-90放射栓塞后的辐射肺炎:一个系统性审查
1Diagnostic Imaging and Interventional Radiology, Moffitt Cancer Center, Tampa, Florida.
Journal of vascular and interventional radiology : JVIR
|October 20, 2024
概括
-90 (90Y) 放射性栓塞的确定的肺剂量极限可能不适用于所有人. 玻璃微球导致比树脂更高的肺辐射剂量,这表明预防辐射肺炎 (RP) 的毒性值不同.
科学领域:
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
- 核医学就是核医学.
背景情况:
- 辐射性肺炎 (RP) 是伊-90 (90Y) 放射性栓塞的一个严重并发症.
- 目前关于最大耐受性肺剂量的指导方针是基于来自小型病例系列的有限证据 (第5级).
- 由于其高死亡率,了解RP风险至关重要.
研究的目的:
- 评估90Y放射栓塞后肺剂量测量和辐射肺炎 (RP) 的现有证据.
- 评估目前的肺剂量限制在不同90Y微球类型中的适用性.
主要方法:
- 在PubMed,Embase,Cochrane和谷歌学者中报告的RP病例的系统文献综述.
- 编制和分析48个RP案件的数据库.
- 对玻璃和树脂90Y微球之间的肺辐射剂量和肝肺分流计算的比较.
主要成果:
- 辐射性肺炎发生在放射栓塞后3个月的中位数,死亡率为40%.
- 与树脂 (21.5 Gy) 相比,用玻璃90Y微球治疗的患者获得的肺辐射剂量 (41.4 Gy) 显著更高.
- 肝肺突变计算在玻璃和树脂组之间没有显著差异.
结论:
- 树脂微球的剂量毒性值低于玻璃微球.
- 当前的30-Gy肺剂量极限可能不适用于玻璃和树脂90Y微球.
- 最大可容忍的肺剂量需要重新评估,肝肺分流计算方法需要改进.
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