重粒子放射線與肝癌治療之應用

Heavy-Particle Radiotherapy and Treatment of Hepatocellular Carcinoma

10.6142/VGHN.33.2.126

楊美華(Mei-Hua Yang)；藍耿立(Keng-Li Lan)；梁麗麗(Li-Li Liang)

放射線治療 ； 粒子治療 ； 重粒子治療 ； 碳離子 ； radiotherapy ； particle radiotherapy ； heavy particle radiotherapy ； carbon ion

榮總護理

33卷2期（2016 / 06 / 01）

126 - 133

繁體中文

癌症治療的三大主軸為手術、化學治療及放射治療。統計顯示近半數以上癌症病人會接受放射線治療，因此放射線治療在治療癌症上所扮演的角色不容小覷。近年來由於放射物理、生物醫學與電腦科技的迅速發展，使得放射線治療的技術一日千里。除傳統的直線加速器、螺旋刀、電腦刀等，自1990年美國啟用第一台醫療用質子治療機治療癌症病人，接著日本放射線醫學綜合研究所在1994年開始利用碳離子治療癌症病人至今已20餘年，碳離子質量為質子的12倍，故被歸類為重粒子。截至目前為止，全世界已有一萬三千人接受過重粒子治療，而其中超過8000人是在日本放射線醫學綜合研究所。碳離子放射治療在肺癌、肝癌、頭頸部腫瘤、復發直腸癌及婦科腫瘤等治療上得到非常顯著的效果，對經過許多傳統治療失敗的病人而言，碳離子無疑是一值得推薦治療選項。任何治療對正常組織及器官不免或多或少伴隨著副作用，因此放射腫瘤護理師必須熟知相關知識及可能引起的副作用，提供專業且客製化護理指導，讓病人治療過程中得到妥善的照護順利完成治療。本院即將成立台灣首座重粒子治癌中心，預計2019年開始營運，期望嘉惠更多癌症病人以提供更多的治療選擇。

Surgery, chemotherapy, and radiotherapy are the three major anticancer treatment modalities. Radiotherapy plays a pivotal role in cancer treatment, evidenced by the fact that approximately half of cancer patients receive it. Because of significant advances in the fields of physics, radiobiology, and information technology, great progress has been made in radiotherapy. In addition to conventional photon beam radiotherapy that uses linear accelerator-based equipment, such as tomotherapy and cyberknives, the first proton therapy facility was opened for cancer patient treatment in the United States in 1990. Subsequently, in 1994, the National Institute of Radiological Sciences (NIRS) in Japan began treating cancer patients with carbon ion radiotherapy. Carbon ion weighs 12 times more than proton particles, and is therefore categorized as a heavy particle. To date, more than 13,000 cancer patients have been treated with carbon ion radiotherapy. Among them, more than 8,000 patients were treated at NIRS. The most crucial results of carbon ion radiotherapy have been demonstrated in the treatment of patients with diagnoses including lung, liver, head and neck, recurrent colorectal, and gynecological cancers. For patients with cancers refractory to conventional therapy, carbon ion radiotherapy is a legitimate option. However, this form of therapy is still not free from toxicity toward normal tissues and organs. Therefore, nurses specialized in radiation oncology should be familiar with the mechanisms and toxicity associated with this novel therapy. The provision of customized information and professional care to patients will assist them in completing the treatment smoothly. Our hospital aims to establish the first carbon ion radiotherapy facility in Taiwan in 2019. We hope to offer more treatment options and improved care for cancer patients.

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