Radiation segmentectomy of hepatic metastases with Y-90 glass microspheres.
Radiation segmentectomy of hepatic metastases with Y-90 glass microspheres.
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DOI：
10.1007/s00261-021-02956-6
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发表时间：
2021-07
影响因子：
2.4
通讯作者：
Sofocleous, C. T.
中科院分区：
文献类型：
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作者：
Kurilova, I.;Bendet, A.;Fung, E. K.;Petre, E. N.;Humm, J. L.;Boas, F. E.;Crane, C. H.;Kemeny, N.;Kingham, T. P.;Cercek, A.;D'Angelica, M. I.;Beets-Tan, R. G. H.;Sofocleous, C. T.
目的评价90Y玻璃微球放射节段切除术(RS)治疗不能切除或经皮消融的局限性转移性肝病的安全性和有效性。纳入2015年6月至2017年12月接受RS治疗的≤3肿瘤患者。根据医学内照射剂量法(MIRD)，肿瘤目标辐射剂量为>；190Gy.根据Choi和RECIST 1.1标准定义治疗节段的肿瘤反应、局部肿瘤进展(LTP)、无LTP生存期(LTPFS)和疾病进展率。毒性用改良的SIR标准进行评估。10例14个肿瘤患者接受了12次RS。肿瘤平均大小3 cm(1.4~5.6)。中位随访时间为17.8个月(1.6~37.3个月)。CHOI和RECIST 1.1标准的应答率分别为8/8(100%)和4/9(44%)。在研究期间，总的LTP率为3/14(21%)。1年、2年和3年LTPFS分别为83%、83%和69%。未达到LTPFS的中位数。治疗节段的疾病进展率为6/18(33%)。中位生存期为41.5个月(智商16.7~41.5)。肿瘤放射剂量中位数为293Gy163~1303。一个主要的并发症发生在Whiple手术后的患者，该患者在RS后6.5个月出现预防性头孢替坦过敏反应和RS区肝脓肿。所有患者在最后一次随访时均存活。对于有有限转移性肝病和有限治疗选择的患者，≤3肝段RS可以安全地提供两年内83%的局部肿瘤控制率。最佳剂量学方法需要进一步研究。
To evaluate safety and efficacy of radiation segmentectomy (RS) with 90Y glass microspheres in patients with limited metastatic liver disease not amenable to resection or percutaneous ablation. Patients with ≤3 tumors treated with RS from 6/2015–12/2017 were included. Target tumor radiation dose was > 190 Gy based on Medical Internal Radiation Dose (MIRD) dosimetry. Tumor response, local tumor progression (LTP), LTP-free survival (LTPFS) and disease progression rate in the treated segment were defined using Choi and RECIST 1.1 criteria. Toxicities were evaluated using modified SIR criteria. Ten patients with 14 tumors underwent 12 RS. Median tumor size was 3 cm (range, 1.4–5.6). Median follow-up was 17.8 months (range, 1.6–37.3). Response rates per Choi and RECIST 1.1 criteria were 8/8 (100%) and 4/9 (44%), respectively. Overall LTP rate was 3/14 (21%) during the study period. One-, two- and three -year LTPFS was 83%, 83% and 69%, respectively. Median LTPFS was not reached. Disease progression rate in the treated segment was 6/18 (33%). Median overal survival was 41.5 months (IQR, 16.7–41.5). Median delivered tumor radiation dose was 293 Gy (range, 163–1303). One major complication was recorded in a patient post-Whipple procedure who suffered anaphylactic reaction to prophylactic cefotetan and liver abscess in RS region 6.5 months post-RS. All patients were alive on last follow-up. RS of ≤ 3 hepatic segments can safely provide a two-year local tumor control rate of 83% in selected patients with limited metastatic liver disease and limited treatment options. Optimal dosimetry methodology requires further investigation.
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影响因子：
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作者：
Elias, Dominique;Di Pietroantonio, Danielo;De Baere, Thierry
通讯作者：
De Baere, Thierry
影响因子：
2.5
作者：
Padia, Siddharth A.;Johnson, Guy E.;Shin, David
通讯作者：
Shin, David
影响因子：
19.7
作者：
Lewandowski, Robert J.;Gabr, Ahmed;Salem, Riad
通讯作者：
Salem, Riad
影响因子：
19.7
作者：
Biederman, Derek M.;Titano, Joseph J.;Kim, Edward
通讯作者：
Kim, Edward
DOI：
10.1016/j.jvir.2017.08.026
发表时间：
2018-01-01
影响因子：
2.9
作者：
Biederman, Derek M.;Titano, Joseph J.;Kim, Edward
通讯作者：
Kim, Edward