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題名:POSTOPERATIVE RADIATION THERAPY IN PATIENTS WITH PATHOLOGIC RISKS OF STAGE IB TO IIA CERVICAL CARCINOMA     (18點)
初期子宮頸癌之手術後放射線治療
著者:Chung-Man Leung(梁頌文) ;Yu-Chang Hu(胡渝昌) ;Chien-Hsun Chen(陳建勳) ;Wen-Shan Liu(劉文山) ;Yuen-Yee Kan(簡婉儀) ;Ching-Hsiung Chang(張慶雄)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:子宮頸癌 ; 手術後放射線治療 ; 預後因子 ; Cervical cancer ; Postoperative radiotherapy ; Prognostic factors
刊名:Therapeutic Radiology and Oncology
頁碼:71-79
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

且且: 探討手術後放射線治療對於初期子宮頸癌之結果及病理預後因子o 材蚓血有注:自1 9 9 1 年4 月至2 0 0 0 年1 2 月, 共有1 3 0 位罹患子宮頸癌之病患接受根除性子宮切除術台併骨盆淋巴腺摘除術與手術後放射線治療。其中1 9 位病患接受化學治療。所有病患於術後病理檢查發現至少有下述一項危險因子: 1. 骨盆淋巴轉移、2 .淋巴轉移個數超過l個、3 .子宮旁組織侵犯、4 . 血管間隙侵犯、5 . 手術切繞不足、6 . 原發腫瘤大於4公分、7 .多於一項危險因子口體外放射線治療給予每一位病患全骨盆腔4 1 - 5 4 Gy 之腫瘤劑量, 分次劑量為1.8Gy " 其中1 24 位病患利用腔內近接治療給予陰道縫台緣2 .5 - 2 1 .5 Gy 之追加劑量。 站里:五年全部存活率及無疾病存活率分別為7 6 . 5 % 和7 6 . 1 % " 6 位病患發生局部復發, 16 位病患發生追端轉移, 7 位病患發生局部復發及遠端轉移。單變數分析的結果指出: 只有血管間隙侵犯對存活率有顯著性的影響( p =0.05 )口血管間隙侵犯及多於一項危險因子與高遠端轉移發生機率相關( p =0.05 及p = 0 .0 2 ) 口以多因子分析而言, 只有血管問隙侵犯仍然為存活率的影響因子。20位( 1 5 % )病患治療後出現後遺症:胃腸道方面有1 2位( 9 % ) , 泌尿系統方面有8位( 6 % ) 。五年無發生後遺症機率為9 1 % '其中1 0位( 8 % ) 病患有3 -4 級的後遺症。 結論:此研究結果, 對於初期子宮頸癌病患接受根除性子宮切除術台併手術後放射線治療, 能給予病患合理的存活率。但如果病患其有血管間隙侵犯或多於一項危險因子, 其存活時間較短且遠端轉移發生率較高。
Purpose : To investigate the prognostic impact of pathologic risk factors and failure patterns in patients with stage IB to IIA cervical carcinoma treated with postoperative adjuvant pelvic irradiation. Material and Method : Between April 1991 to December 2000, 130 patients with FIGO IB to IIA carcinoma of the cervix were treated with radical hysterectomy, bilateral pelvic lymphadenectomy and postoperative radiation therapy. Nineteen patients received systemic chemotherapy. All the patients had at least one of the following pathologic risk factors: 1. positive pelvic nodal metastasis, 2. multiple positive lymph nodes, 3. parametrial invasion, 4. vascular space invasion, 5. positive surgical margin, 6. bulky tumor size > 4 cm, 7. multiple pathologic risk factors. The radiation dose delivered to the whole pelvis range from 41-54 Gy in 1.8 Gy fractions. One hundred twenty-four patients received 2.5- 21.5 Gy intracavitary brachytherapy. Results : The patients were followed for a median of 57.9 months (range: 4.1 - 129.9). The 5-year overall survival and disease free survival rate were 76.5% and 76.1%, respectively. A total of 29 (22.3%) patients developed recurrence. Six recurrences were in the pelvis alone. Sixteen patients recurred only at sites outside the pelvis. Seven patients had both pelvic and distant recurrences. We demonstrated that only vascular space invasion had significant effect on disease free survival by univariate analysis (p = 0.05). Vascular space invasion and multiple pathologic risk factors were significantly correlated with higher incidence of distant metastasis. (p = 0.05 and p = 0.02, respectively). In multivariate analysis of these factors showed that only vascular space invasion remained significant risk factors (p = 0.05). Therapeutic complications occurred in 20 (15%) patients, including gastrointestinal in 12 (9%) patients or genitourinary in 8 (6%) patients. The overall 5-year complication-free rate was 91%. Ten (8%) of those patients had grade 3 and 4 late morbidity. Conclusion : Our study suggested that postoperative radiotherapy after radical hysterectomy give reasonable survival in early stage carcinoma of the cervix. Poor survival and higher incidence of distant metastasis were observed if presence of vascular space invasion or multiple pathologic risk factors.


    

本卷期目次
Therapeutic Radiology and Oncology
Outcome of Radiotherapy in Histologically Confirmed Neoplasms of the Pancreas/ Yuan-Hua WuPin-Wen LinWu-Chou SuHelen H. W. Chen
Postoperative Chemoradiotherapy in Locally Advanced Esophageal Carcinoma: Low-Dose and Standard-Dose Radiotherapy Compared/ Yi-Hsien LinKwan-Hwa ChiCheng-Ying ShiauLing-Wei WangSheng-Yu ChenMien-Jung LiangYu-Ming LiuSang-Hue Yen
Brain Metastasis from Small Cell Cervical Carcinoma with Long-Term Survival - A Case Report/ Yi-Wei ChenLing-Wei WangKen-Jen YuChin-Chen PanHsiu-Mei WuRen-Shyan LiuSang-Hue Yen
Postoperative Radiation Therapy in Patients with Pathologic Risks of Stage IB to IIA Cervical Carcinoma/ Chung-Man LeungYu-Chang HuChien-Hsun ChenWen-Shan LiuYuen-Yee KanChing-Hsiung Chang
Radiation Therapy for Malignant Pheochromocytoma: Two Case Report and Review of the Literature/ Hsing-Lung ChaoJing-Min HwangYee-Min JenDai-Wei LiuHon-Yi LinWeng-Yoon ShumChun-Shu Lin
Postirradiation Malignant Fibrous Histiocytoma of the Breast: A Case Report and Review of the Literature/ Dai-Wei LiuWen-Lin HsuYung-Hsiang HsuMoon-Sing LeeHis-Sheng ChsiaEn-Lin TsaiYi-Ru JuShao-Hu Wu
Primary Breast Lymphoma Treated with Chemotherapy and Local Radiotherapy: Case Report and Review of Literature/ Chia-Chun HuangMu-Tai LiuChu-Ping PiTung-Hao Chang
Non-AIDS Kaposi's Sarcoma: Case Report and Review of the Leiterature/ Shih-Kai HungKuo-Hwa ChangHsien-Chih TsaiHong-Wen ChenShun-Ting ChenYuen-Liang Lai
BRAIN METASTASIS FROM SMALL CELL CERVICAL CARCINOMA WITH LONG-TERM SURVIVAL-A CASE REPORT/ Yi-Wei ChenLing-Wei WangKen-Jen YuChin-Chen PanHsiu-Mei WuRen-Shyan LiuSang-Hue Yen
NON-AIDS KAPOSI'S SARCOMA: CASE REPORT AND REVIEW OF THE LEITHERATURE/ Shih-Kai HungKuo-Hwa ChangHsien-Chih TsaiHong-Wen ChenShun-Ting ChenYuen-Liang Lai
POSTIRRADIATION MALIGNANT FIBROUS HISTIOCYTOMA OF THE BREAST: A CASE REPORT AND REVIEW OF THE LITERATURE/ Dai-Wei LiuWen-Lin HsuYung-Hsiang HsuMoon-Sing LeeHsi-Sheng ChsiaEn-Lin TsaiYi-Ru JuShao-Hu Wu
PRIMARY BREAST LYMPHOMA TREATED WITH CHEMOTHERAPY AND LOCAL RADIOTHERAPY: CASE REPORT AND REVIEW OF LITERATURE/ Chia-Chun HuangMu-Tai LiuChu-Ping PiTung-Hao Chang
POSTOPERATIVE RADIATION THERAPY IN PATIENTS WITH PATHOLOGIC RISKS OF STAGE IB TO IIA CERVICAL CARCINOMA/ Chung-Man LeungYu-Chang HuChien-Hsun ChenWen-Shan LiuYuen-Yee KanChing-Hsiung Chang
OUTCOME OF RADIOTHERAPY IN HISTOLOGICALLY CONFIRMED NEOPLASMS OF THE PANCREAS/ Yuan-Hua WuPin-Wen LinWu-Chou SuHelen H. W. Chen
POSTOPERATIVE CHEMORADIOTHERAPY IN LOCALLY ADVANCED ESOPHAGEAL CARCINOMA: LOW-DOSE AND STANDARD-DOSE RADIOTHERAPY COMPARED/ Yi-Hsien LinKwan-Hwa ChiCheng-Ying ShiauLing-Wei WangSheng-Yu ChenMien-Jung LiangYu-Ming LiuSang-Hue Yen
RADIATION THERAPY FOR MALIGNANT PHEOCHROMOCYTOMA: TWO CASE REPORT AND REVIEW OF THE LITERATURE/ Hsing-Lung ChaoJing-Min HwangYee-Min JenDai-Wei LiuHon-Yi LinWeng-Yoon ShumChun-Shu Lin
 
   
 
   

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