Radiation Oncology, Chulolongkorn University : Prognostic Factors

Radiation Oncology Chulolongkorn University

Prognostic Factors

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1. ¡ÒÃ·ÕèÁÐàÃç§á¾Ãè¡ÃÐ¨ÒÂä»ÊÙèµèÍÁ¹éÓàËÅ×Í§ã¡Åéà¤ÕÂ§ ÁÐàÃç§ÅÓäÊéãËè·Õèà»ç¹à©¾ÒÐ·Õè·ÕèàÂ×èÍºØ¼ÔÇÅÓäÊé (Dukes’ A Stage) ¨ÐÁÕÍÑµÃÒÃÍ´ªÕÇÔµà©ÅÕèÂ·Õè 5 »ÕÁÒ¡¡ÇèÒ 90% ËÃ×ÍÃÐÂÐ Dukes’B
70-85% ÃÐÂÐ Dukes’ C 30-60% ¶éÒà»ç¹ÁÐàÃç§ã¹ÃÐÂÐá¾Ãè¡ÃÐ¨ÒÂ Dukes’D ¨ÐàËÅ×ÍÍÑµÃÒÃÍ´ªÕÇÔµã¹ 5 »Õ à¾ÕÂ§ 5% à·èÒ¹Ñé¹
2. ¨Ó¹Ç¹¢Í§µèÍÁ¹éÓàËÅ×Í§·ÕèÁÕà«ÅÅìÁÐàÃç§ ¶éÒÂÔè§ÁÕ¨Ó¹Ç¹µèÍÁ¹éÓàËÅ×Í§·ÕèÁÕà«ÅÅìÁÐàÃç§ÍÂÙèÁÒ¡¢Öé¹à·èÒäÃ âÍ¡ÒÊ·ÕèâÃ¤¨Ðá¾Ãè¡ÃÐ¨ÒÂáÅÐ¡ÅÑºà»ç¹«éÓ¨ÐÁÕÁÒ¡¢Öé¹à·èÒ¹Ñé¹ àªè¹ ¶éÒÁÕµèÍÁ¹éÓàËÅ×Í§ÁÒ¡¡ÇèÒ 4 µèÍÁ·ÕèÁÕà«ÅÅìÁÐàÃç§ ¨ÐÁÕâÍ¡ÒÊ¡ÅÑºà»ç¹«éÓÁÒ¡¡ÇèÒã¹ÃÒÂ·ÕèÁÕµèÍÁ¹éÓàËÅ×Í§·ÕèÁÕà«ÅÅìÁÐàÃç§µÑé§áµè 1-4 µèÍÁ à»ç¹µé¹
3. ¡ÒÃ·ÕèÁÐàÃç§à¨ÃÔàµÔºâµ·ÐÅØ¼¹Ñ§ÅÓäÊéãËè ¶éÒÁÐàÃç§à¨ÃÔàµÔºâµ¨Ò¡àÂ×èÍºØ¼ÔÇà¢éÒä»¶Ö§¼¹Ñ§ÅÓäÊéãËèáÅéÇ ÍÒ¨·ÐÅØÍÍ¡ä»ÊÙèÍÇÑÂÇÐã¡Åéà¤ÕÂ§ àªè¹ Pericolic Fat ¡ç¨ÐÁÕâÍ¡ÒÊ¡ÅÑºà»ç¹«éÓä´éÁÒ¡¢Öé¹ à¾ÃÒÐÁÕâÍ¡ÒÊ·Õèà«ÅÅìÁÐàÃç§ËÅ§àËÅ×ÍÍÂÙèÀÒÂËÅÑ§¡ÒÃ¼èÒµÑ´ä´éÁÒ¡
4. ¾ÂÒ¸ÔÊÀÒ¾áºº Poorly Differentiated Carcinoma ÁÐàÃç§·ÕèÁÕ¾ÂÒ¸ÔÊÀÒ¾áºº¹Õé¨Ðá¾Ãè¡ÃÐ¨ÒÂä´éÁÒ¡¡ÇèÒ ª¹Ô´ Well Differentiated Carcinoma áÅÐÁÕ¡ÒÃ´Óà¹Ô¹âÃ¤·ÕèÃØ¹áÃ§¡ÇèÒ
5. ÁÐàÃç§áµ¡·ÐÅØÍÍ¡ÁÒ¹Í¡ÅÓäÊé ¡ÒÃ·ÕèÁÐàÃç§áµ¡·ÐÅØÍÍ¡ÁÒ¹Í¡¼¹Ñ§ÅÓäÊéãËè ËÃ×Íä»µÔ´¡ÑºÍÇÑÂÇÐã¡Åéà¤ÕÂ§ ·ÓãËéâÍ¡ÒÊ·ÕèÁÕà«ÅÅìÁÐàÃç§µ¡¤éÒ§ÍÂÙèËÅÑ§¡ÒÃ¼èÒµÑ´ÁÕÁÒ¡ áÅÐ¡èÍãËéà¡Ô´¡ÒÃ¡ÅÑºà»ç¹«éÓà©¾ÒÐ·Õèã¹ªèÍ§·éÍ§ÊÙ§
6. Venous Invasion ºÒ§¤ÃÑé§à«ÅÅìÁÐàÃç§¨Ðá¾Ãè¡ÃÐ¨ÒÂà¢éÒä»ÊÙèàÊé¹àÅ×Í´´Ó·ÕèÃÑºàÅ×Í´¨Ò¡ÅÓäÊéãËèã¹µÓáË¹è§¹Ñé¹ ·ÓãËéÊÒÁÒÃ¶á¾Ãè¡ÃÐ¨ÒÂä»µÒÁ¡ÃÐáÊàÅ×Í´ä»ÊÙèÊèÇ¹Í×è¹ æ ä´é
7. Preoperative Elevation of Carcinoembryonic Antigen (CEA) ¡ÒÃ·ÕèÁÕ¤èÒ¢Í§ CEA ÊÙ§
àªè¹ ÁÒ¡¡ÇèÒ 5 ng/ml ¡èÍ¹¼èÒµÑ´ªÕéºè§ÇèÒ¨ÐÁÕâÍ¡ÒÊ¡ÒÃ¡ÅÑºà»ç¹«éÓ¢Í§âÃ¤ä´éÁÒ¡¢Öé¹ËÅÑ§¡ÒÃ¼èÒµÑ´
8. DNA Aneuploidy â´Â»¡µÔà«ÅÅì·ÑèÇä»¨ÐÁÕ»ÃÔÁÒ³ DNA ·Õè¤§·Õè (Diploid) à«ÅÅìÁÐàÃç§ÍÒ¨ÁÕ¡ÒÃà¨ÃÔàµÔºâµ¼Ô´»¡µÔ áÅÐÁÕ¡ÒÃÊÃéÒ§ DNA ÁÒ¡ (Hyperdiploid) ËÃ×Í¹éÍÂ¡ÇèÒ»¡µÔ (Hypodiploid) ¨Ò¡¡ÒÃÈÖ¡ÉÒ¾ºÇèÒÁÐàÃç§·ÕèÁÕ»ÃÔÁÒ³ DNA ¼Ô´»¡µÔ ¨Ðà»ç¹ÁÐàÃç§·ÕèÁÕ¡ÒÃ¾ÂÒ¡Ã³ìâÃ¤·ÕèäÁè´Õ áÅÐÁÕ¡ÒÃ´Óà¹Ô¹¢Í§âÃ¤·ÕèÃØ¹áÃ§¡ÇèÒÁÐàÃç§·ÕèÁÕ»ÃÔÁÒ³ DNA »¡µÔ (Diploid Tumor)
9. Specific Chromosome Deletion (Allelic Loss) ¡ÒÃ·ÕèÁÕÊèÇ¹¢Í§â¤ÃâÁâ«ÁºÒ§ÍÑ¹¢Ò´ËÒÂä» àªè¹ â¤ÃâÁâ«Á ·ÕèÁÕÂÕ¹ª×èÍ nM23 ÍÂÙè ¨Ð·ÓãËéà«ÅÅìÁÐàÃç§àËÅèÒ¹ÕéÊÒÁÒÃ¶á¾Ãè¡ÃÐ¨ÒÂ (Metastasis) ä´éÁÒ¡¡ÇèÒ»¡µÔ àª×èÍÇèÒÂÕ¹Êì·Õè¢Ò´ËÒÂä» àËÅèÒ¹Õé·ÓË¹éÒ·Õè»éÍ§¡Ñ¹¡ÒÃá¾Ãè¡ÃÐ¨ÒÂ
¢Í§à«ÅÅìÁÐàÃç§

µÒÃÒ§·Õè 2 áÊ´§»Ñ¨¨ÑÂ·ÕèºÍ¡¶Ö§¡ÒÃ¾ÂÒ¡Ã³ì·ÕèàÅÇ¢Í§âÃ¤ÁÐàÃç§ÅÓäÊéãËèËÅÑ§¡ÒÃ¼èÒµÑ´
Tumor spread to regional lymph nodes
Number of regional lymph nodes involved
Tumor penetration through the bowel wall
Poorly differentiated histology
Tumor adherence to adjacent organs
Venous invasion
Preoperative elevation of CEA titer (>5.0 ng/ml)
? Aneuploidy
? Specific chromosomal deletion (allelic loss)

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Last modified on 25 October 1996