| 作成者 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| 本文言語 |
|
| 出版者 |
|
|
|
| 発行日 |
|
| 収録物名 |
|
| 巻 |
|
| 号 |
|
| 開始ページ |
|
| 終了ページ |
|
| 出版タイプ |
|
| アクセス権 |
|
| JaLC DOI |
|
| 関連DOI |
|
| 関連URI |
|
| 関連HDL |
|
| 概要 |
We report on a 69-year-old woman with rhabdomyosarcoma arising from the nasal and paranasal sinuses. She was referred to our hospital with a reduced ability to smell and impaired bilateral vision, na...rrowing of the visual field, and left facial pain. Computed tomography (CT) revealed a large tumor in the nasal and left paranasal sinuses invading the left orbital cavity and anterior skull base, and lymph node swellings in the submental and left accessory nerve areas. A biopsy specimen from the nasal tumor was diagnosed histologically as a rhabdomyosarcoma, alveolar type. Because the intracranial direct invasion and distant metastases to the thoracic spine were suspected by pretreatment examination, our case was determined to be inoperable by a head and neck surgeon. Radiotherapy with a total dose of 60 Gy was carried out to control the primary disease. The three-dimensional conformal radiotherapy (3D-CRT) and intensitymodulated radiotherapy (IMRT) techniques were used in order to reduce the doses to risk organs. Combined with radiotherapy, chemotherapy was also performed for the treatment of lymph-node metastases and distant diseases. After the treatment was completed, the primary tumor and lymph-node metastases disappeared completely ; there was no sign of re-growth during the follow-up period. Chemoradiotherapy may be an effective treatment also for inoperable adult rhabdomyosarcoma in the head and neck region. Furthermore, the 3D-CRT and IMRT techniques are both useful methods of radiotherapy for this disease.
症例は69歳,女性.鼻腔および副鼻腔原発横紋筋肉腫で,両側視力低下,視野狭窄および嗅覚異常にて九大病院に紹介受診.CT上,腫瘤は鼻腔および副鼻腔を充満し,左眼窩内および頭蓋底部への浸潤を認めた.また,オトガイ下および左副神経領域にリンパ節転移と考えられるリンパ節腫大を認めた.鼻腔腫瘤からの生検にて,横紋筋肉腫・胞巣型と診断された.頭蓋底部への浸潤および胸椎転移を認めた為,手術適応なしと判断された.治療として,原発巣への放射線治療60Gy/30分割および化学療法(VAC療法)3サイクルを行った.放射線治療には,局所線量増加と周囲リスク臓器線量低減目的にて,3次元原体照射(3D-CRT)および強度変調放射線治療(IMRT)を用いた.治療後,原発腫瘍およびリンパ節転移は消失した.症例は,12ケ月後に骨転移の増悪にて死亡したが局所領域の再発は見られなかった.化学療法および放射線治療の併用は成人の横紋筋肉腫においても有効であり,3D-CRTやIMRTを用いた放射線治療は局所制御および副作用低減において有用と考えられた.続きを見る
|
Mendeley出力
fam96_10_p363