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1
題名:Treatment Results of Rectal Adenocarcinoma after Curative Surgery and Recurrent Disease after Salvage Treatment     (16點)
原發性直腸腺癌經根除手術後及其復發經拯救性治療的治療結果
著者:Hsien-Chun Tseng(曾顯群) ;Jian-Sheng Jan(詹建勝)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:直腸腺癌 ; 根除手術 ; 拯救性治療 ; Rectal adenocarcinoma ; Curative surgery ; Salvage treatment
刊名:Therapeutic Radiology and Oncology
頁碼:81-88
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

且且: 本文主要分析原發直腸腺癌的經根除手術治療的結果以及討論復發直腸腺癌之拯救性治療扮演的角色。 材料且完這﹒ 台中榮民總醫院放射腫瘤科自1 9 8 0 年至1 9 9 5 年癌病登記有9 0 位原發直腸腺癌患者接受放射治療的登記資料,但手術過程中發現有骨盆腔以外擴散的的患者、確定診斷時接受姑息性手術者、及治療記錄不完整者皆不列入本文分析, 有效分析者共有60位患者,所有病患均接受了根除手術,輔助治療採用放射線治療或化學治療則主要由外科醫師決定;腫瘤復發藉由理學檢查、影像檢查如電腦斷層或磁振造影、大腸鏡檢、癌胚抗原( C EA ) 、或是超音波檢查的結果來確定。本文使用Ka p la n-M e ier 方法自手術日開始算起分析存活的時間。 益星: 這6 0 位患者之兩年及五年的全體存活率分別是6 3 及3 3 % '一般復發率是8 8 % ﹒術後到局部復發平均時間是2 6 個月, 術後到遠處轉移平均時問是2 1 個月。僅有5 位患者的單獨骨盆腔復發能夠接受再度治癒性的手術切除。直腸癌復發接受姑息性治療的患者,其中值存活時間是6個月, 7 位直腸癌復發的患者僅接受拯救性放射線治療, 自診斷出腫瘤復發日算起, 接受拯救性手術的患者之存活中值時間為1 6個月,對於僅接受拯救性放射治療的患者,其存活中值時間為8 . 5個月。 益益: 原發直腸腺癌的患者僅接受根除性手術, 仍有很高的復發率, 有少數局部復發的患者可再次施行根除性的手術而獲得較長的存活時間。
Purpose: This study was to analyze the treatment results of our patients with rectal adenocarcinoma receiving curative surgery ± radiotherapy and discuss the role of salvage treatment for recurrence. Materials and Methods: A total of 90 patients with rectal adenocarcinoma who received radiotherapy from 1980 to 1995 were registered at Department of Radiation Oncology, Taichung Veteran General Hospital. The patients who were found to have extrapelvic extension at operation, palliative surgery at diagnosis, and incomplete data were excluded. Sixty patient s were analyzable. All these 60 patients received potentially curative surgery at diagnosis . Adjuvant therapy with radiotherapy or chemotherapy was mainly decided by the surgeon. Recurrence of tumor was documented by physical examination, imaging studies such as CT scan or MRI, colonoscopy, CEA, or sonography. The salvage treatment of recurrent tumor included reoperation with curative or palliative intent, radiotherapy alone or with chemotherapy. Analysis of survival was calculated from the date of operation using Kaplan-Meier method. Results : Of these 60 patients 2- and 5-year overall survival rate were 63% and 33%, respectively. Overall recurrence rate was 88%. The mean loco-regional recurrence time was 26 months vs. 21 months for distant metastasis. Only 5 patients with isoloated pelvic recurrence can be salvaged by reoperation with curative intent. The patients with recurrent cancer receiving palliative surgery survived at a median of 6 months. Seven patients with recurrent disease were salvaged with radiotherapy only. The patients with salvage surgery survived at a median of 16 months after diagnosis of recurrence vs. 8.5 months for patients with salvage radiotherapy only. Clinical variables such as age, gender, stage, tumor location, and tumor size had no statistically significant impact on survival. Conclusion : There was substantially high recurrence rate for patients with even potentially curative resection of primary rectal adenocarcinoma. A minority of patients with isolated local recurrence can be salvaged by aggressive reoperation with a relatively long survival.


    

本卷期目次
Therapeutic Radiology and Oncology
使用不同電子錐時的電子射束特性變化探討/ 劉幕台林招膨朱鐵吉林桂華林松彥黃勝賢葉啟源
乳酸桿菌科菌株提高免疫力及抗癌方面的研究/ 羅敏菁季匡華
A Radiotherapy Survey on the Institutional Manpowers, Patients, and Treatment Characteristics in the Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital between 1987-1996/ Chong-Jong WangStephen Wan LeungHui-Chun ChenChing-Yeh HsiungLi-Min SunFu-Min FangShyh-An YehHsuan-Chih HsuEng-Yen Huang
硼中子捕獲治療的輻射劑量與品質之研究/ 許芳裕董傳中
熱發光劑量計對質子的回應/ 林松彥林招膨朱鐵吉徐竹村劉幕台葉啟源
骨盆固定器對擺位誤差的影響/ 劉文山張慶雄胡渝昌陳建勳蔡麗芳
不同方式放射線照射法對鼻咽癌病人唾液腺功能之影響/ 任益民林玉清王宜斌許文林吳錦榕黃經民熊佩韋張立平陳昌明
手術中放射治療:林口長庚紀念醫院的初步經驗/ 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
維生素K3單獨或併用游離輻射對人類肝癌細胞的影響/ 黃正仲陳惠娥曾婉芳林冠如鄧文炳林芳仁
Treatment Results of Rectal Adenocarcinoma after Curative Surgery and Recurrent Disease after Salvage Treatment/ Hsien-Chun TsengJian-Sheng Jan
維生素K3單獨或併用游離輻射對人類肝癌細胞的影響/ 黃正仲陳惠娥曾婉芳林冠如鄧文炳林芳仁
乳酸桿菌科菌株提高免疫力及抗癌方面的研究/ 羅敏菁季匡華
骨盆固定器對擺位誤差的影響/ 劉文山張慶雄胡渝昌陳建勳蔡麗芳
硼中子捕獲治療的輻射劑量與品質之研究/ 許芳裕董傳中
熱發光劑量計對質子的回應/ 林松彥林招膨朱鐵吉徐竹村劉幕台葉啓源
使用不同電子錐時的電子射束特性變化探討/ 劉幕台林招膨朱鐵吉林桂華林松彥黃勝賢葉啓源
不同方式放射線照射法對鼻咽癌病人唾液腺功能之影響/ 任益民林玉清王宜斌許文林吳錦榕黃經民熊佩韋張立平陳昌明
手術中放射治療:林口長庚紀念醫院的初步經驗/ 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
Treatment Results of Rectal Adenocarcinoma after Curative Surgery and Recurrent Disease after Salvage Treatment/ Hsien-Chun TsengJian-Sheng Jan
A Radiotherapy Survey on the Institutional Manpowers, Patients, and Treatment Characteristics in the Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital between 1987-1996/ Chong-Jong WangStephen Wan LeungHui-Chun ChenChing-Yeh HsiungLi-Min SunFu-Min FangShyh-An YehHsuan-Chih HsuEng-Yen Huang
 
   
 
   

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