腎細胞癌手術後放射線治療

POSTOPERATIVE RADIOTHERAPY OF RENAL CELL CARCINOMA

鍾昌宏(Chang H. Chung) ； 陳光耀(Kuang Y, Chen)

《中華放射線醫學雜誌》 2卷1期 (1977/03) Pp. 21-26

摘要

榮民總醫院癌病治療中心自1962年1月至1972年12月，共看14例腎細胞癌，接受犯側腎切除手術後，發現腎盂、尿道、局部淋巴結、腎靜脈或下腔靜脈等被癌細胞侵犯，再接受放射線治療。其中12例男性，2例女性，年齡自24歲至67歲，平均年齡50歲。侵犯右腎者11例，左側者3例。住院時主要徵狀是不痛性血尿、腰痛、腹部腫塊或發燒。全部病例皆接受腎切除術，並經病理報告為腎細胞癌，接受放射線治療，放射劑量3,500至6,000雷得。所有病例都有3年以上的跟查，其絕對生存率1年為86%(12/14)，3年為64%(9/14)，5年為70%(7/10)。治療中少數病患發生短暫性噁心、嘔吐、胃口欠佳、輕微下瀉或腹部不適等反應，但無肝損害或嚴重性腸胃不適症狀。7例死亡中，5例轉移至肺，1例轉移至腦，另1例則對側腎也見侵犯。依此報告與各文獻所載，顯示手術無法完全切除腎癌細胞而加用放射線治療時，預後較佳。

並列摘要

During the period of January 1962 to December, 1972, 14 cases of renal cell carcinoma admitted to the Veterans General Hospital, Taipei were reviewed. All patients received surgical removal of the primary renal tumor plus post-operative radiotherapy. The mean age was 50. The right kidney was involved in 11 cases. Other three cases involved the left side. The presenting symptoms were painless hematuria, lumbago, abdominal mass and fever. Nephrectomy on the affected kidney was the method of initial treatment, followed by post -operative radiotherapy if the pelvis, ureter, regional lymph node or renal vein were involved. The radiation doses ranged between 3,500 rads and 6,000 rads T. D. Only few patients had mild radiation reaction such as temporary nausea, vomiting, anorexia or abdominal discomfort but no hepatic damage or severe gastrointestinal upset was noted. Definite improvement was obtaineo in survival rate from post-operative radiotherapy of renal cell carcinoma.