Stereotactic Body Radiotherapy (SBRT) for spinal metastases
Abstract
การแพร่กระจายของโรคมะเร็งมาที่กระดูกพบได้บ่อยเป็นอันดับสามรองจากการแพร่กระจายไปยังปอดและตับ โดย กระดูกสันหลังเป็นบริเวณที่พบได้บ่อยที่สุด เนื่องจากมีเส้นทางการแพร่กระจาย หลายทิศทางผ่านระบบหลอดเลือดแดง ระบบหลอดเลือดดํา และระบบทางเดินนํ้าเหลือง รวมทั้งมีสิ่งแวดล้อมภายในไขกระดูกที่เหมาะกับการเจริญเติบโตของ เซลล์มะเร็งตามทฤษฎี “seed and soil” theory (1) จากการศึกษาพบว่ามีการกระจายของโรคมะเร็งมายังกระดูกสันหลัง ในผู้ป่วยโรคมะเร็งทั้งหมดสูงถึง 30%-90% ซึ่งพบความผิดปกติทางระบบประสาทร่วมด้วยได้ประมาณ 5%-30% อันเนื่อง มาจากหลายสาเหตุ เช่น เส้นประสาทไขสันหลังถูกกดทับ ความไม่มั่นคงหรือผิดรูปของกระดูกสันหลัง กระดูกสันหลังหัก ยุบ หรือความผิดปกติของเส้นเลือดที่มาเลี้ยงไขสันหลัง (vascular incompetence) เช่น การบวมจากเลือดคั่ง (edema due to venous congestion) หรือการขาดเลือดจากภาวะเส้นเลือดแดงอุดตัน (cord ischemia by arterial embolism) เป็นต้น (2)
References
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2015-12-29
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ส่งทอง อ. Stereotactic Body Radiotherapy (SBRT) for spinal metastases. J Thai Assn of Radiat Oncol [Internet]. 2015 Dec. 29 [cited 2024 Nov. 15];21(2):62-90. Available from: https://he01.tci-thaijo.org/index.php/jtaro/article/view/203274
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