Salem Riad, Hunter Russell D
Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, IL, USA.
Int J Radiat Oncol Biol Phys. 2006;66(2 Suppl):S83-8. doi: 10.1016/j.ijrobp.2006.02.061.
To present a critical review of yttrium-90 (TheraSphere) for the treatment of hepatocellular carcinoma (HCC). Medical literature databases (Medline, Cochrane Library, and CANCERLIT) were searched for available literature concerning the treatment of HCC with TheraSphere. These publications were reviewed for scientific and clinical validity. Studies pertaining to the use of yttrium-90 for HCC date back to the 1960s. The results from the early animal safety studies established a radiation exposure range of 50-100 Gy to be used in human studies. Phase I dose escalation studies followed, which were instrumental in delineating radiation dosimetry and safety parameters in humans. These early studies emphasized the importance of differential arteriolar density between hypervascular HCC and surrounding liver parenchyma. Current trends in research have focused on advancing techniques to safely implement this technology as an alternative to traditional methods of treating unresectable HCC, such as external beam radiotherapy, conformal beam radiotherapy, ethanol ablation, trans-arterial chemoembolization, and radiofrequency ablation. Yttrium-90 (TheraSphere) is an outpatient treatment option for HCC. Current and future research should focus on implementing multicenter phase II and III trials comparing TheraSphere with other therapies for HCC.
对钇-90（TheraSphere）治疗肝细胞癌（HCC）进行批判性综述。检索医学文献数据库（Medline、Cochrane图书馆和CANCERLIT），以获取有关TheraSphere治疗HCC的现有文献。对这些出版物的科学性和临床有效性进行了综述。有关钇-90用于HCC治疗的研究可追溯到20世纪60年代。早期动物安全性研究的结果确定了用于人体研究的辐射暴露范围为50-100 Gy。随后进行了I期剂量递增研究，这些研究有助于确定人体的辐射剂量测定和安全参数。这些早期研究强调了高血管性HCC与周围肝实质之间小动脉密度差异的重要性。当前的研究趋势集中在推进技术，以安全地应用该技术作为治疗不可切除HCC的传统方法的替代方案，如外照射放疗、适形束放疗、乙醇消融、经动脉化疗栓塞和射频消融。钇-90（TheraSphere）是HCC的一种门诊治疗选择。当前和未来的研究应集中在开展多中心II期和III期试验，将TheraSphere与其他HCC治疗方法进行比较。
