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Is there a role for Ytrrium-90 in the treatment of unresectable and metastatic intrahepatic cholangiocarcinoma?钇[90Y]树脂微球在不可切除和转移性肝内胆管癌治疗中的作用如何?
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Multimodality treatment of intrahepatic cholangiocarcinoma: A review.多模态治疗肝内胆管细胞癌:综述。
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Unresectable solitary hepatocellular carcinoma not amenable to radiofrequency ablation: multicenter radiology-pathology correlation and survival of radiation segmentectomy.不可切除的单发肝细胞癌不适合射频消融:多中心放射科-病理相关性和放射段切除术的生存。
Hepatology. 2014 Jul;60(1):192-201. doi: 10.1002/hep.27057. Epub 2014 May 27.
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Surgery and chemotherapy for intrahepatic cholangiocarcinoma.肝内胆管癌的手术与化疗
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用钇90标记的玻璃微球行放射节段切除术/肝叶切除术治疗不可切除的肝内胆管癌

Unresectable Intrahepatic Cholangiocarcinoma Treated with Radiation Segmentectomy/Lobectomy Using Yttrium 90-labeled Glass Microspheres.

作者信息

Kumar Premsai, Mhaskar Rahul, Kim Richard, Anaya Daniel, Frakes Jessica, Hoffe Sarah, Choi Junsung, Kis Bela

机构信息

Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, FL, USA.

University of South Florida Morsani College of Medicine, Tampa, FL, USA.

出版信息

J Clin Exp Hepatol. 2022 Sep-Oct;12(5):1259-1263. doi: 10.1016/j.jceh.2022.03.008. Epub 2022 Apr 1.

DOI:10.1016/j.jceh.2022.03.008
PMID:36157145
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9499841/
Abstract

BACKGROUND

There is no curative treatment option for patients with unresectable intrahepatic, cholangiocarcinoma (IHC). The aim of this study was to evaluate the efficacy of; radiation segmentectomy/lobectomy using Y90-labeled glass microspheres in patients with; unresectable IHC.

METHODS

This IRB-approved, single-center study included, 16 patients (age: 67 ± 7.7 years) with IHC who received radiation segmentectomy or lobectomy, treatment using Y90-labeled glass microspheres between May 2009 and October 2019. Radiation, segmentectomy/lobectomy was defined as at least 190 Gy dose delivered into treated liver; volume.

RESULTS

The median OS from IHC diagnosis was 22.7 months (95% CI: 13.9-66.1) and from, radioembolization it was 7 months (95% CI: 4.33-54.17). Patients who did not receive, chemotherapy before the radioembolization had significantly longer median OS (26.8 vs. 5.9, months,  = 0.03). Four patients had >20 months survival after radioembolization, including 2, patients with survival of 42 and 54 months. There was no 30-day mortality and no severe, complications.

CONCLUSION

Radiation segmentectomy/lobectomy is safe with minimal side effects. The median, OS of the study group is modest; however, 4 patients (25%) showed excellent survival. These results suggest a need for a larger study to define the IHC patient group who could, most benefit from this procedure.

摘要

背景

对于无法切除的肝内胆管癌(IHC)患者,目前尚无治愈性治疗方案。本研究的目的是评估使用钇-90标记的玻璃微球进行放射节段切除术/叶切除术治疗无法切除的肝内胆管癌的疗效。

方法

这项经机构审查委员会批准的单中心研究纳入了2009年5月至2019年10月期间接受使用钇-90标记的玻璃微球进行放射节段切除术或叶切除术治疗的16例肝内胆管癌患者(年龄:67±7.7岁)。放射节段切除术/叶切除术的定义为向治疗的肝脏体积输送至少190 Gy的剂量。

结果

从肝内胆管癌诊断开始的中位总生存期为22.7个月(95%置信区间:13.9 - 66.1),从放射栓塞开始为7个月(95%置信区间:4.33 - 54.17)。在放射栓塞前未接受化疗的患者中位总生存期明显更长(26.8个月对5.9个月,P = 0.03)。4例患者在放射栓塞后存活超过20个月,其中2例患者存活42个月和54个月。无30天死亡率,也无严重并发症。

结论

放射节段切除术/叶切除术安全,副作用最小。研究组的中位总生存期一般;然而,4例患者(25%)显示出良好的生存期。这些结果表明需要进行更大规模的研究来确定最能从该手术中获益的肝内胆管癌患者群体。