实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (3): 324-327.doi: 10.3969/j.issn.1672-5069.2026.03.002
唐伟国, 刘源
收稿日期:2024-05-23
出版日期:2026-05-10
发布日期:2026-05-18
通讯作者:
刘源,E-mail:liu_yuan2000@sina.com
作者简介:唐伟国,男,25岁,硕士研究生。
Tang Weiguo, Liu Yuan
Received:2024-05-23
Online:2026-05-10
Published:2026-05-18
唐伟国, 刘源. 钇-90微球放射栓塞治疗原发性肝癌患者并发症及防治措施研究进展[J]. 实用肝脏病杂志, 2026, 29(3): 324-327.
Tang Weiguo, Liu Yuan. Yttrium-90 microsphere radioembolization in the treatment of patients with primary liver cancer[J]. Journal of Practical Hepatology, 2026, 29(3): 324-327.
| [1] Weber M, Lam M, Chiesa C, et al. EANM procedure guideline for the treatment of liver cancer and liver metastases with intra-arterial radioactive compounds.Eur J Nucl Med Mol Imaging, 2022, 49(5): 1682-1699. [2] Vogel A,Martinelli E,Vogel A,et al.Updated treatment recommendations for hepatocellular carcinoma (HCC) from the ESMOclinical practice guidelines. Ann Oncol, 2021, 32(6): 801-805. [3] 王斯妮, 贾中芝, 胡红杰, 等. 钇-90微球的特性、放射栓塞的操作技术及安全防护——钇-90微球放射栓塞系列回顾(一). 介入放射学杂志, 2017, 26(10): 952-958. [4] Biederman DM,Titano JJ,Tabori NE, et al. Outcomes of radioembolization in the treatment of hepatocellular carcinoma with portal vein invasion: Resin versus glass microspheres. J Vasc Interv Radiol, 2016, 27(6): 812-821,e2. [5] Bester L,Meteling B,Pocock N,et al.Radioembolization versus standard care of hepatic metastases:Comparative retrospective cohort study of survival outcomes and adverse events in salvage patients. J Vasc Interv Radiol, 2012, 23(1): 96-105. [6] Sangro B, Martínez-Urbistondo D, Bester L, et al. Prevention and treatment of complications of selective internal radiation therapy: Expert guidance and systematic review. Hepatology, 2017, 66(3): 969-982. [7] 郑丽丽, 贾中芝, 王斯妮, 等. 钇-90微球放射栓塞治疗肝脏恶性肿瘤的不良反应和并发症——钇-90微球放射栓塞系列回顾(五). 介入放射学杂志, 2018, 27(2): 190-196. [8] Padia SA, Lewandowski RJ, Johnson GE, et al. Radioembolization of hepatic malignancies: Background,quality improvement guidelines, and future directions. J Vasc Interv Radiol, 2017, 28(1): 1-15. [9] Müller SP, Ezziddin S, Antoch G, et al. Selektive intraarterielle radiotherapie (SIRT) malignerlebertumoren. Nuklearmedizin, 2017, 56(5): 162-170. [10] Salem R, Parikh P, Atassi B, et al. Incidence of radiation pneumonitis after hepatic intra-arterial radiotherapy with yttrium-90 microspheres assuming uniform lung distribution. Am J Clin Oncol, 2008, 31(5): 431-438. [11] Hamm CA, Busch F, Pöhlmann A, et al. Non-invasive imaging biomarkers to predict the hepatopulmonary shunt fraction before transarterial radioembolization in patients with hepatocellular carcinoma. J Hepatocell Carcinoma, 2023, 10: 27-42. [12] Ward TJ, Tamrazi A, Lam MG, et al. Management of high hepatopulmonary shunting in patients undergoing hepatic radioembolization. J Vasc Interv Radiol, 2015, 26(12): 1751-1760. [13] Schiro BJ, Amour ES, Harnain C, et al. Management of high hepatopulmonary shunts in the setting of Y90 radioembolization. Tech Vasc Interv Radiol, 2019, 22(2): 58-62. [14] Theysohn JM, Schlaak JF, Müller S, et al. Selective internal radiation therapy of hepatocellular carcinoma: potential hepatopulmonary shunt reduction after sorafenib administration. J Vasc Interv Radiol, 2012, 23(7): 949-952. [15] Thüring J, Zimmermann M, Bruners P, et al. Short-term oral sorafenib for therapy of intratumoral shunts of hepatocellular carcinoma to enable intraarterial treatment. Cardiovasc Intervent Radiol, 2019, 42(10): 1494-1499. [16] Bledsoe TJ, Nath SK, Decker RH. Radiation pneumonitis. Clin Chest Med, 2017, 38(2): 201-208. [17] Collins J, Salem R. Hepatic radioembolization complicated by gastrointestinal ulceration. Semin Intervent Radiol, 2011, 28(2): 240-245. [18] Carretero C, Munoz-Navas M, Betes M, et al. Gastroduodenal injury after radioembolization of hepatic tumors. Am J Gastroenterol, 2007, 102(6): 1216-1220. [19] Sangro B, Carpanese L, Cianni R, et al. Survival after yttrium-90 resin microsphere radioembolization of hepatocellular carcinoma acrossbarcelona clinic liver cancer stages: a European evaluation. Hepatology, 2011, 54(3): 868-878. [20] Lam MGEH, Banerjee S, Louie JD, et al. Root cause analysis of gastroduodenal ulceration after yttrium-90 radioembolization. Cardiovasc Intervent Radiol, 2013, 36(6): 1536-1547. [21] Hamami ME, Poeppel TD, Müller S, et al. SPECT/CT with 99mTc-MAA in radioembolization with 90Y microspheres in patients with hepatocellular cancer. J Nucl Med, 2009, 50(5): 688-692. [22] Kallini JR, Gabr A, Thorlund K, et al. Comparison of the adverse event profile of TheraSphere© with SIR-spheres© for the treatment of unresectable hepatocellular carcinoma: A systematic review. Cardiovasc Intervent Radiol, 2017, 40(7): 1033-1043. [23] Sun B, Lapetino SR, Diffalha SA, et al. Microvascular injury in persistent gastric ulcers after yttrium-90 microsphere radioembolization for liver malignancies. Hum Pathol, 2016, 50: 11-14. [24] Feely M, Tondon R, Gubbiotti M, et al. Gastrointestinal tract injury by yttrium-90 appears largely restricted to resin microspheres but can occur years after embolization. Am J Surg Pathol, 2022, 46(9): 1234-1240. [25] Braat MN, van Erpecum KJ, Zonnenberg BA, et al. Radioembolization-induced liver disease: a systematic review. Eur J Gastroenterol Hepatol, 2017, 29(2): 144-152. [26] Maleux G, Albrecht T, Arnold D, et al. Predictive factors for adverse event outcomes after transarterial radioembolization with yttrium-90 resin microspheres in Europe: Results from the prospective observational CIRT study. Cardiovasc Intervent Radiol, 2023, 46(7): 852-867. [27] Prince DS, Schlaphoff G, Davison SA, et al. Selective internal radiation therapy for hepatocellular carcinoma: A 15-year multicenter Australian cohort study. J Gastroenterol Hepatol, 2022, 37(11): 2173-2181. [28] Piana PM, Gonsalves CF, Sato T, et al. Toxicities after radioembolization with yttrium-90 SIR-spheres: incidence and contributing risk factors at a single center. J Vasc Interv Radiol, 2011, 22(10): 1373-1379. [29] Gil-Alzugaray B, Chopitea A, Iñarrairaegui M, et al. Prognostic factors and prevention of radioembolization-induced liver disease. Hepatology, 2013, 57(3): 1078-1087. [30] Kessler J, Park JJ. Yttrium-90 radioembolization after local hepatic therapy: How prior treatments impact patient selection, dosing, and toxicity. Tech Vasc Interv Radiol, 2019, 22(2): 112-116. [31] Seidensticker M, Seidensticker R, Damm R, et al. Prospective randomized trial of enoxaparin, pentoxifylline and ursodeoxycholic acid for prevention of radiation-induced liver toxicity. PLoS One, 2014, 9(11): e112731. [32] Kowdley KV. Ursodeoxycholic acid therapy in hepatobiliary disease. Am J Med, 2000, 108(6): 481-486. [33] Parakh S, Gananadha S, Allen R, et al. Cholecystitis after yttrium-90 resin microsphere radioembolization treatment: Clinical and pathologic findings. Asian J Surg, 2016, 39(3): 144-148. [34] Padia SA, Johnson GE, Lewandowski RJ, et al. Transarterial yttrium-90 radioembolization of hepatocellular carcinoma perfused by the cystic artery: Multi-institutional feasibility study. J Vasc Interv Radiol, 2020, 31(12): 2022-2027. [35] Powerski M, Busse A, Seidensticker M, et al. Prophylactic embolization of the cystic artery prior to radioembolization of liver malignancies--an evaluation of necessity. Cardiovasc Intervent Radiol, 2015, 38(3): 678-684. [36] Atassi B, Bangash AK, Lewandowski RJ, et al. Biliary sequelae following radioembolization with Yttrium-90 microspheres. J Vasc Interv Radiol, 2008, 19(5): 691-697. [37] Devulapalli KK, Fidelman N, Soulen MC, et al. 90Y radioembolization for hepatic malignancy in patients with previous biliary intervention: Multicenter analysis of hepatobiliary infections. Radiology, 2018, 288(3): 774-781. [38] Parikh RS, Abousoud O, Hunt S, et al. Infection rates following hepatic embolotherapy in patients with prior biliary interventions: Comparison of single-drug moxifloxacin and multidrug antibiotic prophylaxis. J Vasc Interv Radiol, 2021, 32(5): 739-744. [39] Mascarenhas N, Ryu RK, Salem R. Erratum: hepatic radioembolization complicated by abscess. Semin Intervent Radiol, 2017, 34(03): 303-304. [40] Hoffmann RT, Jakobs TF, Kubisch CH, et al. Radiofrequency ablation after selective internal radiation therapy with Yttrium90 microspheres in metastatic liver disease-Is it feasible? Eur J Radiol, 2010, 74(1): 199-205. [41] Leong QM, Lai HK, Lo RG, et al. Radiation dermatitis following radioembolization for hepatocellular carcinoma: a case for prophylactic embolization of a patent falciform artery. JVasc Interv Radiol, 2009, 20(6): 833-836. [42] Su YK, Mackey RV, Riaz A, et al. Long-term hepatotoxicity of yttrium-90 radioembolization as treatment of metastatic neuroendocrine tumor to the liver. J Vasc Interv Radiol, 2017, 28(11): 1520-1526. [43] Wang DS, Louie JD, Kothary N, et al. Prophylactic topically applied ice to prevent cutaneous complications of nontarget chemoembolization and radioembolization. J Vasc Interv Radiol, 2013, 24(4): 596-600. [44] Li X, Montazeri SA, Paz-Fumagalli R, et al. Prognostic significance of neutrophil to lymphocyte ratio dynamics in patients with hepatocellular carcinoma treated with radioembolization using glass microspheres. Eur J Nucl Med Mol Imaging, 2021, 48(8): 2624-2634. [45] Alexander ES, Pantel AR, Carlin SD, et al. Prospective study of systemic yttrium-90 elution during radioembolization of hepatic metastases. J Vasc Interv Radiol, 2020, 31(12): 2007-2013.e1. |
| [1] | 蔡蓓蓓, 韦海燕, 顾丽英. 甲磺酸仑伐替尼联合特瑞普利单抗治疗晚期原发性肝癌患者效果研究*[J]. 实用肝脏病杂志, 2026, 29(3): 401-404. |
| [2] | 杜隆, 孙世杰, 尹子文. 区域性入肝血流阻断腹腔镜精准肝切除术治疗原发性肝癌患者价值评估*[J]. 实用肝脏病杂志, 2026, 29(3): 413-416. |
| [3] | 钱梦姣, 孙研俊, 钟瑶. CT和MRI多期动态增强扫描诊断乙型肝炎肝硬化背景下原发性肝癌价值研究*[J]. 实用肝脏病杂志, 2026, 29(3): 417-420. |
| [4] | 刘安龙, 李金红, 于洁, 刘辉. 仑伐替尼联合信迪利单抗治疗原发性肝癌患者的疗效及其对谷胱甘肽还原酶(GR)的影响*[J]. 实用肝脏病杂志, 2026, 29(3): 479-480. |
| [5] | 蒋楠, 刘泉, 郝福荣. 免疫联合SBRT治疗中晚期原发性肝癌患者疗效与安全性分析*[J]. 实用肝脏病杂志, 2026, 29(2): 285-288. |
| [6] | 孙志青, 赵彦娜, 贺祥昆, 葛晨. 损伤控制性手术原则治疗原发性肝癌自发性破裂大出血患者止血效果研究*[J]. 实用肝脏病杂志, 2026, 29(2): 293-296. |
| [7] | 蔡蓉蕾, 廖荣信, 罗伟, 唐良俊. 三维适形放疗治疗原发性肝癌患者放射性肝损伤增强MRI表现特征分析*[J]. 实用肝脏病杂志, 2026, 29(2): 297-300. |
| [8] | 李建林, 李娅, 郑秋然, 王燕. 125I放射性粒子植入联合TACE治疗原发性肝癌患者疗效研究*[J]. 实用肝脏病杂志, 2025, 28(6): 894-897. |
| [9] | 田潭平, 杨定华, 宋新, 周旅, 周国超, 付华, 蔡融民, 彭鹏. TACE联合免疫和靶向综合治疗中晚期原发性肝癌患者临床效果研究*[J]. 实用肝脏病杂志, 2025, 28(6): 898-901. |
| [10] | 张小昭, 雷凯, 祁亚斌, 金雷, 朱代华. 阿替利珠单抗联合靶向药物和TACE术治疗中晚期原发性肝癌患者疗效研究*[J]. 实用肝脏病杂志, 2025, 28(5): 759-762. |
| [11] | 王佳会, 崔立明. TACE联合仑伐替尼和信迪利治疗超出up-to-seven标准的原发性肝癌患者临床疗效研究*[J]. 实用肝脏病杂志, 2025, 28(5): 771-775. |
| [12] | 张萌, 党至纯, 李婷, 刘晨瑞, 王沐淇, 吴姣姣, 贺娜, 李亚萍. 肝硬化合并与不合并原发性肝癌患者血小板数目及凝血功能差异比较研究*[J]. 实用肝脏病杂志, 2025, 28(4): 577-580. |
| [13] | 彭贺, 郝建玲, 黄建业, 李楠楠, 骆锦前. TACE术联合靶向和免疫治疗原发性肝癌患者疗效研究*[J]. 实用肝脏病杂志, 2025, 28(4): 593-596. |
| [14] | 彭乐, 黄古叶, 徐莉虹. RALOX-HAIC在原发性肝癌发病机制中的作用研究进展[J]. 实用肝脏病杂志, 2025, 28(4): 636-640. |
| [15] | 杨懿瑾, 洪晗, 陈彬, 崔洪全, 王逸, 张甲. FOLFOX肝动脉灌注化疗联合仑伐替尼和PD-1抑制剂治疗中晚期原发性肝癌患者疗效研究*[J]. 实用肝脏病杂志, 2025, 28(3): 426-429. |
| 阅读次数 | ||||||
|
全文 |
|
|||||
|
摘要 |
|
|||||