Rösler H, Triller J, Baer H U, Geiger L, Beer H F, Becker C, Blumgart L H
Dept. of Nuclear Medicine, University of Berne, Inselspital, Switzerland.
Nuklearmedizin. 1994 Oct;33(5):206-14.
Twenty patients with unresectable hepatocellular carcinoma (HCC) were followed up to 5 years after transarterial radiotherapy with 90Y-resin particles. Diagnostic radioembolizations of 99mTc-macroaggregates facilitated scintigraphic assessment of activity distribution, dose evaluation and final procedural verification. The overall survival rates were 56, 38 and 14% (after 1, 2 and 3 years, resp.). Patients with unifocal HCC and a single feeding artery (n = 7) even presented 83, 67 and 40% (2 alive after 2.75 and 4 years). With multiple arteries (n = 7), the longest survival was 26 months. Patients with multifocal HCC survived up to 33 months after selective radioembolization. Quality of life was improved in all. Survival was positively correlated with absorbed dose but residual/recurrent tumour occurred even after > or = 300 Gy. Post-treatment symptoms were minimal (35 applications), pulmonary shunt rates were correctly predicted and pulmonary complications avoided.
对20例无法切除的肝细胞癌（HCC）患者进行了经动脉90Y树脂微球放疗，并随访5年。99mTc-大聚合白蛋白的诊断性放射性栓塞有助于通过闪烁扫描评估活性分布、剂量评估及最终操作验证。总体生存率分别为56%、38%和14%（分别在1年、2年和3年后）。单灶性HCC且只有单一供血动脉的患者（n = 7）的生存率分别为83%、67%和40%（2例分别在2.75年和4年后仍存活）。有多个供血动脉的患者（n = 7），最长生存期为26个月。多灶性HCC患者在选择性放射性栓塞后存活长达33个月。所有患者的生活质量均得到改善。生存率与吸收剂量呈正相关，但即使在吸收剂量≥300 Gy后仍会出现肿瘤残留/复发。治疗后症状轻微（35次治疗），肺分流率得到正确预测且避免了肺部并发症。
