Helical Tomotherapy Reduces Pain Efficiently for Circuited Pleural Metastasis of Nasopharyngeal Carcinoma-A Case Report

導航螺旋刀有效降低鼻咽癌肋膜轉移之疼痛：病例報告

謝忱希(Chen-Hsi Hsieh) ； 陳裕仁(Yu-Jen Chen) ； 劉士華(Shih-Hua Liu) ； 田蕙茹(Hui-Ju Tien) ； 吳樂榮(Le-Jung Wu) ； 陳建安(Chien-An Chen) ； 廖立人(Li-Jen Liao) ； 林育靖(Yu-Chin Lin) ； 熊佩韋(Pei-Wei Shueng)

《放射治療與腫瘤學》 18卷4期 (2011/12) Pp. 341-345

https://doi.org/10.6316/TRO/201118(4)341

摘要

鼻咽癌肋膜轉移常因腫瘤形成圓柱狀與鄰近危險器官而造成治療困難。導航螺旋刀是一新式影像導航之強度調控放射治療儀器，能提供高順形度腫瘤治療與危險器官閃避之功能。故導航螺旋刀可用於困難治療之腫瘤。一位38歲鼻咽癌患者因肋膜轉移造成強烈神經疼痛症狀，經導航螺旋刀36 Gy治療後，腫瘤體積從629 ml降至158 ml，有效降低神經疼痛症狀。疼痛指數由10降至0，同時無肺部副作用產生。故若以緩和治療為目的，導航螺旋刀亦可對特殊形狀之腫瘤提供有效且安全之治療。[放射治療與腫瘤學2011；18(4)：341-345]

關鍵字

導航螺旋刀 ； 鼻咽癌 ； 肋膜轉移 ； 痛

並列摘要

Nasopharyngeal carcinoma (NPC) with pleural circulative metastasis is difficult to treat due to the cylinder shape and close critical organs. Helical tomotherapy (HT) is a new type of CT-based rotational intensity modulated radiotherapy with highly conformal dose distributions and critical organs sparing. HT could be helpful in this kind of difficult situation.A 38-year-old male Asian nasopharyngeal carcinoma patient with pleural and liver metastasis was treated. Thirty-six Gy was delivered to bilateral pleural and mediastinum metastatic sites with HT. After HT treatment, pain was controlled by narcotics successfully. Pain scale decreased from 10 to 0. Tumor volume decreased from 629 ml to 158 ml. HT reduced V20 by more than 50% for each lung and reduced the mean lung dose by 22.2% and 33.8% in the right lung and left lung when compared with the IMRT technique, respectively.For palliative treatment, HT provides impressive ability for irregularly shaped metastatic sites and reduces painful sensation successfully.[Therapeut Radiol Oncol 2011; 18(4): 341-345]

並列關鍵字

Helical tomotherapy ； Nasopharyngeal carcinoma ； Pleural metastasis ； Pain