期刊
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
卷 13, 期 9, 页码 S223-S229出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/S1051-0443(07)61790-4
关键词
liver neoplasms, therapeutic radiology microspheres; yttrium, radioactive
Hepatocellular carcinoma (HCC) constitutes a difficult health challenge because of its poor prognosis and limited treatment options. Most available therapies are used only for palliation. The use of yttrium-90 microspheres is a new intraarterial therapy consisting of beta-irradiating microspheres measuring 20-30 mum in diameter that can be delivered directly to the tumors. Y-90 microspheres, which carry the radiation, are selectively taken up by the tumors, thus preserving normal liver. In several studies to date, Y-90 microspheres have proved to have a low toxicity profile and have generally been well tolerated by patients. Other than transient elevation in liver enzyme levels and mild fatigue and fever, no substantial treatment-related toxicities have been observed. Gastrointestinal toxicities occur in a limited number of cases and are preventable with proper knowledge of visceral arterial anatomy. The effect on survival is also promising, with median survival rates of 23 months (95% confidence interval = 14,44) and 11 months (95% confidence interval = 6, 26) for patients with Okuda stage I and stage II disease, respectively. On the basis of these data, intraarterial delivery of Y-90 microspheres offers a new alternative in the treatment of unresectable HCC.
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