Radiation Oncology Chulolongkorn University
Patterns of failure
¨Ò¡¢éÍÁÙŵèÒ§ æ ·ÕèÊÐÊÁÁÒ·Ñ駨ҡ·Ò§¤ÅÕ¹Ô¤áÅШҡ¡Ò÷ӼèҵѴµÃǨȾ¼ÙéàÊÕªÕÇÔµ¾ºÇèÒ»ÑËÒ¡ÒáÓàÃÔº¢Í§âä੾ÒзÕè à»ç¹»ÑËÒÊÓ¤ÑÍѹ˹Öè§·Õèà¡Ô´¢Öé¹ËÅѧ¨Ò¡¡Ò÷ӼèҵѴÁÐàÃç§ÅÓäÊéãËèÊèǹ»ÅÒ (rectal cancer) â´Â੾ÒÐÊèǹ·ÕèÍÂÙèãµéµèÍ peritoneal reflection â´Â¾ºÇèÒ¨ÐÁÕ¡ÒáÓàÃÔº¢Í§âäã¹ÍØé§àªÔ§¡ÃÒ¹ (pelvic recurrences) ÊÓËÃѺ¼Ùé»èÇÂÁÐàÃç§ÅÓäÊéãËèÊèǹ»ÅÒÂÃÐÂÐ Dukes’B2 25% - 30% áÅÐÊÙ§¶Ö§ 40% - 80% ã¹ÃÐÂÐ Dukes’C ËÅѧ¨Ò¡¡Ò÷ӼèҵѴÍÂèÒ§à´ÕÂÇ4-8 à˵ؼÅÊӤѷÕè·ÓãËéÁÕ¡Òà ¡ÓàÃÔº¢Í§âäÊÙ§ à¹×èͧÁÒ¨Ò¡ÅÑ¡É³Ð¢Í§ÍØé§ àªÔ§¡ÃÒ¹«Öè§á¤º ¡Ò÷ӼèҵѴà¾×èÍãËéä´é¢Íºà¢µ·ÕèËèÒ§¨Ò¡µÑÇ¡é͹ÁÐàÃç§ÍÂèÒ§à¾Õ§¾Í (wide radial margin) ¹Ñé¹·Óä´éÂÒ¡ à¹×èͧ¨Ò¡¡é͹ÁÐàÃç§ ÁÑ¡¨ÐÍÂÙèªÔ´µÔ´ ¡Ñº¢Íº¢Í§â¤Ã§¡Ãд١àªÔ§¡ÃÒ¹ ´éÇÂà˵عÕé¨Ö§·ÓãËéÁÕ¡ÒáÓàÃÔº¢Í§âäã¹ÍØé§àªÔ§¡ÃÒ¹ÊÙ§ ¨Ö§ä´éÁÕ¡ÒÃ¹Ó ÇÔ¸Õ¡ÒéÒÂÃѧÊÕ ÍÒ¨¨Ðà»ç¹¡ÒéÒÂÃѧÊÕ¡è͹ËÃ×ÍËÅѧ¨Ò¡¡Ò÷ӼèҵѴ ¨Ø´»ÃÐʧ¤ìà¾×èÍ·Õè¨Ð¡Ó¨Ñ´à«ÅÅìÁÐàÃç§¢¹Ò´àÅç¡ æ ·ÕèÍÒ¨ËŧàËÅ×ÍÍÂÙè (eradicate residual microscope disease) Êèǹ¼Ùé»èÇÂÁÐàÃç§ÅÓäÊéãËèÊèǹµé¹ (colonic cancer) «Öè§µÑÇÁÐàÃç§ÍÂÙèà˹×͵èÍ peritoneal reflection ¶éÒÊÒÁÒö·Ó¼èҵѴµÑÇ¡é͹ÁÐàÃç§ (resectable cancer) ÍÍ¡ä»ä´éËÁ´ âÍ¡Òʢͧ¡ÒáÓàÃÔº¢Í§âä੾ÒзÕè (local recurrence) ¨Ðà¡Ô´¢Öé¹¹éÍ¡ÇèÒàÁ×èÍà»ÃÕºà·Õº¡ÑºÁÐàÃç§ÅÓäÊéãËèÊèǹ»ÅÒ ¤×ͨоºä´éà¾Õ§ 3% - 12% à·èÒ¹Ñé¹ã¹¼Ùé»èÇÂ¡ÅØèÁ¹Õé áµè¢³Ðà´ÕÂǡѹ¨Ð¾ºÇèÒÁÕ¡ÒÃá¾Ãè¡ÃШÒ¢ͧâä价ҧ¡ÃÐáÊàÅ×Í´ä´éÁÒ¡ â´Â੾ÒСÒÃá¾Ãè¡ÃШÒÂä»·ÕèµÑº(9-11)
Last modified on 25 October 1996