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[直肠癌和乙状结肠癌的热放疗——主要应用于无法手术切除的原发及复发病例]

[Thermoradiotherapy for adenocarcinoma of the rectum and sigmoid--application to primarily inoperable and recurrent cases].

作者信息

Takeshita N, Tanaka Y, Matsuda T

机构信息

Department of Radiology, Tokyo Metropolitan Komagome Hospital.

出版信息

Nihon Igaku Hoshasen Gakkai Zasshi. 1992 Apr 25;52(4):472-82.

PMID:1630892
Abstract

Between February 1983 and May 1990, 19 rectal cancers and three sigmoid colon cancers were treated with thermoradiotherapy. Among four patients with primary rectal cancer, one received preoperative treatment and three were judged inoperable. All the inoperable patients responded well to treatment and were judged operable. Pathological examination of the resected specimens confirmed the effectiveness of treatment. In one case in particular, no cancer cells were observed in the specimen or at autopsy, 21 months after thermoradiotherapy. Eighteen cases of recurrent colorectal cancer were also treated. Judged by tumor shrinkage alone, these patients were classified into five cases of PR and 13 of NR. When the low density area seen on CT images after treatment was added to the criteria, there was one case of CR, six of PR, and 11 of NR, and the effectiveness ratio shown by the sum of CR and PR was 38.9%. Fourteen cases in the thermoradiotherapy group and 16 in the radiation therapy group were compared as to the reduction in postoperative perineal pain caused by recurrence at the pre-sacral area. It was found that thermoradiotherapy was significantly superior to radiation therapy in the frequency and duration of pain relief. Although most patients complained of the sensation of heat, this was within tolerable limits, and no severe side effects were experienced.

摘要

1983年2月至1990年5月期间,对19例直肠癌和3例乙状结肠癌患者进行了热放疗。在4例原发性直肠癌患者中,1例接受了术前治疗,3例被判定无法手术。所有无法手术的患者对治疗反应良好,并被判定可以手术。切除标本的病理检查证实了治疗的有效性。特别是有1例患者,在热放疗后21个月,标本或尸检中均未观察到癌细胞。还对18例复发性结直肠癌患者进行了治疗。仅根据肿瘤缩小情况判断,这些患者分为5例部分缓解(PR)和13例无缓解(NR)。当将治疗后CT图像上出现的低密度区域纳入标准时,有1例完全缓解(CR)、6例PR和11例NR,CR和PR之和显示的有效率为38.9%。比较了热放疗组的14例患者和放疗组的16例患者术前骶骨区域复发引起的术后会阴疼痛减轻情况。结果发现,热放疗在缓解疼痛的频率和持续时间方面明显优于放疗。虽然大多数患者抱怨有热感,但在可耐受范围内,未出现严重副作用。

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