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題名:加速式放射治療應用於鼻咽癌之經驗     (14點)
Accelerated Radiotherapy for Nasopharyngeal Carcinoma
著者:詹建勝(Jian-Sheng Jan) ;林進清(Jin-Ching Lin)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:加速式 ; 放射治療 ; 鼻咽癌 ; Accelerated ; Radiotherapy ; Nasopharyngeal carcinoma
刊名:放射治療與腫瘤學
頁碼:243-249
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

且且: 改變至于次的放射治療已被證實可以提高腫瘤控制率, 本前瞻性研究係探討每天照射二次之加速式放射治療對鼻咽誼之可行性、療效及副作用。 姐姐盟主法. 自民國八十一年十二月至八十四年+二月, 共有的位鼻咽適病人進入本研究﹒ 其中男性3 2 例、女性I I 例﹒年齡介於28至7 8 歲,大多數病人病理切片屬於分化很差或未至于化筍,根據1 9 8 8 年削c c 介期系統, 第二期一例, 第三期五例, 三十七例( 86 . 1 % ) 屬於第四潮。加速式放射治療方式如下: 每天照射二次, 每次1. 5旬, 上下午治療至少隔六小時, 每週照射五天﹒ 總劑量為72 Gy/48 今次/5 週。 益星: 病人的急性副作用,主要是口腔黏膜發炎反應( 56 % 達第三、四級) 和皮膚反應(60% 達第三、四級) 。有11 例因毒性反應在接受約三週加速式放射治療後, 要求改為傳統分次治療, 每天只照射一次,另有2例分別l休息二和四週之久。雖然如此,所有病人都能完成足量的放射治療, 平均每人接受72 Gy/47 分次( 67.5 至79 Gy) , 平均治療時間3 8 夭。迄今追~時間已2 4至60個月( 中值追~ 時間4 1 個月) , 目前治療失敗者有1 5 例, 單獨鼻咽部復發4 例, 鼻咽部合{井遠處時移者l例, I 例先發生遠處申導干事後又發生鼻咽部及頸部淋巴復發﹒ 其他9 例都是遠處聽移, 三年鼻咽部控制率的-帥,頸部控制率9 7 . 3 克,遠處轉移控制率71. 2 克, 三年總存活率5 4 .間, 三年無病存活率為6 5 . 7鬼。 益益: 加速王t放射治療對晚期鼻咽癌是可行且很有效的治療方式﹒ 遠處聽移是治療失敗的主要原因,放療後再追加輔助1生化學治療,以減少遠處聽移發生,提高存活率,值得進一步研究。
Purpose: Altered frac tionated radiotherapy can enhance the local contro l in many types of tumor when com pared with co nventional rad iotherapy, espec ially for head and neck cancer. The purpose of this prospect ive phase II study is to eva luate the feas ibility, response and toxic ities of acce lera ted radiotherapy for nasopharyngeal carci noma (NPC). Materials and Methods: Thro ugh Decem ber 1992 to December 1995, 43 patients with pathologica lly documented NPC were entered . The re were 32 male and II female with a medi an age of 51 yea rs (range 28-78). The pathology of most patients (9 1%) belongs to WHO type II and III. According to 1988 AlCC stag ing sys tem, 37 patients (86 .1%) were stage IV, 5 ( 11.6%) stage III , and I (2.3%) stage II. The acce lerated radiotherapy consists of 1.5 Gy/fraction, two fractio ns per day, with at least a 6-hour interval. The total dose is usually 72 Gy/48 fractions in 5 weeks. Results : The major toxicities were mucositis and skin reac tion. Grade 3/4 mucositis occurred in 24 patients (55.8%) and grade 3/4 skin reaction in 26 patie nts (60.5 %). Eleve n patien ts asked to change to conventional radiotherapy (1 .8-2.0 Gy/fraction, one fraction per day) duri ng the later part of radio therapy, and 2 patients had interruption for 2 and 4 weeks . Althoug h the original acce lerated schedule in 13 patient s were modified , all patie nts completed the treatment with average dose 72 Gy/47 fractions/38 days (range 67 .5-79 Gy). After a media n follow-up time of 4 1 months (range 24-60), the nasopharynx disease-free, neck disease-free, and dis tant metastasis disease-free survivals are 86 .6%, 97.3%, and 71 .2% respec tively. The 3-year overall surviva l and disease-free survival are 54 .1% and 65 .7%. Most patie nts failed due to distant metastases. Conclusion : Our data indicate that acce lerated radi otherapy for advance NPC is both feas ible and effective, with acceptable toxici ties . Post-radiation adj uvant chemotherapy to era dicate subcli nica l micromet astasis should be further studied.


    

本卷期目次
放射治療與腫瘤學
台灣放射腫瘤科護理模式之調查與方向/ 梁雲王秀仁孫立民王重榮
國際質子加速器醫學治療設備參訪報告/ 許文林翁武忠陳光耀吳國海
Relationship of CD44 and Bcl-2 Expression to Nodal Radiation Resistance in Non-hodgkin’s Lymphomas/ Yu-Shiang DaitMong-Liang ChenZon-Dar HuangChi-Yuan TzenKou-Hwa ChangYuen-Liang LaiChang-Hung ChunMeng-Hao WuYu-Jen Chen
手術中放射治療施放器之設計/ 洪碩動曾雁明
直線加速器立體定位放射手術系統/ 羅濟慶趙良曉陳光耀林光大
Neutron Dose Measurement for Medical Linear Accelerator/ Wen-Song HwangJeng-Hung LeeChew-Hann ChiuWei-Li Chen
加速式放射治療應用於鼻咽癌之經驗/ 詹建勝林進清
Combined Radiotherapy and Chemotherapy for Gastric Schwannoma with Gross Residual Tumor-case Report/ Robert TanAndrew Young
鼻咽癌病患放射治療中斷的原因及分析/ 陳玉萍曾雁明曾振淦洪志宏
加速式放射治療應用於鼻咽癌之經驗/ 詹建勝林進清
鼻咽癌病患放射治療中斷的原因及分析/ 曾雁明曾振淦洪志宏
Relation Ship of CD44 and Bcl-2 Expression to Nodal Radiation Resistance in Non-Hodgkin's Lymphomas/ Yu-Shiang DaiMong-Liang ChenZon-Dar HuangChi-Yuan TzenKou-Hwa ChangYuen-Liang LaiChang-Hung ChungMeng-Hao WuYu-Jen Chen
Neutron Dose Measurement for Medical Linear Accelerator/ Wen-Song HwangJeng-Hung LeeChew-Hann ChiuWei-Li Chen
直線加速器立體定位放射手術系統/ 羅濟慶趙良曉陳光耀林光大
手術中放射治療施放器之設計/ 洪碩勳曾雁明
台灣放射腫瘤科護理模式之調查與方向/ 梁雲王秀仁孫立民王重榮
國際質子加速器醫學治療設備參訪報告/ 許文林翁武忠陳光耀吳國海
Combined Radiotherapy and Chemotherapy for Gastric Schwannoma with Gross Residual Tumor-Case Report/ Robert TanAndrew Young
放射治療與腫瘤學第四卷作者姓名索引
 
   
 
   

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