钇90微球治疗原发性肝癌

Yttrium 90 microspheres in the management of hepatocellular carcinoma

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。

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.