ORAL CANCER PATIENT WITH AN UNRESECTABLE LUNG OLIGOMETASTASIS SUCCESSFULLY TREATED BY STEREOTACTIC ABLATIVE RADIOTHERAPY (SABR ) WITH SIMULTANEOUSLY INTEGRATED INNER-ESCALATED BOOST (SIEB ): A CASE REPORT

口腔癌病人合併無法切除之肺寡量轉移病灶接受「立體定位燒灼性」及「同步腫瘤內增量」放射治療：一個病例報告

陳良政(Liang Cheng Chen) ； 洪世凱(Shih-Kai Hung) ； 李文星(Moon-Sing Lee) ； 邱文彥(Wen-Yen Chiou) ； 沈秉杰(Bing-Jie Shen) ； 石怡婷(Yi-Ting Shih) ； 徐鳳春(Feng-Chun Hsu) ； 蔡維達(Wei-Ta Tsai) ； 林怡安(Yi-An Lin) ； 謝慧苓(Hui-Ling Hsieh) ； 林柏豪(Po-Hao Lin) ； 郭心語(Hsin-Yu Kuo) ； 林宏益(Hon-Yi Lin)

《放射治療與腫瘤學》 23卷3期 (2016/09) Pp. 191-203

https://doi.org/10.6316/TRO/201623(3)191

摘要

口腔癌是台灣常見的頭頸癌之一，大部分在初診斷時為局部性疾病。即使疾病進展到後期，遠端轉移的比例仍然不多。在過去一旦癌症病人有了遠端轉移，即使轉移的數量少或體積很小（寡量轉移）仍被認為是無法治癒的疾病。因此這類病人大部分接受緩和治療。然而有許多的文獻顯示在接受積極的治療情況下，寡量轉移的癌症病人比起瀰漫性轉移，可以有較長的無疾病存活期，這些證據顯示寡量轉移的癌症是有望治癒，而不是完全無法治癒的疾病。這些現象在很多不同種類癌症上皆有被觀察到，包含大腸直腸癌、黑色素瘤、子宮內膜癌等。然而口腔癌被報告的資料很少。因此本文報告一位口腔癌病人，合併無法切除的肺單顆轉移病灶，接受「立體定位燒灼性」及「同步腫瘤內增量」放射治療。在治療完成的四個月後腫瘤達到完全緩解。而且在最後一次回診追蹤時（完成放射治療兩年後），病人的頭頸部及肺部區域皆沒有殘存的腫瘤。

關鍵字

寡量轉移 ； 立體定位燒灼性放射治療 ； 同步腫瘤內增量放射治療 ； 口腔癌

並列摘要

Oral cancer, one common subtype of head and neck cancers in Taiwan, mainly presented as a locoregional disease at diagnosis. Even in its late course, distant metastasis is still rare. Previously, once cancer patients with distant metastasis - even in limited number or small size (i.e., oligometastasis) - were considered as having an ＂incurable＂ disease. Thus, palliative treatments were recommended. However, several lines of evidence showed that while applying aggressive managements, most oligometastatic cancer patients demonstrated a durable disease-free survival when compared with those patients with disseminated metastases. This observation implicated that oligometastasis may be a 'potentially curable,' rather than ＂incurable＂ disease status. This phenomenon has been observed in several types of cancers, such as colorectal cancer, melanoma, and endometrium cancer. But, few data were reported in oral cancer. Herein, we presented an oral cancer patient with an un-resectable pulmonary oligometastasis. Stereotactic ablative radiotherapy (SABR) was given in conjunction with Simultaneous Integrated Inner-Escalated Boost (SIEB) technique. Four months after SABR/SIEB, complete response was observed. Moreover, no evidence of cancer disease was noted in both lung and head-and-neck region till the last follow-up (two years after RT).

並列關鍵字

Oligometastasis ； Stereotactic ablative radiotherapy (SABR) ； Simultaneously Integrated Inner-Escalated Boost (SIEB) ； Oral cancer