钇‑90微球选择性内放射治疗在肝癌降期转化移植中的应用进展  

Progress in the application of selective internal radiation therapy with yttrium‐90 microspheres in the downstaging and conversion treatment of hepatocellular carcinoma before liver transplantation

作　　者：张琳[1] 冯晓彬[1] 黄鑫[1] 梁子威 何作祥[2] 卢倩 董家鸿[1] Zhang Lin;Feng Xiaobin;Huang Xin;Liang Ziwei;He Zuoxiang;Lu Qian;Dong Jiahong(Hepatopancreatobiliary Center,Beijing Tsinghua Changgung Hospital,Key Laboratory of Digital Intelligence Hepatology of Ministry of Education,Tsinghua University,Beijing 102218,China;Department of Nuclear Medicine,Beijing Tsinghua Changgung Hospital,Tsinghua University,Beijing 102218,China)

机构地区：[1]清华大学附属北京清华长庚医院肝胆胰中心,数智肝胆病学教育部重点实验室(清华大学),北京102218 [2]清华大学附属北京清华长庚医院核医学科,北京102218

出　　处：《中华消化外科杂志》2024年第12期1566-1570,共5页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(81930119);中国医学科学院医学与健康科技创新工程创新单元项目(2019-I2M-5-056)。

摘　　要：外科手术是肝癌患者获得长期生存的主要手段,但仅有20%~30%的患者可接受根治性手术。如何优化以外科为主导的肝癌综合治疗策略,使患者成功达到降期转化,是我国肝癌治疗亟需解决的关键问题。钇-90微球选择性内放射治疗(^(90)Y-SIRT)具有强效杀灭肿瘤能力,其治疗肝癌的降期效果显著优于经动脉化疗栓塞,是理想的降期转化及桥接治疗方式。笔者在介绍^(90)Y-SIRT特点的基础上,综述^(90)Y-SIRT在肝癌肝移植前降期转化、桥接方面的临床研究进展,并探讨基于^(90)Y-SIRT的联合降期转化策略。^(90)Y-SIRT与靶向、免疫治疗的协同效应,在未来的降期转化治疗中具有广阔的应用前景。Surgery is the main treatment for patients with hepatocellular carcinoma to achieve long‑term survival.However,only 20%−30%of patients can receive radical surgery.How to optimize the surgery oriented comprehensive treatment strategy and enable patients to successfully downstage to surgery are key issues to be solved in hepatocellular carcinoma treatment in China.Selective internal radiation therapy with yttrium‑90 microspheres(^(90)Y‑SIRT)has strong ability of tumor killing,and it is reported that^(90)Y‑SIRT is an ideal downstaging and bridging therapy for hepatocellular carcinoma,due to its superior downstaging efficacy compared with transarterial chemoembolization.Based on the introduction of characteristics of^(90)Y‑SIRT,the authors review the clinical research progress of^(90)Y‑SIRT in the preoperative downstaging and bridging treatment of hepatocellular carcinoma before liver transplantation,and discuss^(90)Y‑SIRT‑based conversion strategy.The^(90)Y‑SIRT has shown synergistic effect with targeted therapy and immunotherapy,and will have a broad application prospect in downstaging and conversion therapy in the future.

关 键 词：肝肿瘤 钇-90微球 选择性内放射治疗 肝移植 降期 桥接 治疗 疗效 

分 类 号：R735.7[医药卫生—肿瘤]