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韩国肝细胞癌经动脉放射性栓塞治疗:当前临床实践、设施要求及患者选择

Transarterial Radioembolization for Hepatocellular Carcinoma in Korea: Current Clinical Practices, Facility Requirements, and Patient Selection.

作者信息

Hyun Dongho

出版信息

J Korean Soc Radiol. 2025 Jul;86(4):447-456. doi: 10.3348/jksr.2025.0049. Epub 2025 Jul 25.

Abstract

Before initiating Yttrium-90 (Y) radioembolization, both the interventional radiology and nuclear medicine departments must prepare facilities for radionuclide handling, implement appropriate radiation protection and monitoring measures, and ensure that all medical personnel possess the required government-issued certification. According to current guidelines, transarterial radioembolization is recommended as an alternative treatment option for patients with a single hepatocellular carcinoma measuring ≤8 cm and classified as stage I, II, or III according to the modified Union for International Cancer Control staging system. However, these indications may be adjusted based on the institution's medical clinical setting and resources. Given the potential for irreversible tissue damage from Y, treatment efficacy and safety must be assessed through planning angiography and either planar imaging or SPECT-CT using Tc-macroaggregated albumin.

摘要

在开始钇-90(Y)放射性栓塞治疗之前,介入放射科和核医学科都必须准备好处理放射性核素的设施,实施适当的辐射防护和监测措施,并确保所有医务人员持有政府颁发的所需证书。根据现行指南,对于单个肝细胞癌直径≤8 cm且根据国际癌症控制联盟改良分期系统分类为I期、II期或III期的患者,推荐经动脉放射性栓塞作为一种替代治疗选择。然而,这些适应症可能会根据机构的医疗临床情况和资源进行调整。鉴于Y可能造成不可逆的组织损伤,必须通过计划血管造影以及使用锝标记的大颗粒白蛋白进行平面成像或SPECT-CT来评估治疗效果和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ce/12328919/e04ae56a747e/jksr-86-447-g001.jpg

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