Jakobs T F, Hoffmann R T, Tatsch K, Trumm C, Reiser M F
Institut für Klinische Radiologie, Klinikum Grosshadern der Ludwig-Maximilians-Universität München , Marchioninistr. 15, 81377 München, Deutschland.
Radiologe. 2008 Sep;48(9):839-49. doi: 10.1007/s00117-008-1730-x.
Selective internal radiation therapy (SIRT) is used for the treatment of patients with liver tumors, especially for those with hepatocellular carcinoma (HCC) or liver metastases from various primary tumors. Currently this innovative treatment concept is recommended when established state-of-the-art treatment regimes have failed and tumor progression is noted or if the treatment has to be abandoned because of intolerable toxic effects. For SIRT small biocompatible microspheres (SIR-Spheres(R)) are labelled with the radioactive isotope 90Yttrium, a pure beta emitter, and are superselectively infused into the hepatic arteries. The microspheres are collected in the precapillary vessels in and surrounding the tumor. The beta radiation of 90Yttrium has an average penetration in tissue of approximately 2.5 mm and results in very high doses of radiation being selectively targeted to metastases providing protection to the surrounding healthy liver tissue. In this paper we review the results of SIRT in patients with hepatic metastases from colorectal cancer, breast cancer, neuroendocrine tumors and primary liver cancer (HCC).
选择性体内放射疗法(SIRT)用于治疗肝肿瘤患者,尤其是肝细胞癌(HCC)患者或各种原发性肿瘤的肝转移患者。目前,当既定的先进治疗方案失败且出现肿瘤进展,或者由于无法耐受的毒性作用而不得不放弃治疗时,推荐采用这种创新的治疗理念。对于SIRT,将小的生物相容性微球(SIR-Spheres®)用放射性同位素钇-90标记,钇-90是一种纯β发射体,然后将其超选择性注入肝动脉。微球聚集在肿瘤内和肿瘤周围的毛细血管前血管中。钇-90的β辐射在组织中的平均穿透深度约为2.5毫米,可使高剂量辐射选择性地靶向转移灶,同时保护周围的健康肝组织。在本文中,我们回顾了SIRT在结直肠癌、乳腺癌、神经内分泌肿瘤和原发性肝癌(HCC)肝转移患者中的治疗结果。