- 期刊
The Value of FDG PET/CT to Monitor Treatment Response Post 90Y-Microsphere Selective Internal Radiation Therapy in Colorectal Cancer with Hepatic Metastasis: Preliminary Experience in Kaohsiung Medica
氟化去氧葡萄糖正子電腦斷層造影在釔－90微球體選擇性肝內放射線治療於大腸癌肝轉移的治療評估價值：高醫的初步經驗
摘要
釔－90微球體（釔－90選擇性體內放射線治療）爲不能手術狀態肝癌息者的一種替代性放射性栓塞的治療方式，來減少肝臟惡性組織的體積。在腫瘤學上，氟化去氧葡萄糖正子電腦斷層造影可以有效監測化學治療和放射線治療反應。我們提出兩個晚期大腸直腸癌合併大量肝臟轉移且無法手術及化療無效，接受此新療法的病例。我們先安排正子電腦斷層造影評估大腸癌的轉移範圍及嚴重度。在病人的兩側肝葉可以看到大量氟化去氧葡萄糖的攝取活性。其中一位病人同時發現肝臟汁的腹膜轉移病灶。在肝內鎝－99m-巨聚合白蛋白掃描復，兩位病人的左肝葉以及右肝葉分別接受了2.5GBq和2.2GBq的釔－90微球體劑量。治療後四到六週後，再安排另一次正子電腦斷層造影評估治療後的反應，可以發現氟化去氧葡萄糖新陳代謝的活性顯著減少於治療肝葉。氟化去氧葡萄糖正子電腦斷層造影在釔－90微球體治療以後，的確可以快速提供腫瘤新陳代謝功能的狀態以反應治療療效。
並列摘要
Yttrium-90 selective internal radiation therapy (90Ymicrosphere SIRT) is an alternative radioembolic method to reduce malignant occupying volume of liver in condition of nonsurgical status. FDG PET/CT is valid to monitor treatment response post chemotherapy and radiation therapy in most oncological situations. Herein, we present two cases who received this new technique under document approval for advanced colorectal cancer and massive hepatic metastasis. Initially, FDG PET/CT was arranged to evaluate the extent of metastasis of colorectal cancer. There was massive high grade FDG avid hepatic metastasis in bilateral lobes of liver in both patients. One of them had another massive extrahepatic peritoneal seeding. After evaluation with (superscript 99m)Tc-MAA hepatic perfusion imaging, both of them received 2.5 and 2.2 GBq 90Y-microsphere SIRT in the right and left lobes, respectively. After a 4-to 6-weeks period, a follow-up FDG PET/CT was arranged again to further monitor treatment response. Significant reduction of FDG metabolic activity was demonstrated in these two cases. FDG PET/CT indeed provides immediate diate functional status of neoplastic metabolic response after 90Y-microsphere SIRT.
延伸閱讀
- Yew, D. S. Y., Lin, K. H., Shih, B. F., Wu, M. Z., Tsao, C. H., & Chen, H. W. (2022). 用Tc-99m Mebrofenin肝膽閃爍造影診斷繼發於肝細胞癌治療的支氣管膽道廔管：病例報告和文獻回顧. 核子醫學暨分子影像雜誌, 35(2), 66-71. https://doi.org/10.6332/ANMMI.202206_35(2).0003
- 簡嘉嫻（2021）。探討電腦斷層導引射頻灼燒術治療肝臟腫瘤的效能和總生存率之研究〔碩士論文，義守大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0074-2701202114412100
- 李昕迪（2019）。蒙地卡羅模擬法評估肝腫瘤患者之釔-90微球體放射栓塞治療的輻射劑量分布〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-0802201915162300
- 劉綉娟（2020）。轉移性大腸直腸癌使用FOLFIRI化療組合藥物，在不同Irinotecan劑量合併Bevacizumab治療方案生活品質與成本效用：前瞻性兩年世代研究〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-2107202021463500
- 黃挺碩（2014）。系統性回顧及統合分析的研究方法釐清術後干擾素治療於肝癌病患的存活及幫助執行腹膜炎術後抗生素使用的臨床試驗〔博士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2014.01394