頁籤選單縮合
題 名 | 手術中放射治療: 林口長庚紀念醫院的初步經驗=Intraoperative Radiation Therapy: The Preliminary Experience in Chang Gung Memorial Hospital |
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作 者 | 林信吟; 曾雁明; 蔡介生; 陳文政; 曾振淦; 鄭隆賓; 詹益銀; 王嘉修; 葉大森; 王正儀; 洪志宏; | 書刊名 | 放射治療與腫瘤學 |
卷 期 | 5:2 1998.06[民87.06] |
頁 次 | 頁73-80 |
分類號 | 416.36 |
關鍵詞 | 手術中電子射線放射治療; 手術中近接放射治療; 體外放射治療; Intraoperative electron radiotherapy; IOERT; Intraoperative brachytherapy; IOBRT; External beam radiotherapy; EBRT; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:對於局部侵犯相當嚴重或發生局部復發之腹部、骨盆腔內的惡性腫瘤而言, 僅靠單一種治療方式要來達到長期的疾病控制及存活率是相當困難的。本研究主要是報告林 口長庚醫院對於上述情況的腫瘤採用手術中放射治療的初步經驗。 材料與方法:自1996年3月起,本院開始針對下列情況的腫瘤採用手術中合併使用放射 治療的方式。一類是針對原發但尚未經過其它方式治療的腫瘤{如胰臟癌、胃癌);另一類則 是對復發的骨盆腔內腫瘤(如直腸癌、子宮頸癌)做救援性的治療。至1997年11月止,共治 療了48位成人患者,年齡分布從32.4至75.7歲(中位數:60.5歲)。治療的患者計有19例 胰臟癌、6例膽道癌、6例胃癌、9例大腸直腸癌、11例復發的空腸平滑肌肉瘤(jejunal leiomyosarcoma)、及7例復發的婦科惡性腫瘤。 結果:58%的患者至今仍存活,包括7例胰臟癌、4例膽道癌、3例胃癌、8例大腸直腸 癌、及5例婦科惡性腫瘤。除了能夠接受骨盆腔器官全摘除的骨盆腔腫瘤之外,其它病例在 手術中放射治療之時仍有殘留的腫瘤或甚至根本無法切除該腫瘤。74%之胰臟癌患者在術前 因腫瘤壓迫到主動脈旁神經叢引起的極度疼痛在接受手術中放射治療之後即刻得到相當好的 緩解。與手術中放射治療的高劑量有關之併發症至目前為止有1例發生(2%)。 結論:對於局部有極高復發危險性之腹部—骨盆腔惡性腫瘤而言,手術中放射治療是個 安全且可行的治療方式之一。手術中放射治療對於減輕胰臟腫瘤所引起的疼痛相當有效。進 一步的評估須要更長時間的追蹤。 |
英文摘要 | Purpose: In patients with locally recurrent or advanced abdominal/pelvic malignancies, long-term disease control and survival are difficult to achieve with single modality therapy. This report presents the preliminary results of intraoperative radiotherapy (IORT) in our hospital. Materials and Methods: In our hospital. IORT has been utilized either as part of the initial management in some previously untreated primary malignancies (e.g., pancreatic carcinoma, gastric carcinoma) or part of the salvage or adjuvant treatment in other malignancies (e.g., recurrent rectal or cervical cancer) since March 1996. Up to November 1997, 48 adult patients underwent this treatment modality with age ranging from 32.4 to 75.7 years old (median: 60.5). The malignancies treated by IORT consisted of 19 pancreatic cancers, 6 cholangiocarcinomas, 6 gastric cancers, 9 colorectal cancers, one case of recurrent jejunal leiomyosarcoma, and 7 gynecologic cancers. Result: Twenty-eight of 48 patients (58 %) were alive (including 7/19 pancreatic cancers, 4/6 cholangiocarcinoma, 3/6 gastric cancers, 8/9 colorectal cancers, 5/7 gynecologic cancers). Except for some patients with pelvic malignancies receiving pelvic exenteration, all of the other patients had either gross residual or unresectable disease. Seventy-four percent of the patients with pancreatic cancer suffering from epigastralgia or back pain before treatment had achieved good symptomatic relief after surgery and IORT. IORT-related complications due to high dose irradiation occurred in two patients (4 %). Conclusion: The preliminary results suggested that IORT was a safe and feasible modality for abdominal pelvic malignancies at high risk for local recurrence. It was especially effective in relieving tumor pain caused by pancreatic cancer. Longer follow-up should be needed to evaluate the toxicity and efficacy of this approach. |
本系統中英文摘要資訊取自各篇刊載內容。