中国癌症杂志 ›› 2021, Vol. 31 ›› Issue (8): 762-768.doi: 10.19401/j.cnki.1007-3639.2021.08.010

• 综述 • 上一篇    

90 Y微球选择性内放射治疗在结直肠癌肝转移中的应用及研究进展

张迎强 1,2 ,林岩松 1,2   

  1. 1. 中国医学科学院北京协和医学院北京协和医院核医学科,北京 100730 ;
    2. 核医学分子靶向诊疗北京市重点实验室,北京 100730
  • 出版日期:2021-08-30 发布日期:2021-09-03
  • 通信作者: 林岩松 E-mail: linys@pumch.cn

Application and research progress of  90 Y microspheres internal radiation therapy in colorectal cancer with liver metastasis

ZHANG Yingqiang 1,2 , LIN Yansong 1,2    

  1. 1. Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China; 2. Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China
  • Published:2021-08-30 Online:2021-09-03
  • Contact: LIN Yansong E-mail: linys@pumch.cn

摘要: 结直肠癌(colorectal cancer,CRC)是全球死亡率第2位的恶性肿瘤,高达50%的患者在初诊或治疗后出现肝转移,成为CRC患者的主要致死原因。对于结直肠癌肝转移(colorectal cancer with liver metastases,CRLM)患者,在系统治疗的基础上联合局部治疗是目前最主要的治疗方式。作为局部微创治疗的重要手段之一,放射性核素钇-90(yttrium-90,90 Y)微球选择性内放射治疗(selective internal radiation therapy,SIRT)在国外已有近20年的临床使用经验,大量临床研究证明了其治疗肝脏肿瘤的疗效和安全性。美国国立综合癌症网络(National Comprehensive Cancer Network,NCCN)、欧洲肿瘤内科学会(European Society for Medical Oncology,ESMO)等国际指南均推荐 90 Y微球SIRT作为CRLM患者的局部微创治疗选择。在国内,中国临床肿瘤学会(Chinese Society of Clinical Oncology,CSCO)发布的《结直肠癌诊疗指南(2019)》亦将 90 Y微球SIRT作为Ⅲ级推荐。研究表明 90 Y微球SIRT单用、或与其他局部治疗以及系统治疗联用均可令患者获益,这一治疗手段可使转移性结直肠癌(metastatic colorectal cancer,mCRC)患者的肝转移病灶得到局部控制,延长患者生存期并提高生活质量。从姑息治疗和转化治疗两方面综述了 90 Y微球SIRT在CRLM治疗中的应用进展。

关键词: 90 Y微球, 选择性内放射治疗, 结直肠癌

Abstract: Colorectal cancer (CRC) is the second leading cause of cancer death worldwide. Hepatic metastases, which account for the major cause of mortality in CRC patients, occur in about half of the patients when the primary tumor is discovered or after the treatment. Local treatment along with systematic therapy is the most common schedule for CRC patients with liver metastases (CRLM). As one of the well-accepted minimally invasive local therapies, yttrium-90 ( 90 Y)-microspheres selective internal radiotherapy (SIRT) has shown its confirmed efficacy and safety and been applied in CRLM patients abroad for nearly 20 years. National Comprehensive Cancer Network (NCCN) and European Society for Medical Oncology (ESMO) guidelines recommend 90 Y microspheres SIRT as a local minimally invasive treatment option for CRLM patients. The Guidelines for the Diagnosis and Treatment of Colorectal Cancer (2019) issued by Chinese Society of Clinical Oncology (CSCO) also recommended  90 Y-microspheres SIRT at level Ⅲ. In this study, we reviewed the progress of  90 Y-microspheres SIRT in terms of palliative and translational treatment for metastatic colorectal cancer (mCRC), which indicated that 90 Y-microspheres SIRT had the advantages in local control as well as the improvement of survival time and living quality, either alone or combined with other local or systemic therapies.

Key words: 90 Y-microspheres, Selective internal radiation therapy, Colorectal cancer