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1
題名:THE EXPERIENCE OF TOTAL BODY IRRADIATION IN BONE MARROW TRANSPLANTATION PATIENTS REFERRED TO THE CHAI-YI CHRISTIAN HOSPITAL-A PRELIMINARY REPORT     (16點)
轉診至嘉義基督教醫院做骨髓移植執行全身照射之經驗初步報告
著者:Rubin Yu-Wen Wang(王裕文) ;Tsai-Yun Chen(陳彩雲) ;Jian-Shiuh Chen(陳建旭) ;How-Ran Guo(郭浩然) ;Yin-Che Lu(盧彥哲) ;Shu-Mu Huang(黃叔牧) ;Chao-Ming Jaun(阮昭銘)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:全身放射治療 ; 骨髓移植 ; 直線加速器 ; Total body irradiation ; Bone marrow transplantation ; Linear accelerator
刊名:Therapeutic Radiology and Oncology
頁碼:11-18
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

目的:評估轉至嘉義基督教醫院來做全身放射治療的骨髓移植病患的初步療效。 材料與方法:從 2002 年 8 月到 2004 年 8 月計有 12 位白血病或淋巴瘤要骨髓移植的病患被轉來嘉義基督教醫院做全身放射治療。當中有 10 位完成了做全身放射治療,另外兩位則只做完了模擬定位。全身放射治療患者當中,9 位接受了 1200 cGy,在 3 天內分 6 次照射完畢 ;還有一位兒童則接受了 1320 cGy,在 3 天內分 6 次照射完畢。我們使用從加速器射源焦點到病患中軸的距離為 600 cm 的技術。用的機器是瓦里安的加速器,6 百萬電子伏特的光子,劑量?為每分鐘 300 到 400 監測單位。所有的病患都在部分消毒的條件做全身放射治療 ,並住在本院的骨髓移植病房。我們在病患的胸部的前後順型殼鎖上 1 公分的遮擋合金 ,並採用前後方向的照射技術,並在入射方向離患者約 10 公分處裝置了 2 公分厚的壓克力平板。 結果:到 2005 年 1 月止,完成了做全身放射治療的 10 位患者中,有 5 位還存活。存活患者之中只有 1 位患有植入體對抗宿主疾病而有慢性的口腔黏膜炎,其他的存活患者則無復發或有併發症的問題,當中甚至還有一位未分化的T細胞淋巴瘤化療後只有部分緩解的。在 5 位死亡的患者中,4 位沒有達到完全的緩解並在兩個月內因為植體沒長成功、早期復發、與和全身放射治療無關的次發性感染死去。當中還有兩位還有靜脈阻塞性的肝病。達到完全緩解的死亡病例是一位急性淋巴性白血病的患者,骨髓移植後 3 個月他得了黴菌感染,之後又有腫瘤復發,之後死於 1.5 年後。只做完模擬定位的患者則因為持續的復發和感染而無法真正的來做全身放射治療。 :我們的結果顯示,與旅途有關的感染問題在轉來的骨髓移植做全身放射治療的患者的預後參考價值並不重要。雖然患者數少且追蹤時間不長,我們仍認為初步結果可以接受。慎選合適的患者會有更好的結果,但對之前化療只有部分反應並不代表移植一定失敗。
Purpose : The objective of this study is to evaluate the initial treatment outcome of total body irradiation (TBI) in patients with bone marrow transplantation (BMT) who were referred to the Chai-Yi Christian Hospital (CYCH). Materials and Methods : From August 2002 to August 2004, 12 patients of leukemia or lymphoma were referred to the Chai-Yi Christian Hospital for TBI before BMT. Ten received TBI, and the other two received the simulation procedure only. For TBI, nine received 1200 cGy in 6 fractions over three days, and a child received 1320 cGy in 6 fractions over three days. The distance from focus of linear accelerator (LA) to middle abdomen of patients was 600 cm. We used 6 MeV photon at the dose rates of 300 and 400 monitor unit (MU) per minute with a Varian LA, but without a compensator. All patients were admitted to the BMT ward under partial aseptic environment. We placed a 1 cm lung partial block over thermoplastic shell on the patient’s chest and applied the APPA projection technique with a 2 cm-thick acrylic sheet around 10 cm ahead of the patient. Results : Of the ten patients who received TBI, five survived till January 2005. Only one patient experienced chronic graft vursus host disease with oral mucositis, and the others had no relapse or complications, including a patient with T-anaplastic cell lymphoma who had only partial remission after the chemotherapy. Of the five expired patients, four failed to achieve complete remission and died within two months due to graft failure, secondary infections not related to TBI, or early relapse. Two of them also had venous occlusive liver disease. The patient who had complete remission was a case of acute lymphoblastic leukemia who acquired fungal infection three months after the BMT followed by the relapse and died 1.5 years later. The two patients who went through simulation alone had persistent relapse, and infection episodes hindered them from receiving TBI. Conclusion : Our results suggest that infections related to the transportation of patients did not appear to be a key prognostic factor in TBI of BMT patients referred from other hospitals. Although the follow-up time is short and patient number is small, we consider the initial outcome satisfactory. Selection of patients is essential for better result, but partial remission from initial chemotherapy may not necessarily destine to failure.


    

本卷期目次
Therapeutic Radiology and Oncology
團體衛教癌症營養知識對於病患與家屬之成效探討/ 曾寶秀成佳憲賴明坤
The Experience of Total Body Irradiation in Bone Marrow Transplantation Patients Referred to the Chai-Yi Christian Hospital-A Preliminary Report/ Rubin Yu-Wen WangTsai-Yun ChenJian-Shiuh ChenHow-Ran GuoYin-Che LuShu-Mu HuangChao-Ming Jaun
Occult Breast Cancer Presenting as Axillary Nodal Metastases-A Case Report and Review of the Literature/ Yung-Hsien LiuMu-Tai LiuDar-Ren ChenWen-Tao HuangAi-Yih WangWen-Shan LiuTung-Hao ChangChu-Ping PiChao-Yuan Huang
Primary Mucosa-Associated Lymphoid Tissue Lymphoma of the Larynx: A Case Report and Literature Review/ En-Lin TsaiWen-Lin HsuDai-Wei LiuHis-Sheng ChsiaYi-Ru Su
以不同斜照技術照射乳房之比較/ 梁永昌羅素花胡尹薰何秀雯林立青
強度調控放射治療腔內膠片劑量品質保證/ 林廣軒陳合興陳信雄張國平趙敏
Rectal Sparing by Balloon Catheter Immobilization during Intensity Modulated Radiation Therapy for Prostate Cancer/ Chiao-Ling TsaiJian-Kuen WuChun-Wei WangHsiao-Ju FuJason Chia-Hsien ChengMing-Kuen Lai
RECTAL SPARING BY BALLOON CATHETER IMMOBILIZATION DURING INTENSITY MODULATED RADIATION THERAPY FOR PROSTATE CANCER/ Chiao-Ling TsaiJian-Kuen WuChun-Wei WangHsiao-Ju FuJason Chia-Hsien ChengMing-Kuen Lai
THE EXPERIENCE OF TOTAL BODY IRRADIATION IN BONE MARROW TRANSPLANTATION PATIENTS REFERRED TO THE CHAI-YI CHRISTIAN HOSPITAL-A PRELIMINARY REPORT/ Rubin Yu-Wen WangTsai-Yun ChenJian-Shiuh ChenHow-Ran GuoYin-Che LuShu-Mu HuangChao-Ming Jaun
強度調控放射治療腔內膠片劑量品質保證/ 林廣軒陳合興陳信雄張國平趙敏
以不同斜照技術照射乳房之比較/ 梁永昌羅素花胡尹薰何秀雯林立青
團體衛教癌症營養知識對於病患與家屬之成效探討/ 曾寶秀成佳憲賴明坤
PRIMARY MUCOSA-ASSOCIATED LYMPHOID TISSUE LYMPHOMA OF THE LARYNX: A CASE REPORT AND LITERATURE REVIEW/ En-Lin TsaiWen-Lin HsuDai-Wei LiuHsi-Sheng ChsiaYi-Ru Su
OCCULT BREAST CANCER PRESENTING AS AXILLARY NODAL METASTASES-A CASE REPORT AND REVIEW OF THE LITERATURE/ Yung-Hsien LiuMu-Tai LiuDar-Ren ChenWen-Tao HuangAi-Yih WangWen-Shan LiuTung-Hao ChangChu-Ping PiChao-Yuan Huang
 
   
 
   

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