90Y 微球放射性栓塞治疗神经内分泌肝脏转移瘤：一项机构病例系列研究、系统评价和荟萃分析。
Radioembolisation with 90Y microspheres for neuroendocrine liver metastases: an institutional case series, systematic review and meta-analysis.
机构信息
Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, W12 0HS, United Kingdom.
Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3508, GA Utrecht, the Netherlands.
出版信息
HPB (Oxford). 2019 Jul;21(7):773-783. doi: 10.1016/j.hpb.2018.12.014. Epub 2019 Feb 5.
BACKGROUND
Neuroendocrine liver metastases are clinically challenging due to their frequent disseminated distribution. This study aims to present a British experience with an emerging modality, radioembolisation with yttrium-90 labelled microspheres, and embed this within a meta-analysis of response and survival outcomes.
METHODS
A retrospective case series of patients treated with SIR-Spheres (radiolabelled resin microspheres) was performed. Results were included in a systematic review and meta-analysis of published results with glass or resin microspheres. Objective response rate (ORR) was defined as complete or partial response. Disease control rate (DCR) was defined as complete/partial response or stable disease.
RESULTS
Twenty-four patients were identified. ORR and DCR in the institutional series was 14/24 and 21/24 at 3 months. Overall survival and progression-free survival at 3-years was 77.6% and 50.4%, respectively. There were no grade 3/4 toxicities post-procedure. A fixed-effects pooled estimate of ORR of 51% (95% CI: 47%-54%) was identified from meta-analysis of 27 studies. The fixed-effects weighted average DCR was 88% (95% CI: 85%-90%, 27 studies).
CONCLUSION
Current data demonstrate evidence of the clinical effectiveness and safety of radioembolisation for neuroendocrine liver metastases. Prospective randomised studies to compare radioembolisation with other liver directed treatment modalities are needed.
背景
神经内分泌肝转移由于其广泛分布的特点，临床上极具挑战性。本研究旨在介绍英国在一种新兴治疗方法——钇-90 标记微球放射性栓塞方面的经验，并将其纳入玻璃微球或树脂微球治疗反应和生存结果的荟萃分析中。
方法
对接受 SIR-Spheres（放射性标记树脂微球）治疗的患者进行回顾性病例系列研究。研究结果纳入了已发表的玻璃或树脂微球治疗结果的系统评价和荟萃分析。客观缓解率（ORR）定义为完全或部分缓解。疾病控制率（DCR）定义为完全/部分缓解或稳定疾病。
结果
共确定了 24 例患者。在机构系列中，3 个月时的 ORR 和 DCR 分别为 14/24 和 21/24。3 年总生存率和无进展生存率分别为 77.6%和 50.4%。术后无 3/4 级毒性。荟萃分析 27 项研究的固定效应合并估计 ORR 为 51%（95%CI：47%-54%）。固定效应加权平均 DCR 为 88%（95%CI：85%-90%，27 项研究）。
结论
目前的数据表明，放射性栓塞治疗神经内分泌肝转移具有临床有效性和安全性。需要进行前瞻性随机研究比较放射性栓塞与其他肝脏靶向治疗方法。
Zotero 插件