超声介导钇-90玻璃微球局部注射治疗肝癌

Local injection of Y-90 glass microspheres under ultrasound guidance for the treatment of liver cancer

目的:探讨超声引导瘤内注射钇-90玻璃微球(90Y-GTMS)治疗肝癌方法的疗效,为肝癌患者寻找一种更有效的非手术治疗的方法。方法:对22例共28个肿瘤在超声引导下瘤内注入核素90Y-GTMS,进行直接瘤内包埋放射治疗。每个瘤灶内根据瘤体大小,给予0.5～1.0mci?cm3剂量的90Y-GTMS。结果:22例28个肿瘤中,经治疗后89.3%(25?28)的肿块缩小,另3例3个肿瘤,瘤体大小变化不明显,但随访期内亦无增大。本组病例随访3～60个月(平均28.4个月),13例死亡,9例至今生活正常。治疗后1～3个月对12个瘤灶再次行多点位穿刺病理组织活检:9例肿瘤完全性坏死,未见存活肿瘤细胞。结论:核素90Y-GTMS经超声引导下,进行直接瘤内局部注射治疗,此方法对肝癌细胞破坏性大,疗效肯定,安全、简便、省时、痛苦少,是很有效的治疗肝癌的方法之一。

Objective:To evaluate the effect of the treatment of liver cancer with Yttrium-90glass microspheres( 90 Y-GTMS)through local injection guided by ultrasound in order to develop a more effective method for liver cancer therapy.Methods:Twenty-two consecutive liver cancer patients with a total of 28tumor nodules were enrolled.Under the guidance of ultrasound,90 Y-GTMS was delivered directly into the target tumor at dosage of 0.5～1.0mci?cm 3 for each lesion depending on its size.Results:Follow-up of the patients at3～60months(average28.4months)after treatment disclosed that9patients were still alive.Up to89.3%(25?28)of tumor focuses treated had their size reduced and3did not changed in size.A post-treated biopsy on12tumor foci showed complete destruction of tumor in9cases.Conclusions:Intralesional local injection with 90 Y-GTMS under guidance of ultrasound is a simple,time saving and safe method for liver cancer treatment,the effect was satisfactory.