^(90)钇玻璃微球治疗肝癌的临床研究  

Hepatic Radioembolization with Yttrium90 Glass Microspheres for the Treatment of Primary Liver Cancer

作　　者：曹喜才[1] 贺能树 孙建中 陈光利 范海伦 贾雄山[1] 张长林 杨建国 吕提文 李建华 魏书亮 谭建 贾强 杨立昌 张福海 吴晓琪 周荫保 

机构地区：[1]天津医科大学总医院

出　　处：《临床放射学杂志》1999年第5期296-298,共3页Journal of Clinical Radiology

摘　　要：目的：探讨９０钇玻璃微球治疗肝癌的临床效果。材料与方法：１９９６年８月至１９９８年５月，应用９０钇治疗肝癌１７例。采用含有９０钇的三明治疗法：首先注入９０钇和超液化碘油悬浮液，然后注入三联合化疗药，最后用明胶海绵颗粒栓塞。对其中１２例施行了经皮股动脉药盒导管系统（ＰＣＳ）植入术，并对操作技术进行了改进。结果：１４例（８２％）９０钇积聚在肿瘤区内，平均癌／肝比２．４∶１。１１例肿瘤缩小，６例ＡＦＰ转为阴性，平均生存期１９．５个月，１２例ＰＣＳ术后药盒与留置管全部保持通畅，无１例发生留置管脱出与移位。结论：９０钇是治疗原发性肝癌最好的放射性核素之一。它不仅适合于继发性肝癌，更适用于原发性肝癌，尤其对富血管的局限性肝癌。对存在肝动、门脉瘘者，不应列为禁忌症。Objective: To evaluate the clinical effects of hepatic radioembolization with Yttrium90 (90Y) glass microspheres for the treatment of primary liver cancer. Materials and Methods: Hepatic radioembolization was performed in 17 patients with liver cancer during the period of Aug 1996May 1998. The following sandwich form injection procedure was used. After the suspension of 90Y with ultrafluid lipiodol was injected, three chemotherapeutic agents were administered via hepatic artery, then the hepatic arteries were embolized with Gelfoam particles. Percutaneous portcatheter system (PCS) implantation via femoral artery was performed in 12 cases. Results: The tumor took more 90Y than normal liver in a ratio of 2.41. On CT scan, significant reduction of the tumor size was seen in 11 cases. The average survival period was 19.5 months. In all 12 cases with PCS, the catheters remained patency and no catheter tip dislocation occurred. Conclusion: 90Y glass microspheres is one of the most effective radioisotope for the treating of liver cancer, both primary and metastatic, especially effective for the localized and hypervascular lesion. Hepatic arterioportal shunt should not be considered as a contraindication for radioembolization therapy. The percutaneous PCS implantation via femoral artery offers a permanent access for 90Y injection and other interventional procedures.

关 键 词：玻璃微球 治疗 肝癌 钇90 放射疗法 

分 类 号：R735.705[医药卫生—肿瘤] R730.55[医药卫生—临床医学]