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剂量测量优化和肝细胞癌治疗效果预测在Y-90放射栓塞的评估

Laura Grikke¹, Massimo De Giorgio², Claudia Bianchi²

¹ASST Papa Giovanni XXIII Hospital, Piazza OMS, 1, 24127 Bergamo, Italy; Riga East Clinical University Hospital, Hipokrata street 2, Riga LV-1038, Latvia.

Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)

|May 10, 2025

概括

使用-90微球的优化肝脏放射栓塞剂量测量表明,至少233.2 Gy的剂量预测了肝细胞癌患者的完整反应. 更高的剂量可能会改善结果,而不会增加不良事件.

科学领域:

核医学是一种核医学.
在瘤学瘤学.
放射学放射学是一门学科.

背景情况:

用90个Y微球进行的跨动脉放射栓塞 (TARE) 是肝细胞癌 (HCC) 的标准治疗方法.
精确的剂量测量对于预测治疗成功和最大限度地减少毒性至关重要.
使用PET成像的基于voxel的剂量计提高了剂量分布的评估.

研究的目的:

为⁹⁰Y微球处理提供优化的TARE剂量计协议.
评估基于voxel的剂量计对HCC治疗结果的预测价值.
为了确定与完全放射性反应 (CR) 和存活率相关的剂量值.

主要方法:

基于EANM指南和Planet Dose软件的精细剂量测试协议.
对所有患者进行了治疗前剂量测量,对部分患者进行了治疗后剂量测量.
利用统计分析,包括ROC曲线,来评估CR和生存的预测因素.

主要成果:

分析了133名用90Y微球 (树脂和玻璃) 治疗的HCC患者.
确定了233.2 Gy的树脂微球剂量值作为CR的最佳预测指标 (AUC = 0.62).
与剂量>= 233.2 Gy观察到更高的CR率;在正常肝脏剂量和不良事件或肺毒性之间没有发现相关性.

结论:

损伤吸收剂量是TARE中树脂微球CR的显著预测因素.
至少233.2 Gy的平均剂量与改善的瘤反应有关.
健康肝脏剂量与不良事件之间缺乏相关性,这表明未来的方案中可能会增加剂量.

关键词:

剂量测量方法剂量测量方法在HCC中,HCC是HCC.微球是微球的组成部分.优化优化优化优化在这里,PET是PET.放射性栓塞是一种放射性栓塞.斯佩克特 (Spectre) 是一个运动场.

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