^(32)P玻璃微球经肝动脉栓塞内照射治疗中晚期肝癌

Intraarterial hepatic injection of phosphorus-32 glass microspheres for treatment of primary hepatic carcinomas

目的探讨32P玻璃微球行经肝动脉栓塞内照射的安全性和有效性。方法原发性肝癌26例，经肝动脉选择性插管后，用32P玻璃微球与超液化碘油混合后作栓塞。治疗放射剂量为75～150Gy。结果术后均有肝功能一过性异常，2周后逐渐恢复至术前水平，血象及肾功能无异常改变。术后无严重并发症。微球主要分布于肝内，癌／肝放射比为3.5:1。随访3～19个月23例（88.4％）。病灶有缩小，体积缩小50％以上11例（42．3％）。9例（75．0％）生存期＞1年，中位生存时间为8．1月。结论32P玻璃微球作为一种新型栓塞内放射材料，具有半衰期适中，射程适宜的优势。初步临床应用表明为行肝动脉栓塞内照射安全、有效。

To evaluate the efficacy and safety of Phosphorus-32 Glass Micro spheres (32P-GMS) for treatment of primary hepatic carcinornas using transcatheter arterial embliza tion (TAE ). Methods 26 patients with prlmary hepatic carcinoma were treated by selective tran scatheter arterial infllsion of 32P-GMS emulsified with Lipiodol. 32P-GMS(46~ 76μm )with a dose of 7 5 ~ 150Gy per patient was used. Liver and kidney function,CBC,and imaging examinations including SPECT were routinely examined during the follow-up. Results All the patients tolerated the treat ment well. Transient worsening liver function had occurred in most paitnets after operation to 2 weeks. Other laboratory test measured remained normal. No complications related to radiation thera py were encountered. Radiatlon microspheres were found mainly in liver. The ratio of irradlated tumor to heptic tissues was 3. 5: 1. Turmor size reduced 23 cases,even less than 50 % in eleven cases. Nine patients (75 % ) were alive more than 1 year in the follow-up. The mean survival time was 8. 1 months. Conclusion These preliminary results demonstrated that 32 P-GMS with TAE in a dose range used in this study may be safe and effective on primary liver carcinoma.