摘要
目的 观察肝癌患者采用90Y树脂微球选择性内放射治疗后的临床疗效,并探讨其对患者肝脏和肺脏内放射性活度的影响。方法 回顾性分析2021年10月至2023年10月海南省肿瘤医院收治的90例肝癌患者的临床诊治资料,所有患者均行90Y树脂微球选择性内放射治疗,随访6个月评价患者治疗后的临床效果,比较患者治疗前后的肿瘤长径、各项生化指标以及治疗后不同时间段肝内和肺内放射性活度的变化。结果 治疗后90例患者中46例完全缓解,占51.11%。37例部分缓解,占41.11%,7例进展,占7.78%,缓解率为92.22%(83/90);与治疗前比较,治疗后患者的肿瘤长径缩短,且甲胎蛋白(AFP)下降,差异均有统计学意义(P<0.05),但患者治疗前后的谷氨酰转肽酶(GGT)、总胆红素(TBil)、白蛋白(ALB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)比较差异均无统计学意义(P>0.05);同时,治疗后2 h、24 h、48 h,肝内放射性活度分别为(131.45±20.52) Gy、(101.67±13.21) Gy、(76.23±8.32) Gy,明显高于肺内放射性活度的(15.46±4.76) Gy、(11.18±3.36) Gy、(7.38±1.12) Gy,差异均有统计学意义(P<0.05),但肝内和肺内24 h、48 h的RCR比较差异均无统计学意义(P>0.05)。结论90Y树脂微球选择性内放射治疗肝癌患者可以提高临床缓解率,肺内的放射性活度较低,且随着时间的延长,其放射性活度逐渐减少。
Objective To observe the clinical efficacy of selective internal radiotherapy(SIRT)with 90Y resin microspheres in patients with liver cancer,and to explore its influence on the radioactivity in the liver and lungs of the patients.Methods A retrospective analysis was conducted on the clinical diagnosis and treatment data of 90 liver cancer patients treated by SIRT with 90Y resin microspheres at Hainan Cancer Hospital from October 2021 to October 2023.All patients were followed up for 6 months to evaluate the clinical efficacy after treatment.Changes in tumor long diameter,various biochemical indicators,and hepatic and pulmonary radioactivity at different time points after therapy were compared with pre-treatment values.Results Among the 90 patients,complete remission was achieved after treatment in 46 cases(51.11%),partial remission in 37 cases(41.11%),and disease progression in 7 cases(7.78%),yielding an overall remission rate of 92.22%(83/90).Compared with before treatment,post-treatment tumor long diameter and alpha-fetoprotein(AFP)levels decreased significantly(P<0.05).No significant differences were observed in glutamyl transpeptidase(GGT),total bilirubin(TBil),albumin(ALB),aspartate aminotransferase(AST),or alanine aminotransferase(ALT)before and after treatment(P>0.05).Meanwhile,at 2 h,24 h,and 48 h after treatment,the radioactive activities in the liver were(131.45±20.52)Gy,(101.67±13.21)Gy,and(76.23±8.32)Gy,respectively,significantly higher than corresponding lung radioactive activities of(15.46±4.76)Gy,(11.18±3.36)Gy,and 7.38±1.12(P<0.05).However,there were no statistically significant differences in the ratio of change of radioactivity(RCR)between the liver and the lungs at 24 h and 48 h(P>0.05).Conclusion Selective internal radiotherapy with 90Y resin microspheres markedly improves the clinical remission rate in liver cancer patients.The radioactive activity in the lungs is relatively low and decreases progressively over time.
作者
王志恒
牛惠敏
高石鑫
黄金堂
曾骞
林映桂
金桂云
WANG Zhi-heng;NIU Hui-min;GAO Shi-xin;HUANG Jin-tang;ZENG Qian;LIN Ying-gui;JIN Gui-yun(Interventional Department,Hainan Cancer Hospital,Haikou 570312,Hainan,CHINA;Interventional Department,Jinshazhou Hospital,Guangzhou University of Chinese Medicine,Guangzhou 510168,Guangdong,CHINA;Department of Interventional Vascular Surgery,the First Affiliated Hospital of Hainan Medical University,Haikou 570102,Hainan,CHINA)
出处
《海南医学》
2025年第11期1591-1595,共5页
Hainan Medical Journal
基金
海南省卫生健康行业科研项目(编号:22A200297)。
关键词
肝癌
90Y微球
选择性内放射治疗
肺内放射性活度
疗效
Liver cancer
90Y microsphere
Selective internal radiation therapy
Pulmonary radioactivity
Therapeutic efficacy
