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1
題名:POST-OPERATIVE COMBINATION OF RADIOTHERAPY AND CHEMOTHERAPY IN ESOPHAGEAL CANCER     (18點)
食道癌之手術後合併放射線與化學治療
著者:Chien-Hsun Chen(陳建勳) ;Ching-Hsiung Chang(張慶雄) ;Yu-Chang Hu(胡渝昌) ;Chung-Man Leung(梁頌文) ;Kuo-Chen Chang(張國楨)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:食道癌 ; 放射治療 ; 化學治療 ; 手術後合併治療 ; Esophageal cancer ; Radiotherapy ; Chemotherapy ; Post-operative combination therapy
刊名:Therapeutic Radiology and Oncology
頁碼:13-21
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

旦旦: 評估手術後之合併化學與放射線治療於食道癌的效用, 並尋找影響病患預後的因子。 材料血?有濤: 自1 9 9 1 年1 0 月至2 0 0 0 年I I 月共有5 6 位食道癌患者接受手術後放射線治療。其中23位病患接受單獨放射線治療,劑量約為5 0 Gy , 另外3 3 位並接受合併化學與放射線治療, 使用的藥物為c i sp l at i n 與5 - F U 0 兩組病人除腫瘤長度外並無明顯差異。我們比較兩組病患之存活率以評估合併化學與放射線治療的效用, 並分析年齡、腫瘤的期別、長度、侵犯情形與陽性淋巴的狀態等對預後的影響。 組星: 追蹤中值時間為1 6 個月。5 6 位病患的五年全部存活率為2 0 . 2 % ' 無疾病存活率為19.1% 。其中1 4 . 3 %的患者發生局部復發, 35. 7 % 的病患有遠端轉移。接受單獨放射線治療病患的2 及5年存活率為4 2 . 7 % 及2 3 . 7% ' 而合併治療的病患則為4 1. 0 % 及1 6 . 0% ' 兩組於全部及無疾病存活率並無統計學上的差異( p = 0 .694 及0 . 875 ) 。對於有淋巴轉移的患者而言,合併化學與放射線治療在全部存活率及無疾病存活率上並無優於單獨放射線治療( p = 0 .273 及0.486 ) 。對合併治療的患者, 接受三次或三次以上之化學治療其全部及無疾病存活率並無優於較少次數之病患( p = 0 .96 8 及0 .40 6 ) 。就單變數分析而言, 神經侵犯、陽性淋巴的數目、範團與比例是全部存活率與無疾病存活率的影響因子。以多因子分析而言,只有陽性淋巴的範圍影響存活率。 起益: 根據我們病患的數據, 手術後合併化學與放射線治療並無增加存活率的效應。神經侵犯、陽性淋巴的數目、範圍與比例是影響術後病患預後的重要因子。
Purpose : To evaluate the effect of post-operative concurrent chemoradiotherapy (CCRT) and to determine the prognostic factors in esophageal cancer. Materials and Methods : From October 1991 to November 2000, fifty-six patients with esophageal cancer received post-operative radiotherapy at VGH-KS. Twenty-three patients were treated with radiotherapy (RT) alone at 50 Gy and others underwent RT combined with chemotherapy (C/T) consisting of cisplatin plus 5-flurouracil (5-FU). There was no significant difference in patient characteristics between two groups, except in tumor length. We compared overall, disease-free, loco-regional-free and distant-metastasis- free survival rates between two groups. We also analyzed various prognostic factors including age, tumor length, tumor stage, status of surgical margin, lymph node (LN) metastasis, vascular or neural invasion, and the time interval between operation and radiotherapy. Results : The median follow-up time was 16 months. For all patients, the overall survival (OS) at 5 years was 20.2%, and the disease-free survival (DFS) was 19.1%. Locoregional failure occurred in 14.3% of patients and 35.7% of patients developed distant metastasis. The 2-year and 5-year overall survival rates were 42.7% and 23.7% for RT group and 41.0% and 16.0% for CCRT group. There was no significant difference in OS and DFS between two groups (p= 0.694 and 0.875). In lymph node metastatic patients, overall and disease-free survivals of CCRT group were not superior to those of RT group (p= 0.273 and 0.486). In CCRT group, there was also no significant difference in OS and DFS between the patients receiving less than 3 cycles of C/T and those receiving more (p= 0.968 and 0.406, respectively). By the uni-variate analysis, we found that neural invasion, numbers of LN metastases and involved LN levels, and the percentage of positive dissected LN affected the survival rates. The only prognostic factor of survivals in the multi-variate analysis was the involvement of more than one LN level. Conclusion : Based on our analysis, post-operative combination therapy is no better than adjuvant radiotherapy alone in disease control. The most important prognostic factors affecting the post-operative survival rate of patients are the number of positive lymph node and LN levels involved, the percentage of positive dissected LN and neural invasion.


    

本卷期目次
Therapeutic Radiology and Oncology
子宮頸癌術後放射線治療病人組織病理學預後因子之多變數分析/ 賴耿光馬玉麟許瑞昌葉坤土賴義雄林隆堯周明智
Analysis on the Variation of Respiratory organ motion and a Preliminary Feasibility Study for a Voice Coaching Technique to Improve the Reproducibility of Respiratory Cycle between Tteatiments/ James C. LiWen-Shan LiuHsiang-Chi KuoLi-Miao ChenDavid HuangChi-Wei HsuHis-Chang Chang
電腦斷層模擬攝影應用於全腦脊椎照射照野之設計與評估/ 曾雁明陳臣苑陳汶城林俊彥姚學華李紳豪曾振淦
Rarely Reported Liver Toxicity in Patients Who Were Hepatitis B Carrier and Underwent Chemoirradiation for Gastric Cancer/ Chao-Ming HuangJason Chia-Hsien ChengStella Y. TsaiMei-Ching LiuYih-Lin ChungSkye Hon-Giun ChengWei-Tse FangPo-Sheng YangJames Jer-Min JianAndrew T. Huang
胸部固定器設計與臨床上之應用/ 呂宗憲蕭世禎吳錦榕阮昭銘朱慶文葉如娦彭秋萍游佩潔
Post-Operative Combination of Radiotherapy and Chemotherapy in Esophageal Cancer/ Chien-Hsun ChenChing-Hsiung ChangYu-Chang HuChung-Man LeungKuo-Chen Chang
A Dosimetric Comparison of the Predictive Value of Two Rectal Reference Points for Late Rectal Complications Following the Treatment of Cervical Cancer by High-Dose-Rate Brachytherapy/ Shang-Wen ChenJi-An LiangShih-Neng YangHui-Ling KoCheng-Pang TuAn-Cheng ShiauFang-Jen Lin
ANALYSIS ON THE VARIATION OF RESPIRATORY ORGAN MOTION AND A PRELIMINARY FEASIBILITY STUDY FOR A VOICE COACHING TECHNIQUE TO IMPROVE THE REPRODUCIBILITY OF RESPIRATORY CYCLE BETWEEN TREATMENTS/ James C. LiWen-Shan LiuHsiang-Chi KuoLi-Miao ChenDavid HuangChi-Wei HsuHis-Chang Chang
POST-OPERATIVE COMBINATION OF RADIOTHERAPY AND CHEMOTHERAPY IN ESOPHAGEAL CANCER/ Chien-Hsun ChenChing-Hsiung ChangYu-Chang HuChung-Man LeungKuo-Chen Chang
電腦斷層模擬攝影應用於全腦脊椎照射照野之設計與評估/ 曾雁明陳臣苑陳汶城林俊彥姚學華李紳豪曾振淦
RARELY REPORTED LIVER TOXICITY IN PATIENTS WHO WERE HEPATITIS B CARRIER AND UNDERWENT CHEMOIRRADIATION FOR GASTRIC CANCER/ Chao-Ming HuangJason Chia-Hsien ChengStella Y. TsaiMei-Ching LiuYih-Lin ChungSkye Hon-Giun ChengWei-Tse FangPo-Sheng YangJames Jer-Min JianAndrew T. Huang
A DOSIMETRIC COMPARISON OF THE PREDICTIVE VALUE OF TWO RECTAL REFERENCE POINTS FOR LATE RECTAL COMPLICATIONS FOLLOWING THE TREATMENT OF CERVICAL CANCER BY HIGH-DOSE-RATE BRACHYTHERAPY/ Shang-Wen ChenJi-An LiangShih-Neng YangHui-Ling KoCheng-Pang TuAn-Cheng ShiauFang-Jen Lin
子宮頸癌術後放射線治療病人組織病理學預後因子之多變數分析/ 賴耿光馬玉麟許瑞昌葉坤土賴義雄林隆堯周明智
胸部固定器設計與臨床上之應用/ 呂宗憲蕭世禎吳錦榕阮昭銘朱慶文葉如?彭秋萍游佩潔
 
   
 
   

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