Radiation Oncology Chulolongkorn University

High-Dose Radiation and Sphincter Preservation

ã¹»ÅÒÂ»Õ ¤.È. 1970 ä´éÁÕ¡ÒÃãªéà¤Ã×èͧÁ×ÍËÃ×ÍÍØ»¡Ã³ì ·ÕèàÃÕ¡ÇèÒ Endoluminal stapling devices ÁÒãªé㹡Ò÷ӼèҵѴÁÐàÃç§ÅÓäÊéÊèǹ mid áÅÐ distal rectum à¾×èÍà»ç¹¡ÒÃʧǹËÙÃÙ´¢Í§·ÇÒÃ˹ѡàÍÒäÇé (sphincter preservation techniques) ÃÐÂÐàÇÅÒËÅÒ»շÕè¼èÒ¹ÁÒÈÑÅÂá¾·Âìàª×èÍÇèÒ¡ÒüèҵѴ
ÁÐàÃç§ÅÓäÊéãË­èÊèǹ»ÅÒ ¨ÐµéͧÁբͺࢵÍÂèÒ§¹éÍ 5 à«ç¹µÔàÁµÃ ¨Ò¡µÑÇÁÐàÃ移°ÁÀÙÁÔ¨Ö§¨Ðà¾Õ§¾Í·Õè¨ÐÅ´ÍغѵԡÒáÓàÃÔº¢Í§âä੾ÒзÕè¨Ò¡¡ÒÃá¾Ãè¡ÃШÒ¢ͧâä仵ÒÁ¼¹Ñ§¢Í§ÅÓäÊéãË­è
(intramural spread) áµèã¹ÃÐÂÐËÅѧ¹ÕéÁÕàÍ¡ÊÒÃáÅТéÍÁÙŵèÒ§ æ ·Õèºè§ºÍ¡ÇèҢͺࢵÍÂèÒ§¹éÍ 2 à«ç¹µÔ-àÁµÃ ÍÒ¨¨Ðà¾Õ§¾Í·Õè¨Ð»éͧ¡Ñ¹ intramural spread ä´é 17,18 ¹Í¡¨Ò¡¹Õéà»ç¹·ÕèÂÍÁÃѺ¡Ñ¹ÇèÒ¡ÒÃãªé
High-Dose preoperative radiation ¹Ñé¹ ÊÒÁÒö·Õè¨Ð·ÓÅÒ microscopic tumor ·ÕèÁÕ¡ÒÃá¾Ãè¡ÃШÒÂ仵ÒÁ¼¹Ñ§ÅÓäÊéãË­èä´é «Öè§ÁռŷÓãËéÊÒÁÒöŴ¤ÇÒÁÂÒǢͧÅÓäÊéãË­èÊèǹ»ÅÒ·Õè¨Ðµéͧ¼èҵѴÍÍ¡µÒÁ»¡µÔä´é ©Ð¹Ñé¹ÇÔ¸Õ¡ÒùÕé¨Ö§à»ç¹ÇÔ¸Õ¡ÒÃ˹Ö觢ͧ¡Ò÷ӼèҵѴẺ sphincter-preservation
»ÃÔÁÒ³ÃѧÊÕ·Õè¹ÔÂÁãªé ÊèǹÁÒ¡¨ÐÍÂÙèÃÐËÇèÒ§ 4,500-5,500 cGy ã¹ÃÐÂÐàÇÅÒ 5-6 ÊÑ»´ÒËì
áÅШеÒÁ´éÇ¡Ò÷ӼèҵѴËÅѧ¨Ò¡©ÒÂÃѧÊդúáÅéÇ 4-6 ÊÑ»´ÒËì
¨Ò¡¡ÒÃÈÖ¡ÉҨҡʶҺѹµèÒ§ æ16,19-23 â´Â¡ÒÃãªé High-dose preoperative radiation áÅеÒÁ´éÇ¡Ò÷ӼèҵѴẺ sphincter preservation ¹Ñé¹ ¾ºÇèÒÁÕÍѵÃÒ¡ÒáÓàÃÔº¢Í§âä੾ÒзÕè»ÃÐÁÒ³ 10-20% áÅÐÁÕÍѵÃÒ¡ÒÃÃÍ´ªÕÇÔµÍÂÙèÃÐËÇèÒ§ 70-80% áÅоºÇèÒ 90% ¢Í§¡Ò÷ӧҹ¢Í§ËÙÃÙ´¢Í§·ÇÒÃ˹ѡÍÂÙèã¹à¡³±ì·Õè´Õ

Last modified on 25 October 1996