Radiation Oncology, Chulolongkorn University : ¡ÒÃÃÑ¡ÉÒ Rectal Carcinoma

Radiation Oncology Chulolongkorn University

¡ÒÃÃÑ¡ÉÒ Rectal Carcinoma

¡ÒÃ¼èÒµÑ´ Rectal Carcinoma47
ÁÐàÃç§ÅÓäÊéãËèÊèÇ¹ Rectum ¨ÐÍÂÙèµèÓã¹ÍØé§àªÔ§¡ÃÒ¹ ·ÓãËéºÒ§¤ÃÑé§¶éÒÁÐàÃç§µèÓ¨Óà»ç¹µéÍ§·Ó
Colostomy ·ÕèË¹éÒ·éÍ§ «Öè§¼Ùé»èÇÂÊèÇ¹ÁÒ¡äÁèªÍº·Õè¨ÐÁÕÍØ¨¨ÒÃÐÁÒÍÍ¡·ÕèË¹éÒ·éÍ§·Ò§ªèÍ§ Colostomy
´Ñ§¹Ñé¹¡ÒÃ¼èÒµÑ´¨Ö§¨Óà»ç¹µéÍ§ãªéÇÔ¸Õ·Õè·ÓãËé¼Ùé»èÇÂËÒÂ¨Ò¡âÃ¤·Õèà»ç¹ áÅÐã¹¢³Ðà´ÕÂÇ¡Ñ¹¡çäÁè·ÓãËé¤Ø³ÀÒ¾ªÕÇÔµ¢Í§¼Ùé»èÇÂàÊÕÂä»´éÇÂ ÇÔ¸Õ¡ÒÃ¼èÒµÑ´·Õè¹ÔÂÁã¹»Ñ¨¨ØºÑ¹¹ÕéÁÕ´Ñ§¹Õé

1. Upper Third Rectum ·Ó Low Anterior Resection µÒÁ´éÇÂ Primary Anastomosis
2. Middle Third Rectum ·Ó Sphincter saving Surgery «Öè§ÍÒ¨à»ç¹ Low Anterior
Resection, Abdominosacral Resection ËÃ×Í coloanal Resection
3. Lower Third Rectum ·Ó Abdominoperineal Resection µÒÁ´éÇÂ Colostomy
¡ÒÃ·Ó Sphincter-saving Surgery à»ç¹¤ÇÒÁ¾ÂÒÂÒÁ·Õè¨ÐãËéÅÑ¡É³Ð·Ò§¡ÒÂÇÔÀÒ¤¢Í§ Rectum ·ÓË¹éÒ·Õèä´éàËÁ×Í¹à´ÔÁ ãËé¼Ùé»èÇÂÊÒÁÒÃ¶ÍØ¨¨ÒÃÐ·Ò§·ÇÒÃË¹Ñ¡ä´éËÅÑ§¡ÒÃ¼èÒµÑ´ «Öè§ÁÑ¡¨ÐµéÍ§ãªé¡ÒÃ¼èÒµÑ´ÃèÇÁ¡Ñº¡ÒÃ©ÒÂÃÑ§ÊÕËÃ×ÍãËéÂÒà¤ÁÕºÓºÑ´ ËÃ×ÍãËé·Ñé§à¤ÁÕºÓºÑ´áÅÐ¡ÒÃ©ÒÂÃÑ§ÊÕ ÃèÇÁ
¡Ñº¡ÒÃ¼èÒµÑ´
Radiotherapy
ÃÑ§ÊÕÃÑ¡ÉÒ¨ÐÁÕº·ºÒ·ÊÓ¤Ñã¹¡ÒÃÃÑ¡ÉÒ¼Ùé»èÇÂÁÐàÃç§ÅÓäÊéãËè ÊèÇ¹ rectum ´Ñ§¨Ð¡ÅèÒÇã¹ÃÒÂÅÐàÍÕÂ´µèÍä»
Adjuvant systemic Chemotherapy
¼Ùé»èÇÂÁÐàÃç§ÅÓäÊéãËèÊèÇ¹ rectum ·ÕèÍÂÙèã¹ÃÐÂÐ Dukes’B2 áÅÐ Dukes’C ¾ºÇèÒ¨ÐÁÕ¡ÒÃá¾Ãè¡ÃÐ¨ÒÂ¢Í§âÃ¤ä´é»ÃÐÁÒ³ 30-35% ¡ÒÃãªéÂÒà¤ÁÕºÓºÑ´ 5FU ÍÂèÒ§à´ÕÂÇ, 5FU+Levamisole ËÃ×Í
5FU + Leucovarin + Levamisole ¨ÐÊÒÁÒÃ¶Å´ÍÑµÃÒ¡ÒÃá¾Ãè¡ÃÐ¨ÒÂ¢Í§âÃ¤Å§ä´é áÅÐÍÒ¨¨Ðà¾ÔèÁÍÑµÃÒ¡ÒÃÃÍ´ªÕÇÔµ¢Í§¼Ùé»èÇÂ
ã¹»Ñ¨¨ØºÑ¹¹Õé¾ºÇèÒ¡ÒÃãËéÂÒà¤ÁÕºÓºÑ´ÃèÇÁ¡Ñº¡ÒÃ©ÒÂÃÑ§ÊÕËÅÑ§¡ÒÃ·Ó¼èÒµÑ´ã¹¼Ùé»èÇÂÁÐàÃç§ÅÓäÊéãËè rectum ·ÕèÍÂÙèã¹ÃÐÂÐ Dukes B2 áÅÐ C ¨ÐÊÒÁÒÃ¶Å´ÍÑµÃÒ¡ÒÃ¡ÓàÃÔº¢Í§âÃ¤à©¾ÒÐ·Õè ÁÕÍÑµÃÒ¡ÒÃ»ÅÍ´âÃ¤áÅÐà¾ÔèÁÍÑµÃÒ¡ÒÃÃÍ´ªÕÇÔµ¢Í§¼Ùé»èÇÂ

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Last modified on 25 October 1996