Карточка-задание по английскому языку на тему «MEDICAL WRITING: CASE ABSTRACT_270»
«MEDICAL WRITING: CASE ABSTRACT_270»
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Potential risk of
alpha-glucosidase inhibitor administration in prostate cancer external
radiotherapy by exceptional rectal gas production: a case report
Radiotherapy is a standard
treatment for prostate cancer, and image-guided radiotherapy is increasingly
being used to aid precision of dose delivery to targeted tissues. However,
precision during radiotherapy cannot be maintained when unexpected
intrafraction organ motion occurs.
We report our experience of
internal organ motion caused by persistent gas production in a patient taking
an alpha-glucosidase inhibitor. A 68-year-old Japanese man with prostate cancer
visited our institution for treatment with helical tomotherapy. He suffered
from diabetes mellitus and took an alpha-glucosidase inhibitor. Routine
treatment planning computed tomography showed a large volume of rectal gas; an
enema was given to void the rectum. Subsequent treatment planning computed
tomography again showed a large volume of gas. After exercise (walking) to
remove the intestinal gas, a third scan was performed as a test scan without
tight fixation, which showed a sufficiently empty rectum for planning. However,
after only a few minutes, treatment planning computed tomography again showed
extreme accumulation of gas. Therefore, we postponed treatment planning
computed tomography and consulted his doctor to suspend the alpha-glucosidase
inhibitor, which was the expected cause of his persistent gas. Four days after
the alpha-glucosidase inhibitor regimen was suspended, we took a fourth
treatment planning computed tomography and made a treatment plan without gas
accumulation. Thereafter, the absence of rectal gas accumulation was confirmed
using daily megavolt computed tomography before treatment, and the patient
received 37 fractions of intensity-modified radiotherapy at 74Gy without rectal
gas complications. In this case study, the alpha-glucosidase inhibitor induced
the accumulation of intestinal gas, which may have caused unexpected organ
motion, untoward reactions, and insufficient doses to clinical targets.
We suggest that patients who are
taking an alpha-glucosidase inhibitor for diabetes should discontinue use of
that particular medicine prior to beginning radiotherapy.
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