Entezari Pouya, Gabr Ahmed, Kennedy Kristie, Salem Riad, Lewandowski Robert J
Section of Interventional Radiology, Department of Radiology, Northwestern Memorial Hospital, Chicago, Illinois.
Division of Transplantation, Department of Surgery, Comprehensive Transplant Center, Northwestern University, Chicago, Illinois.
Semin Intervent Radiol. 2021 Oct;38(4):419-424. doi: 10.1055/s-0041-1735530. Epub 2021 Oct 7.
Surgical resection has long been considered curative for patients with early-stage hepatocellular carcinoma (HCC). However, inadequate future liver remnant (FLR) renders many patients not amenable to surgery. Recently, lobar administration of yttrium-90 (Y90) radioembolization has been utilized to induce FLR hypertrophy while providing disease control, eventually facilitating resection in patients with hepatic malignancy. This has been termed "radiation lobectomy (RL)." The concept is evolving, with modified approaches combining RL and high-dose curative-intent radioembolization (radiation segmentectomy) to achieve tumor ablation. This article provides an overview of the concept and applications of RL, including technical considerations and outcomes in patients with hepatic malignancies.
长期以来,手术切除一直被认为是早期肝细胞癌(HCC)患者的治愈方法。然而,未来肝脏残余量(FLR)不足使许多患者无法接受手术。最近,钇-90(Y90)放射性栓塞的叶内给药已被用于诱导FLR肥大,同时控制疾病,最终促进肝恶性肿瘤患者的切除。这被称为“放射性叶切除术(RL)”。随着将RL与高剂量治愈性放射性栓塞(放射性节段切除术)相结合的改良方法的出现,这一概念正在不断发展,以实现肿瘤消融。本文概述了RL的概念和应用,包括技术考量以及肝恶性肿瘤患者的治疗结果。