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比较选择性肝动脉内放射性核素治疗原发性和转移性肝肿瘤的实验室毒性:树脂微球与玻璃微球

Comparing laboratory toxicity of selective intra-arterial radionuclide therapy for primary and metastatic liver tumors: resin versus glass microspheres.

作者信息

Soydaş-Turan Başak, Bozkurt M Fani, Eldem Gonca, Peynircioglu Bora, Ugur Omer, Volkan-Salanci Bilge

机构信息

Department of Nuclear Medicine, Kastamonu Education and Research Hospital, Kastamonu, Türkiye.

Department of Nuclear Medicine, Hacettepe University Faculty of Medicine, Ankara, Türkiye.

出版信息

Ann Nucl Med. 2025 Apr;39(4):373-379. doi: 10.1007/s12149-024-02011-6. Epub 2025 Jan 17.

Abstract

OBJECTIVE

To compare the acute (within 30 days of treatment) laboratory toxicities of Yttrium-90 (Y-90) resin and glass microspheres.

METHODS

Selective intra-arterial radionuclide therapies (SIRTs) with Y-90 resin and glass microspheres were retrospectively reviewed. Liver-hematological data were collected at baseline and at 1 week and 1 month follow-up. The percentage change of laboratory data and the albumin-bilirubin (ALBI) score were calculated.

RESULTS

A total of 219 SIRTs (n: 110 resin, n: 109 glass) from 177 patients were included. There was no difference in age, liver pathologies, extrahepatic disease, baseline liver function tests, and total blood counts between the two microsphere groups. Administered activity was higher in treatments with Y-90 glass microspheres (p < 0.001). An increase in serum liver enzymes was observed after treatment with both microspheres. The difference between the treatment groups was the higher percentage increase of AST and ALT at the first week following Y-90 glass treatment (p < 0.001). However, this situation was not observed after 1 month. No difference in the percentage change of other laboratory parameters was found between two groups. The number of patients with an increase [resin n: 24 (24.7%) vs glass n: 26 (27.1%), p: 0.711) and decrease [resin n: 13 (13.4%) vs glass n: 8 (8.3%), p: 0.258] in the ALBI grade after SIRT was similar among groups.

CONCLUSIONS

An increase in liver enzymes was observed in the early period after SIRT with both microspheres. No significant difference in liver and hematological data was detected during early follow-up between the two groups, except that the percentage increase of AST and ALT were higher at the first week in the Y-90 glass group, possibly due to higher administered activity.

摘要

目的

比较钇-90(Y-90)树脂微球和玻璃微球的急性(治疗后30天内)实验室毒性。

方法

对采用Y-90树脂微球和玻璃微球的选择性动脉内放射性核素治疗(SIRT)进行回顾性分析。在基线、随访1周和1个月时收集肝脏血液学数据。计算实验室数据的百分比变化和白蛋白-胆红素(ALBI)评分。

结果

纳入了177例患者的219次SIRT(树脂微球组110例,玻璃微球组109例)。两组在年龄、肝脏病理、肝外疾病、基线肝功能检查和全血细胞计数方面无差异。Y-90玻璃微球治疗的给药活度更高(p < 0.001)。两种微球治疗后均观察到血清肝酶升高。治疗组之间的差异在于Y-90玻璃微球治疗后第1周AST和ALT的百分比升高更高(p < 0.001)。然而,1个月后未观察到这种情况。两组之间其他实验室参数的百分比变化无差异。SIRT后ALBI分级升高[树脂微球组24例(24.7%) vs 玻璃微球组26例(27.1%),p:0.711]和降低[树脂微球组13例(13.4%) vs 玻璃微球组8例(8.3%),p:0.258]的患者数量在组间相似。

结论

两种微球SIRT后早期均观察到肝酶升高。两组在早期随访期间未检测到肝脏和血液学数据的显著差异,除了Y-90玻璃微球组第1周AST和ALT的百分比升高更高,这可能是由于给药活度更高。

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