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钇-90树脂微球选择性内放射治疗肝脏恶性肿瘤的安全性分析

Safety analysis of Yttrium-90 resin microsphere selective internal radiation therapy on malignant liver tumors

    摘要
  • 摘要:
    目的 探讨钇-90树脂微球选择性内放射治疗（Yttrium-90 resin microsphere selective internal radiation therapy，90Y-SIRT）在肝脏恶性肿瘤中应用的安全性。
    方法 回顾性选择2023年2月至2024年11月于潍坊市人民医院完成90Y-SIRT的64例肝脏恶性肿瘤患者，分析患者的临床特征和治疗后的不良反应发生情况，评估90Y-SIRT的安全性。
    结果 64例患者中，男性52例（81.25%）、女性12例（18.75%）；年龄（56.29±11.08）岁。7例（10.94%）患者病灶最大径＜5 cm、38例（59.38%）患者病灶最大径5～10 cm、19例（29.68%）患者病灶最大径＞10 cm。病灶单发47例（73.44%）、多发17例（26.56%）；原发性肝癌53例（82.81%）、转移性肝癌11例（17.19%）。64例患者中，63例患者顺利完成锝-99m标记的大颗粒聚合白蛋白（Technetium-99m-macroaggregated albumin，99mTc-MAA）灌注试验，并完成90Y-SIRT；1例患者因工作人员失误行2次99mTc-MAA 灌注试验后接受90Y-SIRT。主要不良反应：丙氨酸氨基转移酶（ALT）升高1级26例（40.62%）、2级6例（9.37%），天冬氨酸氨基转移酶（AST）升高1级27例（42.18%）、2级7例（10.93%），恶心1级17例（26.56%）、2级6例（9.37%），腹痛1级12例（18.75%）、2级5例（7.81%）、3级1例（1.56%），呕吐1级11例（17.18%）、2级5例（7.81%）、3级1例（1.56%）。
    结论 90Y-SIRT治疗肝脏恶性肿瘤的不良反应程度较轻，安全性较好。

     

    Abstract:
    Objective To explore the safety of Yttrium-90 resin microsphere selective internal radiation therapy (90Y-SIRT) on malignant liver tumors.
    Methods A retrospective analysis was conducted on 64 patients with malignant liver tumors who underwent 90Y-SIRT from February 2023 to November 2024 at Weifang People’s Hospital. The clinical characteristics of the patients and the occurrence of adverse reactions after treatment were analyzed to assess the safety of 90Y-SIRT.
    Results Among the 64 patients, there were 52 males (81.25%) and 12 females (18.75%); the average age was (56.29±11.08) years. Seven patients (10.94%) had tumors with maximum diameter of less than 5 cm, 38 patients (59.38%) had tumors with maximum diameter of 5-10 cm, and 19 patients (29.68%) had tumors with maximum diameter of greater than 10 cm. There were 47 cases (73.44%) of solitary lesions and 17 cases (26.56%) of multiple lesions; 53 cases (82.81%) were primary liver cancers and 11 cases (17.19%) were metastatic liver cancers. Of the 64 patients, 63 successfully completed the Technetium-99m macroaggregated albumin (99mTc-MAA) perfusion test and received the 90Y-SIRT; one patient received 90Y-SIRT after the second 99mTc-MAA perfusion test due to a work error. The most common adverse reactions included grade 1 alanine aminotransferase (ALT) elevation in 26 cases (40.62%) and grade 2 in 2 cases (9.37%), grade 1 aspartate aminotransferase (AST) elevation in 27 cases (42.18%) and grade 2 in 7 cases (10.93%); grade 1 nausea in 17 cases (26.56%) and grade 2 in 6 cases (9.37%); grade 1 abdominal pain in 12 cases (18.75%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%); grade 1 vomiting in 11 cases (17.18%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%).
    Conclusion The adverse reactions of 90Y-SIRT for treating malignant liver tumors are mild, indicating good safety.

     

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