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研究生:楊淳翔
研究生(外文):Tsun- Hsiang Yang
論文名稱:以電磁熱導針熱消融療法於臨床小動物腫瘤之試驗性研究
論文名稱(外文):Thermal ablation by Electromagnetic Heating Needles on Small Animal Tumors- A Pilot Study
指導教授:李繼忠李繼忠引用關係
指導教授(外文):Jih Jong Lee
口試委員:李雅珍林辰栖廖泰慶
口試日期:2015-06-24
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:臨床動物醫學研究所
學門:獸醫學門
學類:獸醫學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:英文
論文頁數:69
中文關鍵詞:電磁熱導法熱消融熱治療小動物腫瘤
外文關鍵詞:electromagnetic therapythermal ablationhyperthermiasmall animal tumorsheating needles
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熱消融在人類腫瘤的局部控制中已使用數年。相對於傳統外科手術來說,熱消融主要的優點更加快速,導致更少的出血量,以及最重要的是,能夠用非侵入性的方式使用因而大幅降低對於周遭鄰近組織的傷害。電磁熱療法(EMT)是由成功大學所新開發的一種新穎熱消融治療系統。這項新穎治療的優勢在於較便宜的成本因為針具是用間接加熱的方式而且是可拋棄式的,並且沒有對用於探針的數量的限制。在這個研究中,共有10例患者包括11個腫瘤納入此研究。腫瘤類型包括6個肉瘤、4個上皮腫瘤、以及1個圓形細胞瘤。腫瘤治療療效的部分有8個腫瘤 (73%) 達到完全消退以及3個 (27%) 部分消退。此治療方式的併發症較不嚴重但皮膚以及軟組織傷害是可被預期的。治療之後術區將會形成開放性傷口,但此傷口並不會有出血、疼痛、以及其他副作用且在一般護理之將在1.5個月後癒合。在理想的情況下,藉由這項新穎治療的優點、低技術要求和確切的療效,能夠在未來將使更多的動物受益。

Thermal ablation has been used for local control of human neoplasm for several years. The main advantages of thermal ablation are shorter operation time, less hemorrhage than traditional surgical procedures, and most importantly, can be performed minimal invasively with little damage to adjacent tissue. Electromagnetic thermal therapy (EMT) is a new treatment system that is relatively inexpensive and does not have a limit on the total number of heating-needles used. A total of 10 patients and 11 tumors were enrolled into the study. Tumor types included 6 sarcomas, 4 epithelial tumors, and 1 round cell tumor. In terms of tumor efficacy, 8 CR (73%) and 3 PR (27%) were achieved. Complications post therapy was acceptable although dermatological and soft tissue damages were inevitable but manageable. Open wound is expected in most cases after the treatment but without hemorrhage, pain, or other complications. The wounds undergo second-intentional healing approximately 1.5 months post-treatment procedure depending on original tumor size. Ideally, with its advantages and low technique requirements, this novel therapy/device will benefit more cancer bearing animals in the future.

目錄
致謝 ii
中文摘要 iv
Abstract v
List of Tables ix
Chapter I Introduction 1
Chapter II Literature review 4
2.1 The Background of Thermal Ablation of tumors 5
2.2 Mechanism of EMT 6
2.3 Needle placement and temperature distribution 7
2.4 The Effect of Temperature on cells and zones of ablation 8
2.5 Immune response 9
2.6 Adjuvant therapy 10
2.7 Superficial Tumors 11
2.7.1 Squamous cell carcinoma (SCC) 11
2.7.2 Perianal adenoma 11
2.7.3 Feline injection site sarcoma (FISS) 12
2.7.4 Fibrosarcoma 12
2.7.5 Peripheral nerve sheath tumor (PNST) 13
2.7.6 Mast cell tumor (MCT) 13
2.7.7 Mammary gland tumor (MGT) 14
2.8 Visceral tumor 15
2.8.8 Hepatocellular carcinoma (HCC) 15
Chapter III Aim 16
Chapter IV Materials and Method 18
4.1 Patient selection 19
4.2 Pre-treatment patient assessment 19
4.3 Tumor Staging 20
4.4 Treatment design 20
4.5 Trial Standard Operating Procedure 21
4.6 Follow up 21
4.7 Assessment of therapeutic effect 22
4.8 Adverse Effect 22
4.9 Statistical Analysis 23
Chapter V Results 24
5.1 Patient population and tumor types 25
5.2 Tumor Staging 25
5.3 Treatment effect 26
5.4 Adverse effect 27
Chapter VI Discussion 29
6.1 Treatment efficacy 30
6.1.1 Treatment Efficacy- Needle Placement 30
6.1.2 Treatment Efficacy- Modifications to needle placement 31
6.2 Adverse effects 33
6.2.1- Adverse Effect- management 35
6.3 Immune response 37
6.4 Indication for EMT 38
6.5 Limitations 39
6.6 Future prospect 39
Chapter VII Conclusion 42
Tables 44
Figures 57
References 66



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