Xạ trị trong chọn lọc điều trị ung thư gan bằng vi cầu phóng xạ Y-90 tại bệnh viện Bạch Mai

Selective internal radiation therapy forliver cancer with Y-90 microsphere at Bachmai hospital

SUMMARY

Selective Internal Radiation Therapy (SIRT) for liver cancer is a method to inject Y-90 labeled resin microsphere into the hepatic arteries supplying the tumor. Cancer cells will be annihilate by irradiation with ionizing radiation emitted from Y-90. Theprocedure has been standardized and applied in treatment of liver cancer patients at the Nuclear Medicine & Oncology Center, Bach Mai hospital.

Aims of study:

• To establish and standardize the procedure of SIRT with Y-90 microsphere for liver cancer.
• - To assess initial results of SIRT for liver cancer at The Nuclear medicine & Oncology Center, Bach Mai hospital.

Subject and method: 36 patients with primary or secondary liver cancer confirmation. These patients had been treated with Y-90 microsphere and follow-up assessments after treatment 1 and 3 months. Descriptive and propective study. Establishing a standard SIRT with Y-90 microsphere for liver cancer.

Results of study: Procedure of SIRT with Y-90 microsphere for liver cancer has been standardized. Contents of protocol included indications and contraindications; workflow: Arteriographic assessment to map tumor-perfusing vessels and assess portal vein patency; SPECT with Tc 99m MAA to optimize the treatment planning (by dosimetric evaluation) and evaluate hepatopulmonary shunting; inject Y-90 microsphere into the vessels supplying the tumor, SPECT or PET/CT to evaluate the distribution of Y-90 microsphere; Evaluate the outcomes and safety.

The initial treatment results of SIRT forprimary liver cancer patients: more than 80% patients responded with treatment, no patient had complication. AFP level reduced in 77.8% and no change in 22.2% patients, AFP reduced from 4660.3ng/ml to 248.4ng/ml; 72.2% patients mean tumor size was decreased from 7.2 cm to 4.3 cm and was stable in 27.8% patients.The patient with secondary liver cancer from colon cancer: CEAreducedfrom1000 ng/ml to 40ng/ml, tumor size 7.0 cm reduced to 3,0 cm.

Conclusion: Selective internal radiation therapy with Y-90 microsphere for liver cancer is a new, effective and safe method. Procedure of the technique was standardized and applied for liver cancer treatment at the Nuclear medicine & Oncology Center, Bach Mai hospital. The initial results show the efficacy and safety of the technique and it should be disseminated for primary and secondary liver cancer treatment.

Keywords: Y-90 microsphere, liver cancer, Selective Internal Radiation Therapy: SIRT.