- 期刊
TRACHEAL ADENOID CYSTIC CARCINOMA: POST-OP ERATIVE CHEMORADIOTHERAPY – A CASE REPORT
氣管腺樣囊性癌術後同步化學及放射線治療病例報告
摘要
原發性氣管癌是一個罕見的疾病，發生率在每年新發生的癌症中約佔0.1–0.4%，腺樣囊性癌則是組織學分類中排名第二常見的氣管癌。主要的治療方式是手術，而術後的放射線治療也有證據顯示對無疾病存活期還有整體存活率有幫助，然而因為發生率低，目前並沒有針對術後 邊緣接近而進行同步化學及放射線治療的臨床實驗。我們在這邊提出一個之前有右側黏液性乳癌病史的52歲女性腺樣囊性癌病例。在最初的手術後，病患因為手術邊緣腫瘤殘留而接受了後續的同步化學及放射線治療，給與六週的放射線治療60 Gy以及Cisplatin 30 mg/m^2化學治療。病患術後在我們的門診追蹤了一年，除了左聲帶麻痹造成的聲音微弱以外並沒有看到其他的副作用，病患的發音功能也在聲帶注射hyaluronic acid後得到改善。我們得到的結論是術後輔助同步放射線治療併化學治療或許是一個治療氣管腺樣囊性癌很好的方式。
並列摘要
Primary tracheal cancer is a rare disease entity which represents 0.1-0.4% of all newly diagnosed cancers every year. Adenoid cystic carcinoma is the second most common histological type of tracheal cancer. The primary treatment modality is surgical excision. Post-operative radiotherapy also shows benefit in disease-free survival and overall survival. However, there were no randomized trials for post-operative chemoradiotherapy in patients with close margin due to its low incidence. Here, we present a 52-year-old female adenoid cystic carcinoma patient with a history of right breast mucinous carcinoma. After primary surgical resection, the patient received adjuvant concurrent chemoradiotherapy due to positive margin. Radiotherapy 60 Gy together with weekly cisplatin 30 mg/m^2 were delivered within six weeks. The patient was followed at our outpatient clinic for 1 more year after the initial surgery. No severe complications were found except for a persistant weak voice due to left vocal cord palsy. The patient's phonation improved after intracordal hyaluronic acid injection. We concluded that postoperative adjuvant concurrent chemoradiotherapy (CCRT) may be a good treatment modality for tracheal adenoid cystic carcinoma.
延伸閱讀
- Lee, P. Y., Chien, C. R., Chen, W. T. L., Ke, T. W., Kuo, Y. C., Chang, S. C., & Lin, Y. J. (2016). 術前同步化放療於局部侵犯性直腸癌患者之治療成效：單一機構之報告. 放射治療與腫瘤學, 23(2), 85-97. https://doi.org/10.6316/TRO/201623(2)85
- Lin, S. C., Liu, M. T., Pi, C. P., Chang, T. H., Huang, C. Y., Hsu, C. C., & Huang, C. C. (2010). 直腸癌病人接受手術前同步化學放射治療之預後因子分析. 放射治療與腫瘤學, 17(3), 213-225. https://doi.org/10.6316/TRO/201017(3)213
- Chang, K. C., Liu, W. S., Chang, C. H., Hu, Y. C., Chen, C. H., & Leung, C. M. (2013). 食道鱗狀上皮癌術前合併放射與化學治療的治療結果. 放射治療與腫瘤學, 20(3), 171-178. https://doi.org/10.6316/TRO/201320(3)171
- Chu, P. Y., Teng, T. H., Chen, C. C., Hsieh, Y. S., & Lee, C. C. (2006). 原發性氣管腺樣囊狀癌的氣管沖洗細胞學檢查－病例報告. 慈濟醫學雜誌, 18(5), 397-399. https://doi.org/10.6440/TZUCMJ.200610.0397
- 葉啓源、楊光明、童詠偉、賴鵬安（2010）。氣管粗降惡性肌上皮瘤之放射治療：病例報告。放射治療與腫瘤學，17(4)，323-330。https://doi.org/10.6316/TRO/201017(4)323