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在holmium-166后的肺部转移和辐射肺炎TARE:一个案例研究

Meike W M van Wijk¹, Marcel J R Janssen², Mark J Arntz²

¹Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands. meike.vanwijk@radboudumc.nl.

|July 7, 2025

概括

放射性肺炎 (RP) 在 holmium-166 跨动脉放射栓塞 (Ho TARE) 后发生在两名患者身上,即使肺部剂量低于 30 Gy. 这凸显了在治疗前剂量计中对肺部分流的谨慎需要.

科学领域:

核医学就是核医学.
干预性放射学干预性放射学
在瘤学瘤学.

背景情况:

肺部转移分数 (LSF) 评估在亚-90 (Y) 和-166 (Ho) 跨动脉放射栓塞 (TARE) 中至关重要,以减轻辐射肺炎 (RP) 风险.
一般建议肺部剂量低于30 Gy,检测到的肺部变流被认为是相对的禁忌.
在TARE后,很少有RP病例被记录在案,因此需要进一步调查风险因素.

研究的目的:

报告两例辐射性肺炎 (RP) 发生在holmium-166跨动脉放射栓塞后 (Ho TARE).
为了评估与166治疗Ho TARE的患者的肺转分数 (LSF) 和RP发展之间的关系.
强调治疗前剂量测量和肺间隔评估的重要性.

主要方法:

两名肝细胞癌患者接受了Ho TARE作为临床试验和标准实践的一部分.
使用平面成像和工作后和治疗后的SPECT测量了肺转移分数 (LSF) 和肺剂量.
随访包括CT成像,肺部评估和肺功能测试.

主要成果:

两位患者,尽管以前没有肺病史,但接受了13 Gy和18 Gy的肺剂量 (LSF分别为9.8%和7.1%).
观察到RP的临床和放射性迹象,在TARE后的3-4个月内消失.
肺功能测试显示没有限制或阻塞,但显示扩散能力下降.

结论:

虽然肺部剂量低于30 Gy值,但在166 Ho TARE后发生了轻微的RP病例.
这些案例表明,治疗前剂量测量和仔细评估肺部变流是有必要的.
虽然没有确定性,但这些发现提倡在治疗TARE患者时谨慎进行治疗,因为TARE患者的肺部有显著的分流.

关键词:

病例报告;辐射性肺炎.霍尔-166可以被发现.肺部剂量测试肺部剂量测试肺部的转移是指肺部的转移.通过动脉的放射栓塞.

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