The Outcome of Intraluminal Brachytherapy Using Iridium 192(IR-192) for Hepatobiliary Cancers with Biliary Tract Obstruction

膽道腫瘤的銥－192近接治療結果

李欣樺(Hsin-Hua Lee) ； 黃志仁(Chih-Jen Huang) ； 連熙隆(Shi-Long Lian) ； 石明誠(Paul Ming-Chen Shih) ； 吳定國(Ding-Kwo Wu) ； 柯成國(Chen-Cuo Ker)

《放射治療與腫瘤學》 19卷1期 (2012/03) Pp. 31-39

https://doi.org/10.6316/TRO/201219(1)31

摘要

目的：評估局部肝膽道惡性腫瘤在接受高劑量率近接放射治療後之治療效果。材料與方法：自2007年3月至2011年3月，有11位肝膽道惡性腫瘤病患其癌症期別為TI～4，NO～1，M0接受高劑量率近接放射治療。病患之年齡分佈從46歲到79歲，其中位數為68歲。病患於2～3天內接受3～5次高劑量率的銥－192近接放射治療，平均放射線劑量為14 Gy（9～17.5 Gy，3.13 Gy/fraction，b.i.d.）。其中六位病患除了接受近接治療，也接受體外放射治療，其劑量範圍從40 Gy至64.8 Gy，平均放射線劑量為44 Gy。自癌症診斷起算病患之追蹤時間中位數為10個月（1～28個月）。結果：放射線治療前總膽紅素平均為9.66 mg/dL（1.05～29.22 mg/dL）;放射線治療後總膽紅素平均為1.73 mg/dL（0.27～4.23 mg/dL）。三位肝外膽道癌病患之存活中位數為19個月；三位肝內膽道癌病患之存活中位數為9個月；兩位壺腹乳頭癌病患之存活中位數為22個月；兩位肝癌病態之存活中位數為5個月；一位膽囊癌病態、之存活15個月。結論：局部肝膽道惡性腫瘤病患接受高劑量率近接放射治療有助於解除阻塞性黃疸。

關鍵字

肝膽道癌 ； 近接放射治療 ； 銥－192 ； 腔內治療

並列摘要

Purpose: To investigate the outcome of intraluminal brachytherapy (ILBT) using Iridium 192 (Ir-192) for hepatobiliary cancers with biliary tract obstruction. Materials and Methods: The clinical data of eleven patients with hepatobiliary malignancies (clinical stage as Tl-4, NO-1, MO) were collected from March 2007 to March 2011. AII of them had biliary obstruction caused by hepatobiliary cancers. The age at the initial diagnosis ranged from 46 to 79 years with a median of 68 years. AII patients received three to five fractions of high dose-rate Ir-192 ILBT (twice a day, for two to three days) with mean dose 01 14 Gy (9-17.5 Gy, 3.13 Gy/fraction, b.i.d.) and 6 of them also received external beam radiotherapy (EBRT) with mean dose of 44 Gy (40-64.8 Gy, 2 Gy/fraction/day). The median follow-up time from initial diagnosis was 10 months (1-28 months). Results: The mean value of pre-RT total bilirubin was 9.66 mg/dL (1.05-29.22 mg/dL) and that of post-RT was 1.73 mg/dL (0.27-4.23 mg/dL). The median survival time was 19 months for three patients with extra-hepatic cholangiocarcinoma, 9 months for three patients with intra-hepatic cholangiocarcinoma, 22 months for two patients with ampulla of Vater cancer and 5 months for those with hepatocellular carcinoma. The only single patient with gall bladder cancer survived 15 months. Conclusion: Ir-192 intraluminal brachytherapy is a feasible treatment option to relieve biliary tract obstruction and improve bile drainage for patients with hepatobiliary cancers.

並列關鍵字

Cholangiocarcinoma ； Brachytherapy ； Iridium192 ； Radiotherapy ； Obstruction