钇90微球治疗原发性肝癌

刘允怡; 赖俊雄; 刘晓欣

钇90微球治疗原发性肝癌

香港特别行政区新界沙田香港中文大学医学院

详细信息

中图分类号: R735.7
计量
- 文章访问数: 4563
- HTML全文浏览量: 27
- PDF下载量: 1994
- 被引次数: 0
出版历程
- 收稿日期: 2010-12-06
- 出版日期: 2011-04-20

Yttrium 90 microspheres in the management of hepatocellular carcinoma

摘要

摘要: 本文讨论钇90微球治疗原发性肝细胞癌在临床上的应用。在适当选择和计划内放射剂量的情况下,钇90微球可以达到疗效高而副作用少的治疗目的。已发表的医学研究显示钇90微球可有效作为姑息性治疗T晚期肝癌,亦可作为肝移植前的肝癌过渡治疗,延长患者等候肝源的时间。钇90微球能把不能切除的肝癌降期到可切除,亦可把不能进行肝移植的肝癌变成为可以肝移植。使用钇90微球作为内放射肝段/肝叶切除的新方法的疗效非常理想。部分肝切除后肝癌复发的患者,钇90微球亦有理想的疗效。
- 肝肿瘤 /
- 钇 /
- 微球体
Abstract: This article reviews the role of Selective Internal Radiation (SIR) with yttrium 90 microspheres for hepatocellular carcinoma (HCC) .SIR is a safe and well-tolerated therapy, provided that appropriate radiation dose has been well-planned before therapy.Yttrium 90 microspheres are effective as a palliative treatment for advanced T-stage HCC.They have been reported to downstage unresectable HCC to allow for salvage partial hepatectomy with curative intent, or for liver transplantation.They can act as a bridging therapy to prolong the wait for cadaveric liver donation, and as a curative treatment in the form of radiation segmentectomy/lobectomy for patients with associated comorbidities who are not candidates for surgery.They can also be used to treat recurrent and unresectable HCC after partial hepatectomy with good results.
- liver neoplasms /
- yttrium /
- microspheres

HTML全文

参考文献(20)

[1]Lau WY, Lai ECH, Leung TWT.Current role of selective internalirradiation with yttrium-90 microspheres in the management ofhepatocellular carcinoma:a systematic review[J].Int J RadiatOncol Biol Phys, 2010 Sept 30[Epub ahead of print].

[2]Hilgard P, Muller S, Gerken G, et al.Radioembolizationwith yttrium-90 microspheres for hepatocellular carcinoma-methods and results[J].Eur Gastroenterol Hepatol Review, 2010, 6 (1) :82-89.

[3]Lau WY.Radiotherapy with emphasis on radio-embolizationfor liver tumours.In:Blumgart LH, Fong Y, editors.Surgeryof the Liver and Biliary Tract[M].Volume II, 2nd en.London:WB Saunders, 2000:1545-1564.

[4]Lau WY, Kennedy AS, Kim YH, et al.Patient selection andactivity planning guide for selective internal radiotherapywith yttrium-90 resin microspheres[J].Int J Radiat OncolBiol Phys, 2010 Oct 13[Epub ahead of print].

[5]Leung TWT, Lau WY, Ho SKW, et al.Radiation pneumonitis afterselective internal radiation treatment with intraarterial 90yttrium-microspheres for inoperable hepatocellular carcinoma[J].Int JRadiat Oncol Biol Phys, 1995, 33 (4) :919-924.

[6]Inarrairaegui M, Thurston KG, Bilbao JI, et al.Radioembolization with use of yttrium-90 resin microspheresin patients with hepatocellular carcinoma and portal veinthrombosis[J].J Vas Interv Radiol, 2010, 21 (8) :1205-1212.

[7]Lau WY, Ho S, Leung TW, et al.Selective internal radiationtherapy for non-resectable hepatocellular carcinoma withintraarterial infusion of 90 yttrium microspheres[J].Int JRadiat Oncol Biol Phys, 1998, 40 (3) :583-592.

[8]Dancey JE, Shepherd FA, Paul K, et al.Treatment of non-resectable hepatocellular carcinoma with intrahepatic 90Y-microspheres[J].J Nucl Med, 2000, 41 (10) :1673-1681.

[9]Carr BI.Hepatic arterial 90 Yttrium glass microspheres (Therasphere) for unresectable heptocellular carcinoma:Interim safety and survival data on 65 patients[J].LiverTranspl, 2004, 10 (2 Suppl 1) :S107-S110.

[10]Geschwind JF, Salem R, Carr BI, et al.Yttrium-90microspheres for the treatment of hepatocellular carcinoma[J].Gastroenterology, 2004, 127 (5 Suppl 1) :S194-S205.

[11]Liu MD, Uaje MB, Al-Ghazi MS, et al.Use of yttrium-90ThereSphere for the treatment of unresectable hepatocellularcarcinoma[J].Am Surg, 2004, 70 (11) :947-953.

[12]Sangro B, Bibao JI, Boan J, et al.Radioembolizationusing 90Y-resin microspheres for patients with advancedhepatocellular carcinoma[J].Int J Radiat Oncol Biol Phys, 2006, 66 (3) :792-800.

[13]Salem R, Lewandowski RJ, Atassi B, et al.Treatment ofunresectable hepatocellular carcinoma with use of 90Ymicrospheres (TheraSphere) :Safety, tumor response, andsurvival[J].J Vasc Interv Radiol, 2005, 16 (12) :1627-1639.

[14]Salem R, Lewandowski RJ, Mulcahy MF, et al.Radioembolizationfor hepatocellular carcinoma using Yttrium-90 microspheres:A comprehensive report of long-term outcomes[J].Gastroenterology, 2010, 138 (1) :52-64.

[15]Kulik LM, Carr Bi, Mulcahy MF, et al.Safety and efficacy of 90Yradiotherapy for hepatocellular carcinoma with and withoutportal vein thrombosis[J].Hepatology, 2008, 47 (1) :71-81.

[16]Heckman JT, Devera MB, Marsh JW, et al.Bridginglocoregional therapy for hepatocellular carcinoma prior to livertransplantation[J].Ann Surg Oncol, 2008, 15 (11) :3169-3177.

[17]Lau WY, Lai EC.Salvage surgery following downstaging ofunresectable hepatocellular carcinoma-a strategy to increaseresectability[J].Ann Surg Oncol, 2007, 14 (12) :3301-3309.

[18]Kulik LK, Atassi B, van Holsbeeck L, et al.Yttrium-90microspheres (TheraSphere) treatment of unresectablehepatocellular carcinoma:downstaging to resection, RFAand bridge to transplantation[J].J Surg Oncol, 2006, 94 (7) :572-586.

[19]Lewandowski RJ, Kulik LM, Riaz A, et al.A comparativeanalysis of transarterial downstaging for hepatocellularcarcinoma:Chemoembolization versus radioembolization[J].Am J Transpl, 2009, 9 (8) :1920-1928.

[20]Riaz A, Gates VL, Atassi B, et al.Radiation segmentectomy:A novel approach to increase safety and efficacy ofradioembolization[J].Int J Radiat Oncol Biol Phys, 2010 Apr24[Epub ahead of print].

施引文献

资源附件(0)

访问统计