手術中高劑量率近接治療

目的：介紹一種近接治療於放射治療的特殊應用－手術中高劑量率近接治療。材料與方法：利用備有輻射防護牆壁，監視器及電腦控制之麻醉器械的手術房、高劑率遠端控制的近接治療機及特殊設計的超軟應用器，讓輻射劑量可以很均勻地分佈在身體內腔的的任何表面上，尤其是具有彎曲弧度的骨盆腔或後腹腔中。由於這是一種手術中的治療，所以能把可能會造成輻射傷害的重要器官，如小腸、腎臟、肝臓等，在放射治療時隔離。因此，能降低輻射治療劑量而避免產生輻射傷害。結果：手術中的近接治療配合中度劑量的體外照射(40-45Gy)，對於原發直腸癌，後發直腸癌及後腹腔的腫瘤，在二年的腫瘤控制率報告中，有80-90%的效果。結論：手術中高劑量率近接治療，提供難以用傳統治療來達成理想控制的腫瘤，如骨盆腔或腹腔腫瘤，一個新的治癒機會。

關鍵字

手術中高劑量率近接治療；大腸癌；後腹腔癌

並列摘要

Introduction: This is to introduce a special brachytherapy application in radiotherapy intraoperative high-dose-rate brachytherapy. Materials and Methods: Using an operation room possessing radiation-protection walls, monitors and computer-controlled anesthesia instruments, combined with remote-controlled high-dose-rate after-loading brachytherapy modality and a special designed super-flab or super-mould applicator, let radiation dose distribute very evenly on any surface of body inner cavity, especially on the arch surface, such as the cavity of pelvis or retroperitoneum. Since this is a radiotherapy during surgery, the possible radiation-damaged organs, such as intestine, kidney and liver can be blocked as much as possible. Hence, the effective radiotherapy dose can be reduced and avoid radiation-inducing damage. Result: Combination of intraoperative high-dose-rate brachytherapy and moderate dose (40-45Gy) of external radiotherapy in the treatment of primary and recurrent colorectal cancers and retroperitoneum cancers has significantly improved tumor control. For these tumors, there were reported of 80-90% of two-year tumor control rate. Conclusion: Intraoperative high-dose-rate brachytherapy provides a novel curable opportunity for those tumors difficult to reach optimally tumor-controlled by traditional treatment methods, such as the tumors in pelvis or retroperitoneum cavity.

並列關鍵字

Intraoperative brachytherapy ； Colorectal cancers ； Retroperitoneum cancers

國際替代計量

手術中高劑量率近接治療

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