomized clinical trial of patients with olfactory neuroblastoma, there is no standard treatment for the disease. The survival period has increased as treatments have been improve since 1980. Conventional treatments mainly consist of surgery and/or radiotherapy. Chemotherapy was only administered to a few patients; however, it achieved good response. More clinical experience is needed to improve the treatment strategy in order to reduce the possibility of disease recurrence, and also for rescue therapy. We present 2 patients with Kadish C tumors treated using chemotherapy followed by radiotherapy. Both patients demonstrated rapid and excellent response to induction chemotherapy, and have been free of disease for more than 5 years and 2 years after treatment, respectively. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。