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題名:INTRACAVITY BRACHYTHERAPY FOR NASOPHARYNGEAL CARCINOMA WITH ROTTERDAM NASOPHARYNGEAL APPLICATOR     (18點)
鹿特丹鼻咽腔內置入器(Rotterdam Nasopharyngeal Applicator)之鼻咽癌腔內近接治療(Intracavity brachytherapy)
著者:Jr-Uei Ho(何志偉) ;Yen-Chao Chen(陳彥超) ;Ching-Jung Ro(羅慶榮) ;Ann-Joy Cheng(鄭恩加) ;Chen-Kan Tseng(曾振淦) ;Chen-Ju Lin(林倩?) ;Joseph Tung-Chieh Chang(張東杰)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:鼻咽癌 ; 近接治療 ; 鹿特丹置入器 ; Nasopharyngeal carcinoma ; Brachytherapy ; Rotterdam applicator
刊名:Therapeutic Radiology and Oncology
頁碼:33-41
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

且曲: 藉由與其他不同型式的「高劑量率鼻咽腔內置入器J ( 目前白白rat 巳l 且ra c av it ar y nasopharyngeal ap plicatα 之比較以評估「鹿特丹鼻咽置入器J ( Rotterdam Nasopharyngeal Applicator) 之優點與限制 材料血有注: 我們比較了長庚紀念醫院林口分院為鼻咽癌「高劑量率近接治療」所使用的三種不同型式之「鼻咽腔內置入器」此三種分別是: 單管金屬置入器( Si n g le metal ta nd 巳m ) ; 氣球置入器( B a ll ∞n ap plicat α) 和鹿特丹置入器( Ro tt er由m ap plicator) 。我們以一位AlC C s t a g巴Tl 之鼻咽癌病人, 分別置入三種不同型式之置入器, 以獲得一組用鹿特丹置入器所產生之電腦斷層模擬影像,和另兩種置入器所產生的x 光素片模擬影像。另找五個不同程度原發腫瘤侵犯(t umor exte nt) 的病人, 此五位病人的腫瘤侵犯分別是T20 : 腫瘤侵犯到口咽腔( o ro p h a ry n x )T2n : 腫瘤侵犯到鼻腔( n a sa l cavity) T2b : 侵犯到咽旁區( p arap ha ryn g e al sp a c 巳) T3 : 侵犯到顱底( shrll b a s 巴) T4 : 侵犯到顱內( b rai n ) , 將此五位病人的磁振造影( MRI) 病仕畫在商業用的電腦斷層治療計劃軟體上, 以模擬計算此鹿特丹放置器在六腫病仕情形所分別產生的放射劑量分佈D 此外, 該位AlC C st age Tl鼻咽癌病人以單管金屬置入器( Si n gl 巳met al tan d巳m) ; 氣球置入器( B a ll o o n ap p licat α) 所產生的放射劑量分布也被拿來與鹿特丹置入器所產生的計量分布相比較。而此鹿特丹置入器的適用性( fe a s ib i l it y ) , 再現性( r 巳pr 吋u c i b i li t y ) , 和舒適度( comfort )也同時加以評估。 益星: 我們發現鹿特丹置入器( R o tt e rd a m ap p l icato r) 具有再現性, 並且較之於其他兩種置入器, 於鼻咽黏膜或黏膜下腫瘤區域( Mu c o 鈞。r submucosa tumor area) ,具有最好的放射劑量分布(radiation dose dis tribut ion ) 。且其給予Tl 病仕區域處方劑量(p res c rib ed dos e ) 時並不會增加太多的過多劑量( h ot spo t ) 。但因鹿特丹置入器需放置於病人鼻咽腔內為時約二至數天之久, 所以需給予靜脈鎮痛輸液以緩和對病人所造成的的不適。此外, 鹿特丹置入器之治療範圍很難涵蓋太大之咽旁區( h ug 巴p ar ap ha ryn g 巴al sp ac e ) 及顱內腫瘤, 否則則需付出極高過多劑量( h ot sp o t ) 之代價和骨頭嚴重壞死或穿孔( necrosis or p 巳rfor at ion ) 的風險。 革皇島: 我們建議小的鼻咽腔腫瘤( small nas oph ary n g 巳al t u m or ) 可以鹿特丹置入器( R o tt 巳rd amap plicat or) 作為追加劑量之用, 然而此置入器在外形結構上仍有很大的修飾空間以更進一步改善其在鼻咽區域之放射劑量分布。
Purpose : To use Rotterdam nasopharyngeal applicator to examine its results on radiation dose distribution and investigate the possible indications for the treatment of nasopharyngeal tumor. Materials and Methods : We compared three types of HDR nasopharyngeal brachytherapy applicators that were used in Chang Gung Memorial Hospital - Linkou. The three types of applicators were: single metal tandem, balloon applicator and Rotterdam applicator. Three types of applicators were tested in one patient with AJCC stage T1 nasopharyngeal cancer. We further selected five patients with different tumor extension as representative to compare the radiation dose distribution. The five representative case included T2o: tumor extended to oropharynx, T2n: tumor to nasal cavity, T2b: tumor to parapharynx space, T3: tumor to skull base and T4: tumor to brain. We use MRI to define the tumor, CT scan and commercial software to calculate the radiation dose. The feasibility, reproducibility and patients’ comfort were also be evaluated. Results : We found that Rotterdam applicator was more reproducible and best radiation dose distribution to nasopharyngeal mucosa or submucosa tumor area compared to the other 2 applicators. The Rotterdam applicator can deliver prescribed dose to the lesion area without too much hot spot in the treatment of T1-T2a NPC. However, when Rotterdam applicator was placed to the nasopharynx for few days during the treatment, patients would feel much discomfort. It therefore needed intravenous medication or fluid to relieve patients’ discomfort. Besides, Rotterdam applicator also has the limitation in coverage of tumor with huge parapharyngeal space extension or to intracranial area. For the treatment of advanced NPC, it may still be at the price of very high radiation hot spot and face the risk of severe necrosis or bone perforation. Conclusion : With the treatment of small nasopharyngeal tumor, we will suggest Rotterdam applicator to be the choice as an aid of brachytherapy boost. However, there will be a great potential to improve the shape of the Rotterdam applicator to fit better in our patients in order to be common use for the improvement of the radiation dose distribution to the nasopharyngeal area.


    

本卷期目次
Therapeutic Radiology and Oncology
Intracavity Brachytherapy for Nasopharyngeal Carcinoma With Rotterdam Nasopharyngeal Applicator/ Jr-Uei HoYen-Chao ChenChing-Jung RoAnn-Joy ChengChen-Kan TsengChen-Ju LinJoseph Tung-Chieh Chang
Effect of Low Dose Irradiation on the Induction of Sister-Chromatid Exchange in V-79 Cells/ Song-Shei LinYeu-Sheng TyanSu-Jing Yang
Rare Brain Metastasis From Papillary Thyroid Carcinoma at the Cerebellopotine Angle: a Case Report and Review of the Literature/ Weir-Chiang YouJian-Sheng Jan
Three Dimensional Conformal Radiation Therapy to Portal Vein Thrombosis Area as the Initial Treatment for Hepatocellular Carcinoma With Portal Vein Thrombosis: Prognostic Factors and Outcome for Patie/ Yu-Jie HuangStephen Wan LeungChong-Jong WangLi-Min SunShyh-An YehEng-Yen HuangHui-Chun ChenFu-Min FangChing-Yeh HsiungHsuan-Chih Hsu
Choroid Plexus Carcinoma of the Lateral Ventricle: Case Report and Review/ Jenny QueChing-Nan LinLi-Ching LinKuei-Li Lin
蒙地卡羅模擬程式分析銥192近接治療射源在骨和肺組織中的劑量分佈/ 陳弘政陳為立張國華
Prognostic Factors and Results of Radiotherapy for Brain Stem Gliomas/ Chang-Yu WangChong-Jong WangHsuan-Chih HsuEng-Yen HuangStephen Wan LeungHui-Chun ChenLi-Min SunShyh-An YehFu-Min FangChing-Yeh Hsiung
THREE DIMENSIONAL CONFORMAL RADIATION THERAPY TO PORTAL VEIN THROMBOSIS AREA AS THE INITIAL TREATMENT FOR HEPATOCELLULAR CARCINOMA WITH PORTAL VEIN THROMBOSIS: PROGNOSTIC FACTORS AND OUTCOME FOR PATIENTS COMPLETING RADIOTHERAPY BUT CONTRAINDICATED FOR OTHER TREATMENTS/ Yu-Jie HuangStephen Wan LeungChong-Jong WangLi-Min SunShyh-An YehEng-Yen HuangHui-Chun ChenFu-Min FangChing-Yeh HsiungHsuan-Chih Hsu
PROGNOSTIC FACTORS AND RESULTS OF RADIOTHERAPY FOR BRAIN STEM GLIOMAS/ Chang-Yu WangChong-Jong WangHsuan-Chih HsuEng-Yen HuangStephen Wan LeungHui-Chun ChenLi-Min SunShyh-An YehFu-Min FangChing-Yeh Hsiung
EFFECT OF LOW DOSE IRRADIATION ON THE INDUCTION OF SISTER-CHROMATID EXCHANGE IN V-79 CELLS/ Song-Shei LinYeu-Sheng TyanSu-Jing Yang
INTRACAVITY BRACHYTHERAPY FOR NASOPHARYNGEAL CARCINOMA WITH ROTTERDAM NASOPHARYNGEAL APPLICATOR/ Jr-Uei HoYen-Chao ChenChing-Jung RoAnn-Joy ChengChen-Kan TsengChen-Ju LinJoseph Tung-Chieh Chang
蒙地卡羅模擬程式分析銥192近接治療射源在骨和肺組織中的劑量分佈/ 陳弘政陳為立張國華
CHOROID PLEXUS CARCINOMA OF THE LATERAL VENTRICLE: CASE REPORT AND REVIEW/ Jenny QueChing-Nan LinLi-Ching LinKuei-Li Lin
RARE BRAIN METASTASIS FROM PAPILLARY THYROID CARCINOMA AT THE CEREBELLOPOTINE ANGLE: A CASE REPORT AND REVIEW OF THE LITERATURE/ Weir-Chiang YouJian-Sheng Jan
陳明憲醫師去世10週年紀念文/ 王重榮
 
   
 
   

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