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yttrium-90 transarterial radioembolization versus conventional transarterial chemoembolization for patients with hepatocellular carcinoma：a systematic review and meta-analysis

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Cancer Biology & Medicine 2018年第3期15卷 299-310页

作者： Yi Yang Tongguo Si School of Medical Imaging Tianjin Medical University Tianjin 300203 China Department of Interventional Therapy Tianjin Medical University Cancer Institute and Hospital National Clinical Research Center for CancerKey Laboratory of Cancer Prevention and TherapyTianjin Tianjin's Clinical Research Center for Cancer Tianjin 300060 China

Objective: To compare the effects and safety of conventional transarterial chemoembolization(c TACE) and yttrium-90 transarterial radioembolization [TARE(90 Y)] for hepatocellular carcinoma(HCC)Methods: Nine high-quality observational studies, one low bias-risk randomized controlled trial(RCT), and one moderate biasrisk RCT included 1,652 patients [c TACE, 1,124; TARE(90 Y), 528], from whom data were extracted for this systematic review and ***: The extracted study outcomes included 1-year and 2-year overall survival(OS) rates, objective responses(ORs), and serious adverse events(AEs). 1-year OS rates: OR = 0.939, 95 % CI: 0.705-1.251, P = 0.66. 2-year OS rates: overall pooled OR =0.641, 95% CI: 0.382-1.075, P = 0.092; observational study subgroup OR = 0.575, 95% CI: 0.336-0.984, P = 0.043; RCT subgroup OR* = 0.641, 95% CI: 0.382-1.075, P = 0.346. OR: overall pooled OR = 0.781, 95% CI: 0.454-1.343, P = 0.371; m RECIST subgroup OR = 0.584, 95 % CI: 0.349-0.976, P = 0.040; WHO subgroup OR = 1.065; 95% CI: 0.500-2.268, P = 0.870. Serious AEs: overall pooled RR = 1.477, 95% CI: 0.864-2.526, P = 0.154; RCT subgroup RR = 0.680, 95% CI: 0.325-1.423, P = 0.306; observational study subgroup RR = 1.925; 95 % CI: 0.978-3.788, P = ***: TARE(90 Y) increased 2-year OS rates in the observational subgroup and resulted in better OR rates, according to m RECIST criteria, in comparison with c TACE. Furthermore, a lower risk of AEs was observed for TARE(90 Y) than for c TACE.

关键词： Hepatocellular carcinoma conventional transarterial chemoembolization transarterial radioembolization yttrium-90

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yttrium-90 radioembolization for unresectable hepatic metastases of breast cancer: A systematic review

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World Journal of Gastrointestinal Oncology 2020年第2期12卷 228-236页

作者： Michael Feretis Andriy Solodkyy Department of Surgery Addenbrooke’s HospitalCambridge CB20QQUnited Kingdom Department of General Surgery Hinchingbrooke HospitalNorth West Anglia NHS Foundation TrustHuntingdon PE296NTUnited Kingdom

BACKGROUND Liver metastases secondary to breast cancer are associated with unfavourable *** with ytrrium-90 is an emerging option for management of liver metastases of breast cancer when other systemic therapies have failed to achieve disease ***,unlike the case of other liver tumours(colorectal/melanoma metastases/cholangiocarcinoma),its role in the management of breast liver metastases is yet to be *** The aims of this systematic review were to(1)assess the effect of radioembolization with yttrium-90 on tumour response;and(2)to estimate patient survival post *** The review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.A systematic literature search was performed using the PubMed and EMBASE databases from January 2007 to December *** initial search yielded 265 reports which were potentially suitable for inclusion in this *** published in English reporting at least one outcome of interest were considered to be suitable for *** abstracts;case reports,animal studies and reports not published in English were excluded from this *** was retrieved from each individual report on the name of primary author,year of publication,patient demographics,type of microspheres used,radiation dose delivered to tumour,duration of follow-up,disease control rate(%),tumour response,and overall patient *** The final number of studies which met the inclusion criteria was 12 involving 452 *** were no randomized controlled trials identified after the literature *** age of the patients included in this review ranged from 52 to 61 *** duration of the follow up period post-radioembolization ranged from 6 to 15.7 *** total number of patients with breast metastases not confined to the liver was 236(52.2%).Cumulative analysis revealed that radioembolization with yttrium-90 conferred tumour control rate in 8

关键词： Breast cancer Liver metastases yttrium-90 Radioembolization Survival

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yttrium-90 microsphere selective internal radiation therapy for liver metastases following systemic chemotherapy and surgical resection for metastatic adrenocortical carcinoma

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World Journal of Clinical Oncology 2018年第1期9卷 20-25页

作者： Mina S Makary Lawrence S Krishner Evan J Wuthrick Mark P Bloomston Joshua D Dowell Division of Vascular and Interventional Radiology Department of Radiology the Ohio State University Comprehensive Cancer Center Division of Medical Oncology Department of Internal Medicine the Ohio State University Comprehensive Cancer Center Department of Radiation Oncology the Ohio State University Comprehensive Cancer Center Division of Surgical Oncology Department of Surgery and James Cancer Hospital and Richard Solove Research Institute the Ohio State University Comprehensive Cancer Center

Adrenocortical carcinoma(ACC)is a rare malignancy with generally poor outcomes and limited treatment *** surgical resection can be curative for early local disease,most patients present with advanced ACC owing to nonspecific *** those patients,treatment options include systemic chemotherapy and locoregional therapies including radiofrequency ablation and transarterial *** present the first reported case of utilizing yttrium-90 microsphere selective internal radiation therapy(SIRT)in combination with first line EDP-M(Etoposide,Doxorubicin,Cisplatin,Mitotane)chemotherapy and debulking surgical primary tumor resection for treatment of metastatic *** complete radiologic response has been maintained after twelve months with resolution of clinical *** findings prompt the need for further consideration and studies to elucidate the role of SIRT in combination with systemic and surgical treatment for metastatic ACC.

关键词： Adrenocortical carcinoma Hepatic metastases Radioembolization yttrium-90

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Effects of yttrium-90 selective internal radiation therapy on non-conventional liver tumors

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World Journal of Gastroenterology 2015年第27期21卷 8271-8283页

作者： Andrew Kuei Sammy Saab Sung-Ki Cho Stephen T Kee Edward Wolfgang Lee Division of Interventional Radiology Department of Radiology UCLA Medical Center David Geffen School of Medicine at UCLA Los Angeles Department of Medicine Division of Hepatology Pfleger Liver Institute University of California at Los Angeles Los Angeles Division of Interventional Radiology Department of Radiology Samsung Medical Center Sungkyunkwan University School of Medicine

The liver is a common site of metastasis, with essentially all metastatic malignancies having been known to spread to the liver. Nearly half of all patients with extrahepatic primary cancer have hepatic metastases. The severe prognostic implications of hepatic metastases have made surgical resection an important first line treatment in management. However, limitations such as the presence of extrahepatic spread or poor functional hepatic reserve exclude the majority of patients as surgical candidates, leaving chemotherapy and locoregional therapies as next best options. Selective internal radiation therapy(SIRT) is a form of catheter-based locoregional cancer treatment modality for unresectable tumors, involving trans-arterial injection of microspheres embedded with a radioisotope yttrium-90. The therapeutic radiation dose is selectively delivered as the microspheres permanently embed themselves within the tumor vascular bed. Use of SIRT has been conventionally aimed at treating primary hepatic tumors(hepatocellular carcinoma) or colorectal and neuroendocrine metastases. Numerous reviews are available for these tumor types. However, little is known or reviewed on non-colorectal or nonneuroendocrine primaries. Therefore, the aim of this paper is to systematically review the current literature to evaluate the effects of yttrium-90 radioembolization on non-conventional liver tumors including those secondary to breast cancer, cholangiocarcinoma, ocular and percutaneous melanoma, pancreatic cancer, renal cell carcinoma, and lung cancer.

关键词： Liver metastases Breast cancer Melanoma Cholangiocarcinoma Radioembolization Selective internal radiation therapy Transarterial radioembolization yttrium-90

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Radioembolization with yttrium-90 microspheres in hepatocellular carcinoma:Role and perspectives

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World Journal of Hepatology 2015年第5期7卷 738-752页

作者： Cristina Mosconi Alberta Cappelli Cinzia Pettinato Rita Golfieri Radiology Unit Department of Medical and Surgical SciencesAlma Mater Studiorum-University of Bologna Medical Physics Unit Department of Medical and Surgical SciencesAlma Mater Studiorum-University of Bologna

Transarterial radioembolization(TARE) is a form of brachytherapy in which intra-arterially injected yttrium-90-loaded microspheres serve as a source for internal radiation *** the average,it produces disease control rates exceeding 80% and it is a consolidated therapy for hepatocellular carcinoma(HCC);however,current data are all based on retrospective series or non-controlled prospective studies since randomized controlled trials comparing it with the other liver-directed therapies for intermediate and locally advanced stage HCC are still *** data available show that TARE provides similar or even better survival rates when compared to transarterial chemoembolization(TACE).First-line TARE is best indicated for both intermediatestage patients(staged according to the barcelona clinic liver cancer staging classification) who have lesions which respond poorly to TACE due to multiple tumors or a large tumor burden,and for locally advanced-stage patients with solitary tumors,and segmental or lobar portal vein tumor *** addition,emerging data have suggested the use of TARE in patients who are classified slightly beyond the Milan criteria regarding radical treatment for downstaging *** a secondline treatment,TARE can also be applied in patients progressing to TACE or sorafenib;a large number of phase Ⅱ/Ⅲ trials are ongoing with the purpose of evaluating the best association with systemic *** radioembolization is very well tolerated and has a low rate of complications which are mainly related to unintended non-target tissue irradiation,including the surrounding liver *** complications can be additionally reduced by accurate patient selection and a strict pre-treatment evaluation including dosimetry and assessment of the vascular *** a correct treatment algorithm for potential TARE candidates is not clear and standardized,this comprehensive review analyzes the best selection criteria for patients who

关键词： yttrium-90 Hepatocellular carcinoma Radioembolization

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Radiation segmentectomy for hepatic malignancies: Indications, devices,dosimetry, procedure, clinical outcomes, and toxicity of yttrium-90 microspheres

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Journal of Interventional Medicine 2019年第1期2卷 1-4页

作者： Zhongzhi Jia Caoye Wang Ricardo Paz-Fumagalli Weiping Wang Department of Interventional Radiology Second People’s Hospital of ChangzhouChangzhou213003China The Center of Medical Physics with Nanjing Medical University Changzhou213003China Department of Interventional Radiology First People's Hospital of ChangzhouChangzhou213000China Department of Radiology Mayo ClinicJacksonvilleFL32224USA

Radiation segmentectomy(RS) is a new approach to90 Y radioembolization that has been designed to increase the safety and efficacy of radioembolization in patients with unresectable hepatic malignancies. With this technique,high doses(>190 Gy) of radiation are delivered to the tumor through radioembolization performed in a segmental fashion, potentially increasing the radiation dose to the tumor while minimizing injury to the liver parenchyma. The aim of this review is to provide a summary of the indications, device choice, dosimetry, procedure, clinical outcomes, and toxicity of RS based on the clinical series currently available.

关键词： Hepatic malignancy yttrium-90 Radioembolization Radiation segmentectomy

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yttrium-90 radioembolization treatment strategies for management of hepatocellular carcinoma

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World Journal of Radiology 2024年第10期16卷 512-527页

作者： Kelly Hao Andrew J Paik Lauren H Han Mina S Makary College of Medicine The Ohio State UniversityColumbusOH 43210United States Department of Radiology The Ohio State University Medical CenterColumbusOH 43210United States

As the third leading cause of cancer-related deaths worldwide,hepatocellular carcinoma(HCC)represents a significant global health *** paper provides an introduction and comprehensive review of transarterial radioembolization(TARE)with yttrium-90(Y90),a widely performed transcatheter procedure for HCC patients who are not suitable candidates for *** involves the targeted delivery of radioactive microspheres to liver tumors,offering a promising treatment option for managing HCC across various stages of the *** evaluating Y90 TARE outcomes across early,intermediate,and advanced stages of HCC,the review aims to present a thorough understanding of its efficacy and ***,this paper highlights future research directions focusing on the potential of combination therapies with systemic and immunotherapies,as well as personalized *** exploration of these innovative approaches aims to improve treatment outcomes,reduce adverse events,and provide new therapeutic opportunities for HCC *** review underscores the importance of ongoing research and clinical trials to optimize TARE further and integrate it into comprehensive HCC treatment paradigms.

关键词： Transarterial radioembolization Hepatocellular carcinoma yttrium-90 Radiation segmentectomy Radiation lobectomy Portal vein thrombosis Combination therapies Downstaging Curative-intent Locoregional therapy

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Poly(Vinyl Alcohol)/Collagen/Hydroxyapatite Nanoparticles Hybrid System Containing yttrium-90 as a Potential Agent to Treat Osteosarcoma

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Journal of Biomaterials and Nanobiotechnology 2014年第1期5卷 24-30页

作者： Marcelo F.Cipreste Edesia M.B.Sousa Servico de Nanotecnologia e Materiais Nucleares Centro de Desenvolvimento da Tecnologia Nuclear/Comissao Nacional de Energia Nuclear(CDTN/CNEN)Belo HorizonteBrasil

Osteosarcoma is the most common primary malignant bone tumors, affecting mostly children, adolescents and young adults. This is an aggressive tumor that results in a high mortality rate and poor prognosis. Due to the low sensitivity of osteosarcoma to ionizing radiation, such treatment is not used very often and it can be recommended only to postsurgical therapy. As an alternative therapy, functionalized nanomaterials allow their accumulation in tumor tissues due to their unique properties, making them good agents to act as stable carriers for radionuclides. In this work, mesoporous hydroxyapatite nanoparticles were synthesized and the functionalization process with poly(vinyl alcohol) and collagen was investigated. The samples were characterized by X-ray diffraction (XRD), N2 adsorption, elemental analysis (CHN), Fourier Transform Infrared Spectroscopy (FTIR), Nitrogen Adsorption, Transmission Electron Microscopy (TEM), and Thermal Analysis. Also, the yttrium incorporation potential and its release kinetics in the hydroxyapatite matrix were evaluated to study the capacity of this system to treat osteosarcomas. The results indicate that this material has a promisor potential to treat this kind of tumor.

关键词： Osteosarcoma Hydroxyapatite Nanoparticles PVA Collagen yttrium-90

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Transcatheter embolization therapy in liver cancer:an update of clinical evidences

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Chinese Journal of Cancer Research 2015年第2期27卷 96-121页

作者： Yi-Xiang J.Wang Thierry De Baere Jean-Marc Idee Sebastien Ballet Department of Imaging and Interventional Radiology Faculty of MedicineThe Chinese University of Hong KongPrince of Wales Hospital Gustave Roussy Department of Interventional Radiology Guerbet Division of Research & Innovation

Transarterial chemoembolization （TACE） is a form of intra-arterial catheter-based chemotherapy that selectively delivers high doses of cytotoxic drug to the tumor bed combining with the effect of ischemic necrosis induced by arterial embolization. Chemoembolization and radioembolization are at the core of the treatment of liver hepatocellular carcinoma （HCC） patients who cannot receive potentially curative therapies such as transplantation, resection or percutaneous ablation. TACE for liver cancer has been proven to be useful in local tumor control, to prevent tumor progression, prolong patients＇ life and control patient symptoms. Recent evidence showed in patients with single-nodule HCC of 3 cm or smaller without vascular invasion, the 5-year overall survival （OS） with TACE was similar to that with hepatic resection and radiofrequency ablation. Mthough being used for decades, Lipiodol~ （Lipiodol~ Ultra Fluid~, Guerbet, France） remains important as a tumor-seeking and radio-opaque clrug delivery vector in intervendonal oncology. There have been efforts to improve the delivery of chemotherapeutic agents to tumors. Drug-eluting bead （DEB） is a relatively novel drug delivery embolization system which allows for fixed dosing and the ability to release the anticancer agents in a sustained manner. Three DEBs are available, i.e., Tandem~ （CeloNova Biosciences Inc., USA）, DC-Beads~ （BTG, UK） and HepaSphere~ （BioSphere Medical, Inc., USA）. Transarterial radioembolization （TARE） technique has been developed, and proven to be efficient and safe in advanced liver cancers and those with vascular complications. Two types of radioembolization microspheres are available i.e., SIR-Spheres~ （Sirtex Medical Limited, Australia） and TheraSphere~ （BTG, UK）. This review describes the basic procedure of TACE, properties and efficacy of some chemoembolization systems and radioembolization agents which are commercially available and/or currently under clinical evaluation. The key clinical tr

关键词： Transarterial chemoembolization hepatocellular carcinoma (HCC) drug-eluting particles microspheres Lipiodol radioembolization yttrium-90

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Radioembolization for the treatment of unresectable hepatocellular carcinoma:A clinical review

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World Journal of Gastroenterology 2008年第11期14卷 1664-1669页

作者： Saad M Ibrahim Robert J Lewandowski Kent T Sato Vanessa L Gates Laura Kulik Mary F Mulcahy Robert K Ryu Reed A Omary Riad Salem Department of Radiology Section of Interventional RadiologyNorthwestern MemorialHospitalRobert H.Lurie Comprehensive Cancer CenterChicago60611United States Department of Nuclear Medicine Northwestern Memorial HospitalChicago 60611United States Department of Medicine Division of HepatologyNorthwestern Memorial HospitalChicago 60611United States Department of Medicine Divisionof Hematology and OncologyRobert H Lurie ComprehensiveCancer CenterNorthwestern Memorial HospitalChicago 60611United States Department of Radiology Section of Interventional RadiologyNorthwestern MemorialHospitalRobert H.Lurie Comprehensive Cancer CenterChicago60611United States Department of MedicineDivisionof Hematology and OncologyRobert H Lurie Comprehensive Cancer CenterNorthwestern Memorial HospitalChicago 60611United States

Hepatocellular carcinoma(HCC)is the sixth most common cancer in the *** majority of patients with HCC present with unresectable *** patients have historically had limited treatment options secondary to HCC demonstrating chemoresistance to the currently available systemic ***, normal liver parenchyma has shown intolerance to tumoricidal radiation doses,limiting the use of external beam *** of these limitations,novel percutaneous liver-directed therapies have emerged. The targeted infusion of radioactive microspheres (radioembolization)represents one such therapy. Radioembolization is a minimally invasive transcatheter therapy through which radioactive microspheres are infused into the hepatic arteries that supply tumor. Once infused,these microspheres traverse the hepatic vascular plexus and selectively implant within the tumor *** within the arterioles, the 90Y impregnated microspheres emit high energy and low penetrating radiation doses selectively to the *** has recently shown promise for the treatment of patients with unresectable HCC. The objective of this review article is to highlight twocurrently available radioembolic devices(90Y,188Rh)and provide the reader with a recent review of the literature.

关键词： Radioembolization Brachytherapy Hepatocellular carcinoma yttrium-90 Rhenium-188

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