钇‑90微球选择性内放射治疗肝脏恶性肿瘤规范化操作专家共识(2024版)

Expert consensus on the standardized procedure of selective internal radiation therapy with Yttrium‐90 microspheres for liver malignancies(2024 edition)

钇‑90微球选择性内放射治疗(90Y‑SIRT)肝脏恶性肿瘤已有50余年临床应用史,大规模临床应用亦超过20年,其安全性和疗效已被证实,但在我国仍处于起步阶段。90Y‑SIRT操作复杂,涉及多学科团队协作,对操作者要求较高,一旦发生90Y微球异位分布可能会导致严重并发症。因此,规范90Y‑SIRT操作技术,对促进90Y‑SIRT在我国稳步推广至关重要。中国医师协会介入医师分会临床诊疗指南专委会联合中国研究型医院学会肝胆胰外科专业委员会组织国内相关领域专家,基于现有文献证据并结合我国临床实践,围绕患者筛选、术前影像学评估、90Y‑SIRT方案、处方剂量计算、90Y‑SIRT实施、术后管理、常见不良反应与并发症等,共同制订本专家共识,规范90Y‑SIRT操作,保证疗效,降低并发症发生率,促进90Y‑SIRT在国内的推广和普及。

Yttrium-90 microsphere selective internal radiation therapy(90Y-SIRT)has been used clinically for more than 50 years for liver malignancies,with confirmed safety and efficacy.Although it has been widely used for more than 20 years abroad,90Y-SIRT is just getting started in China.The procedure of 90Y-SIRT is relatively complex,which need multidisciplinary teamwork and higher requirements for operators.Once the ectopic distribution of 90Y microspheres occurs,it may lead to relatively serious complications.Therefore,it does need to standardize the procedure of 90Y-SIRT to ensure its efficacy,reduce the incidence of complications,and promote the popularization and application in China.It is for these reasons that experts from Chinese Medical Doctor Association,Clinical Guidelines Committee of Chinese College of Interventionalists and Society for Hepato-pancreatobiliary Surgery of Chinese Research Hospital Association formulate the Expert consensus based on the literature evidence and clinical practice,which including patient selection,preoperative imaging examination,aim of 90Y-SIRT,prescription dose calculation,90Y-SIRT protocol,postoperative management,common adverse reactions and complications,etc.