Jia Zhongzhi, Jiang Guomin, Zhu Chunfu, Wang Kai, Li Shaoqin, Qin Xihu
Department of Interventional Radiology, No. 2 People's Hospital of Changzhou, Nanjing Medical University, Chang Zhou, 213003, China.
Department of General Surgery, No. 2 People's Hospital of Changzhou, Nanjing Medical University, Changzhou, 213003, China.
Eur J Radiol. 2017 Jul;92:111-115. doi: 10.1016/j.ejrad.2017.05.005. Epub 2017 May 4.
To assess the effectiveness of yttrium-90 (Y) radioembolization in the treatment of unresectable liver metastases of melanoma.
PubMed and EMBASE were systemically searched for all English language studies related to Y radioembolization for unresectable liver metastases of melanoma, including clinical trials, observational studies, and abstracts from conferences, published between January 1991 and March 2016.
A total of 12 reports (7 observational studies and 5 abstracts from conferences) involving 255 patients were included in the analysis. The primary sites of melanoma were cutaneous (n=22; 8.6%), ocular (n=197; 77.3%), rectal (n=3; 1.2%), and unknown (n=33; 12.9%). The median disease control rate at 3 months was 73.6% (range, 58.3%-88.9%). Among the 207 patients for whom tumor response at 3 months was reported, complete response was seen in 1.0% (2/207), partial response was seen in 19.3% (40/207), stable disease was seen in 46.9% (97/207), and progressive disease was seen in 32.9% (68/207). The median survival was 10 months (range, 7-13.4 months), and the median 1-year survival rate was 34.6% (range, 23%-80%). Complications of Y radioembolization were reported in 13 cases. The most common side effects were fatigue (median, 36.1%), abdominal pain (median, 17.8%), and nausea (median, 15.0%).
Y radioembolization is a promising alternative therapy for the treatment of unresectable liver metastases of melanoma, with encouraging effects on disease control and survival. Some complications can occur, and side effects are frequent but mild.
评估钇-90（Y）放射性栓塞治疗不可切除的黑色素瘤肝转移的有效性。
系统检索PubMed和EMBASE，查找1991年1月至2016年3月期间发表的所有与Y放射性栓塞治疗不可切除的黑色素瘤肝转移相关的英文研究，包括临床试验、观察性研究及会议摘要。
分析共纳入12篇报告（7项观察性研究和5篇会议摘要），涉及255例患者。黑色素瘤的原发部位为皮肤（n = 22；8.6%）、眼部（n = 197；77.3%）、直肠（n = 3；1.2%）和未知（n = 33；12.9%）。3个月时的疾病控制率中位数为73.6%（范围为58.3% - 88.9%）。在报告了3个月时肿瘤反应的207例患者中，完全缓解率为1.0%（2/207），部分缓解率为19.3%（40/207），疾病稳定率为46.9%（97/207），疾病进展率为32.9%（68/207）。中位生存期为10个月（范围为7 - 13.4个月），1年生存率中位数为34.6%（范围为23% - 80%）。报告了13例Y放射性栓塞的并发症。最常见的副作用是疲劳（中位数为36.1%）、腹痛（中位数为17.8%）和恶心（中位数为15.0%）。
Y放射性栓塞是治疗不可切除的黑色素瘤肝转移的一种有前景的替代疗法，对疾病控制和生存有令人鼓舞的效果。可能会出现一些并发症，副作用常见但较轻。
