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钇-90树脂与玻璃微球放射性栓塞的毒性比较

Toxicity comparison of yttrium-90 resin and glass microspheres radioembolization.

作者信息

Braat Manon N, Braat Arthur J, Lam Marnix G

机构信息

Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, the Netherlands -

Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, the Netherlands.

出版信息

Q J Nucl Med Mol Imaging. 2024 Jun;68(2):133-142. doi: 10.23736/S1824-4785.22.03452-5. Epub 2022 Jun 28.

Abstract

BACKGROUND

To investigate the clinical, hematological and biochemical toxicity differences between glass and resin yttrium-90 (Y)-microspheres radioembolization treatment of primary and metastatic liver disease.

METHODS

Between May 2014 and November 2016 all consecutive glass and resin Y microspheres radioembolization treatments were retrospectively analyzed. Biochemical, hematological and clinical data were collected at treatment day, two weeks, one month and three months follow-up. Post-treatment Y PET/CTs were assessed for the absorbed doses in non-tumorous liver volume (DNTLV) and tumor volume (DTV). Biochemical, hematological and clinical toxicity were compared between glass and resin using chi square tests and repeated ANOVA measures. Biochemical and clinical toxicity was correlated with DNTLV,total by means of Pearson correlation and independent t-tests.

RESULTS

A total of 85 patients were included (N.=44 glass, N.=41 resin). Clinical toxicity the day after treatment (i.e. abdominal pain [P=0.000], nausea [P=0.000] and vomiting [P=0.003]) was more prevalent for resin. Biochemical and hematological toxicities were similar for both microspheres. The DNTLV,total was significantly higher in patients with REILD grade ≥3 in the resin group (43.5 versus 33.3 Gy [P=0.050]). A similar non-significant trend was seen in the glass group: 95.0 versus 69.0 Gy [P=0.144].

CONCLUSIONS

The clinical, hematological and biochemical toxicity of radioembolization treatment with glass and resin is comparable, however, post-embolization syndrome related complaints are more common for resin.

摘要

背景

探讨玻璃微球与树脂钇-90(Y)微球放射性栓塞治疗原发性和转移性肝病在临床、血液学及生化毒性方面的差异。

方法

回顾性分析2014年5月至2016年11月期间所有连续接受玻璃微球与树脂Y微球放射性栓塞治疗的病例。在治疗当天、治疗后两周、一个月及三个月随访时收集生化、血液学及临床数据。对治疗后的Y PET/CT进行评估,计算非肿瘤肝体积(DNTLV)和肿瘤体积(DTV)的吸收剂量。采用卡方检验和重复方差分析比较玻璃微球与树脂微球在生化、血液学及临床毒性方面的差异。通过Pearson相关分析和独立t检验分析生化及临床毒性与DNTLV,total的相关性。

结果

共纳入85例患者(玻璃微球组44例,树脂微球组41例)。树脂微球治疗后当天的临床毒性(即腹痛[P = 0.000])、恶心[P = 0.000]和呕吐[P = 0.003])更为常见。两种微球在生化及血液学毒性方面相似。树脂组中放射性栓塞诱导的肝损伤(REILD)≥3级患者的DNTLV,total显著更高(43.5 Gy对33.3 Gy [P = 0.050])。玻璃微球组也观察到类似但无统计学意义的趋势:95.0 Gy对69.0 Gy [P = 0.144]。

结论

玻璃微球与树脂微球放射性栓塞治疗在临床、血液学及生化毒性方面具有可比性,然而,树脂微球栓塞后综合征相关的不适更为常见。

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