高劑量化學治療併自體周邊造血幹細胞移植用於治療轉移性癌症以及血液惡性疾病病人 —單一機構之經驗及分析

High Dose Chemotherapy followed by Autologous Peripheral Stem Cell Transplantation in Patients with Metastatic Cancer and Hematological Malignancy — A Single Institute’s Experience and Result Analysis

蘇裕傑(Yu-Chieh Su)

指導教授 ： 林勝豐

高雄醫學大學/醫學院/醫學研究所/碩士(2003年)

摘要

運用高劑量化學治療併自體周邊造血幹細胞移植用於治療各式癌症，目前已成為對化學治療具敏感性之血液癌症，或是各種固態惡性腫瘤的重要治療方法之一。對於此項治療施行於惡性淋巴癌已經過多個大型臨床試驗證實對於一些病人確定有較優存活率。而對於化學治療具敏感性的鼻咽癌，到目前為止並沒有用高劑量化學治療的大規模臨床試驗，所以療效較不清楚。我們針對這類病人施行高劑量化學治療後並自體周邊造血幹細胞移植，共有37位病人其中12位為淋巴癌以及10位轉移性鼻咽癌病人，其他為轉移性固態腫瘤病人。我們的經驗顯示，高劑量化學治療併自體周邊造血幹細胞移植，對於此類病人並無嚴重的治療相關副作用。對於淋巴癌病人治療結果顯示，首次或是二次緩解後接受此種治療，可以獲得相當好的長期存活率。對於轉移性鼻咽癌以及其他固態腫瘤的治療經驗則顯示，這樣的積極性治療，並沒有達到完全反應的病人，對於增加長期存活率也不明顯。

關鍵字

高劑量化學治療 ； 自體周邊造血幹細胞移植 ； 鼻咽癌 ； 淋巴癌

並列摘要

There has been a dramatic increase in the number of autologous peripheral blood stem cell transplants (PBSCT) over the last decade. Faster recovery of cell counts, lesser transplant morbidity, shorter hospital stay and reduced cost compared with marrow autografts have been the main advantages. Numerous clinical trials demonstrated improved outcome using HDCT with autologous PBSCT in non-Hodgkin’s lymphoma (NHL). But there are few reports evaluating the role of HDCT with autologous PBSCT in metastatic nasopharyngeal carcinoma (NPC). Here we report our experience in HDCT with autologous PBSCT in 37 cases included 12 NHL patients, 10 metastatic NPC patients and 15 other metastatic solid tumor patients. Our results revealed that, the treatment-related mobility and mortality is not frequent. And the treatment seemed to be benefit for NHL patients who are at first remission or second remission. But in NPC and other solid tumor, our results revealed that HDCT with ICE regimen then autologous PBSCT do not prolong the overall survival and do not produce major response to these patients.

並列關鍵字

High Dose Chemotherapy ； Autologous Peripheral Stem Cell Transplantation ； Nasopharyngeal Carcinoma ； Non-Hodgkin's Lymphoma

參考文獻

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