来自转移性瘤的库辛综合征的肝栓塞:一个单中心病例系列
Shuyao Zhang1, Jorge Esteban Mosquera1, Clive Musonza2
1Department of Internal Medicine, Division of Endocrinology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Journal of the Endocrine Society
|March 13, 2026
概括
肝脏导向栓塞有效地管理库希综合征 (CS) 在转移性上腺皮癌 (ACC) 或神经内分泌瘤 (NET) 的患者,当手术不是一个选择. 这种治疗提供了显著的荷尔蒙控制,并且耐受性很好.
科学领域:
- 内分泌学 在内分泌学.
- 干预性放射学 干预性放射学
- 在瘤学瘤学.
背景情况:
- 转移性上腺皮质癌 (ACC) 或神经内分泌瘤 (NETs) 的库希综合征 (CS) 在手术不可行时,会带来治疗挑战.
- 以肝脏为导向的栓塞,包括跨动脉栓塞 (TAE) 和-90 (Y-90) 放射栓塞,可以缓解肝转移导致的高皮质醇症.
研究的目的:
- 评估肝脏导向栓塞的疗效和安全性,以治疗无法切除,肝脏主导的ACC或NET患者的库辛综合征.
主要方法:
- 一个回顾性单中心病例系列,包括4名患有CS和肝主导转移性ACC或NET的成年患者,他们在2015年至2025年期间接受了肝栓塞 (TAE或Y-90).
- 主要结局是14天内生化反应 (早晨皮质醇≥50%降低或正常化).
- 二次结局包括对照的持续时间,放射性反应 (RECIST 1.1),以及不良事件 (CTCAE v5.0).
主要成果:
- 所有4名患者 (2名ACC,2名NET) 均实现显著的皮质醇降低,2名皮质醇正常化,过渡性上腺功能不充分.
- 一名接受Y-90治疗的患者有持续的缓解;两名接受TAE治疗的患者实现了部分激素控制,允许医学治疗逐渐减少.
- 在大多数病变中,瘤负担稳定或在放射学上得到改善;栓塞受理良好,副作用最小.
结论:
- 肝栓塞是一种可行的息选择,用于由不可切除的肝主导转移引起的CS.
- 该程序提供了有意义的生化改善与可接受的安全性.
- 它支持将复杂的CS案例集成到多学科管理策略中.
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