肝脏肿瘤的选择性内放射治疗:尚待兑现的早期承诺。

IF 4.6 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
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引用次数: 0

摘要

选择性动脉内放射治疗(SIRT)是一项历经 30 年发展的技术。目前主要用于治疗肝脏的原发性和继发性肿瘤。该技术通常依赖于通过在肝动脉内放置一根放射导管来输送治疗性放射性药物或放射性标记微粒。这是因为大多数此类肿瘤只有单一动脉供血,而正常肝细胞则由肝动脉和门静脉同时供血。最初,这种方法是用 I-131 标记的罂粟籽油,但这种技术只在少数中心使用。随着 Y-90 微粒的广泛应用,这种技术变得更加流行。早期的结果很有希望,但在 3 期随机对照试验中,与全身化疗相比,结果令人失望。不过,最近的研究表明,将肿瘤的放射剂量提高到至少 60Gy,并与更有效的全身疗法相结合,开始产生更好的临床效果。血管造影方法也有了进步,使其成为一种日间病例技术,Ho-166 和 Re-188 等新放射性核素的使用为 SIRT 技术提供了更广泛的可能性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Selective Internal Radiotherapy in Liver Tumors: Early Promise Yet to be Fulfilled

Selective intra-arterial radiotherapy (SIRT) is a technique which has evolved over the past 30 years. In present this is primarily used to treat primary and secondary tumors in the liver. The technique normally depends on the delivery of a therapeutic radiopharmaceutical or radiolabeled particulate via a radiologically placed intra-arterial catheter in the hepatic artery. This is because most of these tumors have a single arterial blood supply but normal hepatocytes are supplied by both the hepatic artery and portal vein. Initially, this was done with I-131 labelled poppy seed oil but this technique was only used in a few centers. The technique became more popular when Y-90 particulates become widely available. Early results were promising but in phase 3 randomized controlled trials resulted in disappointing results compared to systemic chemotherapy. More recent work however, have shown that increasing the radiation dose to the tumor to at least 60Gy and combining with more effective systemic therapies are starting to produce better clinical results. There have also been advances in the angiographic methods used to make this into a day-case technique and the use of new radionuclides such as Ho-166 and Re-188 provides a wider range of possible SIRT techniques.

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来源期刊
Seminars in nuclear medicine
Seminars in nuclear medicine 医学-核医学
CiteScore
9.80
自引率
6.10%
发文量
86
审稿时长
14 days
期刊介绍: Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.
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