Invasive Thymoma with Intracaval and Intracardiac Extension Treatment with Three Dimensional Conformal Radiotherapy: Report of a Case and Review of Literature

侵襲性胸腺瘤合併上腔靜脈及心臟侵犯單獨以三度空間順形放射線治療：病例報告及文獻回顧

10.6316/TRO/200714(3)219

崔樂平(Le-Ping Tsuei)；連熙隆(Shi-Long Lian)；謝煥鈞(Huan-Chun Hsien)；郭銘斌(Ming-Pin Kuo)

侵襲性胸腺瘤 ； 心臟侵犯 ； 上腔靜脈侵犯 ； 放射治療 ； Invasive thymoma ； Intracardiac extension ； Intracaval extension ； Radiotherapy

放射治療與腫瘤學

14卷3期（2007 / 09 / 01）

219 - 226

英文

胸腺瘤的治療是以手術為主，至於放射治療主要是扮演輔助或緩解的角色。對於已經有心臟及上腔靜脈侵犯的侵襲性胸腺瘤，手術切除會變得很困難。所以當有這種情形時，放射治療則成為治療的首選。因為胸腺瘤對放射線是相對敏感的，所以放射治療可以達到滿意的症狀緩解及局部控制的目的。近年來，隨著治療技術及設備的進步，放射治療的成果也隨著提昇。重要的放射治療技術改進，包括有順形放射治療、強度調控放射治療、影像導引放射治療以及立體定位放射手術。這些技術可以達到增加腫瘤劑量及降低正常組織劑量的目的。我們報告一個侵襲性胸腺瘤合併心臟及上腔靜脈侵犯，單獨以放射線來治療並達到良好的局部控制的案例。

The main treatment for thymoma is surgery. The role of radiotherapy is adjuvant or palliative treatment. But when the state of thymoma with intracardiac and intracaval invasion occurs, surgery becomes difficult and radiotherapy becomes the first choice of treatment. Thymoma is relatively radiosensitive. Radiotherapy may achieve satisfactory symptom relief and local control. Recently, the improvement of technique and equipment including three-dimensional conformal radiotherapy, intensity modulated radiotherapy, image guided radiotherapy and stereotactic radiosurgery increases the treatment result of radiotherapy. These techniques increase the tumor dose and decrease the normal tissue dose. We report a case of intracardiac and intracaval invasive thymoma treated with radiotherapy alone and resulted in good local control.