- 期刊
支氣管內近接放射治療－台北榮總的初步經驗報告
Endobronchial Brachytherapy-Preliminary Experience in VGH-Taipei
摘要
自1992年11月起至1994年2月止，共有8例非小細胞肺癌患者接受支氣管內近接放射治療，其中7例為satge ⅢA (3)與statge Ⅲ B(4)，另一例原為stageⅠ，經手術治療後局部復發。所有病例皆同時接受體外照射，視治療目的給予40至60Gy的劑量，近接治療則在療程中問及結束時各予－次，給予劑量在距射源輸送管中軸外l公分處8至10Gy。使用銥-192高劑量率遙控後荷式系統(lr-192 High-dose-rate: emote afterloading system)，每次治療約需10分鐘。每位病人在治療結束後四周接受支氣管鏡複查，幷定期追踪胸部x光片或斷層掃描檢查。結果在8例中有5例其支氣管鏡檢顯示腫瘤阻塞範圍有50%以上之改善，有6例其主觀症狀改善，但是僅2例目前病况穩定。 支氣管內近接治療對於因近端支氣管內的腫瘤病灶所造成的堵塞及相關症狀有令人滿意的效果。治療過程中並無顯著的副作用。對於局部腫瘤控制及更精確的效果評估系統則須進一步研究。
並列摘要
Between November 1992 and Feburary 1994, eight patients with primary non-small cell lung cancer were treated with endobronchial brachytherapy with Iridium-192 high dose rate remote afterloading system after teletherapy. Seven patients were previously untreated stage III A (3) and stage III B (4), and one was recurrent after surgery. All patients presented with intraluminal tumor, and received external radiation ranging 40 to 60Gy regarding the therapeutic intents. Brachytherapies were usually performed twice at the median and end of the course of teletherapy, with prescribed dose 8 to 10Gy at 1cm off the cather center. Bronchoscopies were performed 4 weeks after treatments to follow up pulmonary conditions. Five of eight patients obtained more than 50% improvement of endobronchial obstruction; six patients got subjective improvement of previous symptoms; but only two patients were stable conditions to date. Endobronchial brachytherapy is an effective method to relieve intraluminal obstruction by lung cancer in the proximal bronchial trees without significant acute toxicities. Development of more precise quantatative criteriae is needed to document the treatment response. Effectiveness of tumor control and survival will be investigated.