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2014年01月02日

專科介紹 Introduction

  

林口長庚放射腫瘤科現有八台直線加速器,皆可進行強度調控放射線治療(Intensity-Modulated Radiotherapy, IMRT)。其中四台直線加速器可進一步施行影像導引定位(Image-Guided Radiotherapy, IGRT)。此四台影像導引定位機器中有三台是最新的銳速刀(RapidArc),一台是專精於放射手術(Radiosurgery)及小照野放射的諾力刀(Novalis)。在其他特色上,有全國第一部的大孔徑四度空間電腦斷層(4D-CT)模擬攝影機、呼吸調控放射、攝護腺癌組織插種、腦瘤組織插種等先進技術。本科持續性引進最新治療設備及技術,以提供病患最好的治療。

由於本院是全國癌症治療的重鎮,自癌症中心設立以來,除不斷的提昇癌症的診療品質及全人照顧, 更決定興建台灣首座的「質子治療中心」,嘉惠病患。與X光放射治療比較,質子射束在生物體內,可以經由控制能量高低,使其特定深度產生釋出大量的能量,而在穿越的路徑上只釋放出較少能量,並在腫瘤之後的區域,完全沒有輻射量。質子射線這種特性除精準打擊癌細胞外,亦降低正常組織劑量及因輻射所造成之副作用,是目前最精確的癌症放射療法。對如顱底腫瘤、肝癌、早期肺癌等經臨床研究證實可提升治療成功率,而如小兒腫瘤、頭頸癌等則可降低副作用之發生。美、日、歐十多家著名的醫學中心已設置或正在設置,已蔚為世界的趨勢。


Welcome to the Department of Radiation Oncology, Chang-Gung Memorial Hospital at Linkou, the biggest radiation oncology department in Taiwan. We have eight linear accelerators which provide sophisticated radiotherapy techniques, such as Intensity-Modulated radiotherapy (IMRT), Image-Guided radiotherapy (IGRT) and respiratory gating. Three of them are able to perform a state-of-the-art technology: RapidArc therapy, which is a form of volumetric modulated arc therapy (VMAT). RapidArc, an advanced technology from Varian Medical Systems, improves dose conformity while significantly shorten treatment time. In addition, a Novalis system with micro-multileaf collimator provides the most accurate radiosurgery to most sites of the body, including both intracranial and extracranial targets. We also incorporate the 4D-CT technology with respiratory-gating system to treat the malignancies in the mobile organs, such as liver tumor and lung cancer. To provide the highest quality of patient care and a full range of treatment technologies to meet the stringent clinical requirement is always our most important goal.


Our department is setting up the first proton therapy center in Taiwan and is going to treat the first patient in the early 2014. Because proton releases most of its energy in a specific depth while leaving nearly no dose beyond the target region, it is an ideal radiation for many types of tumor. For example, for liver, lung, skull base and other tumors proton beam is able to safely deliver higher dose to the tumor and therefore the likelihood of tumor control is increased. For child, head and neck, or cancers located in the one side of the body, Proton therapy will spare the normal tissue beyond the target region and reduce the complications.  Many well-known medical centers in USA, Japan, German, Korea and other countries had or are going to have proton therapy facility and our department will soon becomes a member in proton therapy society. We believe the set-up of first proton therapy is a milestone of cancer treatment in Taiwan.

醫療服務與特色 Service & Specialty
  

林口長庚放射腫瘤科有十七位主治醫師,除年資較淺者外,皆有部定教職,且多位為正、副教授級。在學術研究 上亦居於領導地位。每位主治醫師皆有其次專科領域(如中樞神經,頭頸部,肺臟,乳房,食道,腸胃消 化道,肝臟,泌尿生殖道,淋巴瘤,小兒腫瘤,軟組織腫瘤等)。除對於各種癌症的治療因次專科化而能 夠更加精緻,並能更專精於次專科的研究。本科每年均有主治醫師出國參加並發表論文於如美國放射腫 瘤年會(ASTRO)、美國癌症研究年會(AACR)、歐洲放射腫瘤年會(ESTRO)等國際性重要醫學會議。此 外,本科定期舉辦期刊討論會,由主治醫師選取其次專科領域最新的重要期刊,不斷更新癌症治療的相 關知識。 本院在癌症治療上,為團隊整合醫療,根據不同的原發部位有二十個團隊。各癌症治療 團隊成員包括內科、外科、腫瘤內科、放射腫瘤科、核子醫學科、放射診斷科及病理科等之醫師,各團隊每週均舉行團隊會議,討論病人的癌症診斷及最佳化之治療計畫,每位新病人都經詳細討論後再給予治療。治療或追蹤中有新狀況的情況,也會提出在團隊會議中討論。期能集各科的醫學專長,給予病人最適合最優質的醫療。


There are seventeen attending physicians in our department. With the exception of junior faculties, all have academic appointment and several of them are associate or full professors. Each physician in our department have his own sub-specialty; the fields cover tumors of central nervous system, head and neck, lung, breast, esophagus, gastrointestinal tract, genitourinary tract, pediatrics, soft tissues, etc. The department has very active teaching and learning activities to continuously update our knowledge in cancer treatment, which include new case round, case round for specific cancer, resident seminar, journal seminars and many others. We also enthusiastically participate in the annual meetings of international cancer societies such as the American Society for Therapeutic Radiology and Oncology (ASTRO), the American Association for Cancer Research (AACR), the European Society for Therapeutic Radiology and Oncology (ESTRO).
The Cancer Center in Chang-Gung Memorial Hospital at Linkou has nineteen cancer-treatment teams based on the primary cancer sites. The faculties in our department are active member in these teams had had a weekly joint meeting with other members including specialists in internal medicine, surgery, oncology, nuclear medicine, diagnostic radiology, and pathology.  Inside the department, we also have weekly new patient round for each sub-specialty.  All these activities will make the patient’s treatment to meet the highest standard of treatment protocol.

沿革與大事記要 Facts & History
  

林口長庚紀念醫院放射腫瘤科於民國68年由林芳仁醫師自美歸國創立。由於林主任受訓於美國紐約著名之癌症中心紐約史隆凱特琳紀念癌症中心(Memorial Sloan Kettering Cancer Center),故本科創立即引進美國先進之制度與放射治療系統,並隨著放射治療科技的進步,與世界同步,成為台灣放射腫瘤界重要的推手。


The Department of Radiation Oncology in Chang-Gung Memorial Hospital at Linkou was set upin 1979 and founded by Dr. F. J. Lin. Since Dr. Lin received his radiation oncology training c in the Memorial Sloan Kettering Cancer Center at New York, our department therefore had the system and the treatment planning program since those in the USA since then. As the progress in the radiotherapy, we also keep up with the latest knowledge and technologies and become leading radiation oncology department in Taiwan.

民國67年

(1978)

陳明憲醫師為第一屆住院醫師,由於機器尚在採購,陳醫師與護理長徐敏燕、技術組長吳漢德先生至台北榮總受訓一年。

Dr. M. S. Chen was the 1st session resident of our department. As the treatment machine was in purchasing, Dr. Chen, Miss Hsu (The Chief nurse), and Mr. Wu (The Chief therapist) received one-year training at Taipei Veterans General Hospital.

民國68年

(1979)

林芳仁醫師自美歸國。第一台鈷-60機器安裝完成並開始治療病患。同年第一台10MV Varian直線加速器亦安裝完成。

Dr. F. J. Lin came back from MSKCC. The 1st 60Co machine started to treat patients. The 1st 10MV Varian Linac were also installed at the same year.

民國69年

(1980)

第一台Toshiba鈷60後荷治療機啟用。

Started to use 1st 60Co-source after-loading machine (Toshiba)

民國76年

(1987)

高雄長庚放射腫瘤科成立,初期由林口醫師輪流支援。

Department of Radiation Oncology in Chang-Gung Memorial Hospital at Kaohsiung was founded and supported by attending physicians from Linkou branch at the beginning.

民國77年

(1988)

曾雁明醫師申請到哈佛大學博士學程,為本科第一位赴美進修博士學位之醫師。

Dr. N.M. Tsang was accepted by the Ph.D. program of Harvard university, as the 1st one to have the Ph.D. degree and training in our department.

民國79年

(1990)

湯國政醫師發表鼻咽癌預後論文於放射腫瘤界最重要期刊International Journal of Radiation Oncology, Biology and Physics,此為本科第一篇發表於此期刊之論文。隔年陳明憲醫師發表子宮頸癌的高劑量率放射治療成果於此期刊,是台灣在子宮頸癌高劑量率放射治療的第一篇國際論文,曾被大量引用,具有重要地位。再隔年洪志宏醫師亦以子宮頸癌為主題,發表第三篇論文。自民國84年後,本科論文即逐漸成為此期刊之常客了。

Dr. Simon G. Tang published the prognosis of NPC, as the first publication of our department in the International Journal of Radiation Oncology, Biology and Physics, the most important journal in the radiation oncology. At the next year, Dr. M. S. Chen published a highly cited paper about the results of HDR radiotherapy for cervical cancer in this journal. Dr. J.H. Hong also had another article about cervical cancer after the year of Dr. Chen’s publication. Since 1995, the articles from our department were frequently published in this journal.

民國81年

(1992)

陳明憲醫師因鼻咽癌治療後遺症,由中耳炎併發腦膿瘍,病逝於美國洛杉磯。同年林芳仁主任離開本科創立新光醫院放射腫瘤科並接中國醫藥學院放射腫瘤科。湯國政醫師接任本科主任。

Dr. M. S. Chen passed away at Los Anglos due to brain abscess caused by media otitis which was a treatment complication of NPC treatment. At the same year, Dr. F. J. Lin left our department and founded the department of R.T.O. at Shin Kong Wu Ho-Su Memorial Hospital and acted as the chairman of department of R.T.O. at China Medical University, Taiwan.

Dr. Simon G. Tang served as the chairman of our department.

民國83年

(1993)

採用BrainLab設立第一套顱內放射手術。年底時引進惡性腦瘤組織插種治療。

Set the 1st intracranial radiosurgery by adopting BrainLab sysetm. Introduced brachytherapy of brain implant for malignant brain tumors.

民國84年

(1995)

引進第一套三度空間順行放射治療計劃系統(3-D treatment planning, ADAC廠牌)及直線加速器之電子影像系統。

Introduced the 1st 3-D treatment planning system(ADAC brand) & electronic image of linac.

民國85年

(1996)

引進手術中放射治療。

Introduced the intra-operative radiotherapy.

民國86年

(1997)

洪志宏醫師接任本科主任。並首創國內最明確的放射腫瘤次專科制度,使主治醫師各有所專,大輻提昇服務品質與深度。

Dr. J. H. Hong took the chairman position of our department since this year and set up the  subspecialty system which expanded the quality and profundity of clinical practices.

民國87年

(1998)

與Optivus公司簽定質子採購意願書,後因規格無法符合本院之高標準而中斷。

Signed a letter-of-intent for proton therapy with Optivus Inc.. However, the contract was not signed because the provided specifications could not meet the requirement from CGMH.

民國89年

(2000)

引進業界最高水準之Picker廠牌之電腦斷層模擬攝影機,同時也引進Cadplan軟體及Vraian直線加速器進行動態式強度調控放射治療,為台灣此領域之開創者。

Introduced Picker CT simulator, the best one at that time, and the Cadplan treatment planning software,

Our department was the first one in Taiwan to introduce the Varian linac for Intensity-Modulated radiotherapy (IMRT).

民國89年

(2000)

引進高劑量率攝護腺後荷式近接治療。

Introduced remote afterloading system of HDR brachytherapy for prostate cancer.

民國90年

(2001)

引進具0.5公分寬度多葉準直儀、呼吸調控、矽晶電子影像系統之最新直線加速器。

Introduced the linac with MLC of 0.5mm thickness, respiratory-gated system, and electronic portal imaging system.

民國91年

(2002)

引進第二台電腦斷層模擬攝影機(GE廠牌),同時裝設呼吸調控於電腦斷層取像,使本科之呼吸調控從電腦取像開始即實施。

Introduced the 2nd CT simulator (GE) with the respiratory-gated device and have the 4D CT image since then.

民國93年

(2004)

昇級Cadplan 治療計劃系統至具有影像融合等強大功能之Eclipse系統。本年度得到研討會議優良科第一名,並於94年度再次得獎,由院方肯定本科之教學實績。

Upgraded Cadplan treatment planning system to Eclipse with the powerful functions like image fusion.

Our department was praised as the best one in the academic conference by the hospital, because of our outstanding performance in teaching., same award was obtained in the next year.

民國95年

(2006)

引進台灣第一台諾力刀(Novalis),進行顱內、顱外放射手術,影像導引放射治療。此機器擁有最細緻的3厘米多葉準直儀、影像導引系統、呼吸調控系、六方自由度電腦控制治療床等最先進的設備。
在顱內顱外放射手術治療能精準至0.6亳米以下。本年底基隆長庚放射腫瘤科成立,由蔡介生醫師擔任主任。

Introduced the 1st Novalis in Taiwan for the intracranial/extracranial radiosurgery and image-guided radiotherapy. The Novalis system had the updated technologies at that time, like the finest 3-mm MLC, image-guided system, respiratory-gated system, and 6D couch.

The Department of Radiation Oncology at CGMH-Keelung was set up and Dr. C.S. Tsai was appointed as the chairman.

民國97年

(2008)

與日本住友重工(Sumitomo Heavy Industry)簽立台灣第一所質子治療中心,預定於民國101年啟用。

Signed a contract for proton therapy with Sumitomo Heavy Industry and scheduled to treat the first patient since 2014.

民國98年

(2009)

引進最新治療技術-銳速刀(RapidArc),可進行360度全體積弧形放射治療,有效減少正常組織劑量,改善病患治療品質。本科目前擁有四台可施行影像導引放射治療(Image-Guided Radiotherapy, IGRT)的直線加速器,可提供更精準的放射治療。

Introduced the 1st RapidArc linac in Taiwan, which was the latest technology performing 360 degree volumetric Arc therapy to reduce the dose of normal tissue and improve the treatment quality. There are 4 linacs with the image-guided technique for more precise radiotherapy since then.