Gates Vanessa L, Atassi Bassel, Lewandowski Robert J, Ryu Robert K, Sato Kent T, Nemcek Albert A, Omary Reed, Salem Riad
Northwestern Memorial Hospital, Northwestern University, Department of Radiology, Section of Interventional Radiology, 676 N St Claire, Suite 800, Chicago, IL 60611, USA.
Future Oncol. 2007 Feb;3(1):73-81. doi: 10.2217/14796694.3.1.73.
Understanding the effect of radiation on tissue, the principles of dosimetry and fractionation have led to the acceptance and adoption of radiation as a standard treatment option for cancer. Delivered in staged and scheduled aliquots, radiation will break nucleic strands and cause cellular death. In general, radiation therapies are delivered using external techniques (external beam and intensity-modulated therapy). One of the limitations of such external techniques is that of nontarget radiation. That is, despite best efforts to collimate and reflect radiation beams to a small target, nontarget radiation and a dose to areas outside the tumor remains a distinct possibility. With the advent of radioembolization using Yttrium-90 microspheres (90Y), the radiation source is delivered optimally through a novel mechanism: directly into the blood vessel providing flow to the tumor. This revolutionary approach capitalizes on the basic principles of tumor hypervascularity, concentrating radiation within that tumor, while at the same time minimizing the risks of nontarget radiation. This review elaborates on this technology.
了解辐射对组织的影响、剂量测定和分次治疗的原则，使得辐射作为癌症的标准治疗选择被接受和采用。以分阶段和预定的小份剂量进行递送时，辐射会破坏核酸链并导致细胞死亡。一般来说，放射治疗是使用外部技术（外照射和调强放疗）进行的。此类外部技术的局限性之一是非靶向辐射。也就是说，尽管尽最大努力将辐射束准直并反射到小目标上，但非靶向辐射以及肿瘤外区域的剂量仍有可能存在。随着使用钇 - 90微球（90Y）的放射性栓塞的出现，辐射源通过一种新颖的机制实现了最佳递送：直接进入为肿瘤供血的血管。这种革命性的方法利用了肿瘤血管过度增生的基本原理，将辐射集中在肿瘤内，同时将非靶向辐射的风险降至最低。本综述详细阐述了这项技术。
