Department of Nuclear Medicine, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
Department of Gastroenterology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.
Curr Oncol. 2022 Mar 29;29(4):2422-2434. doi: 10.3390/curroncol29040196.
Selective internal radiation therapy (SIRT) is part of the treatment strategy for hepatocellular carcinoma (HCC). Strong clinical data demonstrated the effectiveness of this therapy in HCC with a significant improvement in patient outcomes. Recent studies demonstrated a strong correlation between the tumor response and the patient outcome when the tumor-absorbed dose was assessed by nuclear medicine imaging. Dosimetry plays a key role in predicting the clinical response and can be optimized using a personalized method of activity planning (multi-compartmental dosimetry). This paper reviews the main clinical results of SIRT in HCC and emphasizes the central role of dosimetry for improving it effectiveness. Moreover, some patient and tumor characteristics predict a worse outcome, and toxicity related to SIRT treatment of advanced HCC patient selection based on the performance status, liver function, tumor characteristics, and tumor targeting using technetium-99m macro-aggregated albumin scintigraphy can significantly improve the clinical performance of SIRT.
选择性内放射治疗（SIRT）是肝细胞癌（HCC）治疗策略的一部分。强有力的临床数据表明，这种疗法对 HCC 有效，可显著改善患者预后。最近的研究表明，当通过核医学成像评估肿瘤吸收剂量时，肿瘤反应与患者预后之间存在很强的相关性。剂量学在预测临床反应方面起着关键作用，并可以通过使用活动计划的个性化方法（多室剂量学）进行优化。本文回顾了 SIRT 在 HCC 中的主要临床结果，并强调了剂量学在提高其疗效方面的核心作用。此外，一些患者和肿瘤特征预示着预后较差，而基于患者体能状态、肝功能、肿瘤特征和使用锝-99m 聚合白蛋白闪烁扫描进行肿瘤靶向的毒副作用可显著改善 SIRT 的临床疗效。
