Division of Interventional Radiology, Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.
Division of Interventional Radiology, Department of Radiology, University of Chicago, Chicago, IL, USA.
Oncologist. 2024 Feb 2;29(2):117-122. doi: 10.1093/oncolo/oyad327.
Transarterial radioembolization (TARE) with Yttrium-90 (Y90) is a growing area of study due to its benefits in early-, intermediate-, and late-stage hepatocellular carcinoma. Treatment intent, including curative therapy, bridging to transplant, and downstaging disease, informs treatment approach and dosimetry goals. Radiation lobectomy (RL) and radiation segmentectomy (RS) are the 2 main forms of Y90 administration which have shown improved survival outcomes with the development of personalized dosimetry. RS aims to achieve complete pathological necrosis with dose escalation and RL aims for local disease control as well as induction of contralateral lobe hypertrophy to improve hepatic reserve. Furthermore, TARE has been validated in head-to-head comparison to other locoregional and systemic therapies. Lastly, early potential exists for combination therapy between TARE and immune checkpoint inhibitors for advanced stage disease.
经动脉放射性栓塞术（TARE）联合钇-90（Y90）治疗肝癌在早期、中期和晚期都具有显著疗效，因此正在成为研究热点。治疗目的（包括根治性治疗、桥接移植和降期治疗）决定了治疗方法和剂量目标。Y90 放射性肝切除（RL）和放射性肝段切除术（RS）是 Y90 两种主要的给药方式，通过个性化剂量学的发展，这两种方式提高了患者的生存率。RS 通过提高剂量来实现完全的病理坏死，RL 则旨在控制局部疾病并诱导对侧肝叶肥大，以改善肝脏储备。此外，TARE 已在与其他局部区域和全身治疗的头对头比较中得到验证。最后，在晚期肝癌的治疗中，TARE 与免疫检查点抑制剂联合治疗具有早期应用潜力。
