钇-90微球内放射治疗肝内胆管癌的应用现状

摘要/Abstract

摘要： 肝内胆管癌(ICC)作为仅次于肝细胞癌的第二常见原发性肝癌,其治疗面临巨大挑战,尤其是中晚期患者。传统的化学治疗和放射治疗方法对ICC的疗效有限,且不良反应较大,因此寻找新的有效治疗手段成为临床研究的重点。钇-90微球内放射治疗(⁹⁰Y-MBT)作为一种新兴的介入性放射治疗技术,通过肝动脉将带有⁹⁰Y放射性核素的微球精准输送至肿瘤区域,利用β射线对肿瘤细胞进行近距离高剂量照射,从而杀灭肿瘤细胞。本文将对⁹⁰Y-MBT在ICC治疗中的应用现状进行综述。

侯元凯, 王志恒, 曾骞, 周道祝. 钇-90微球内放射治疗肝内胆管癌的应用现状[J]. 肝脏, 2026, 31(6): 913-916.

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参考文献

[1] 郝新,樊蓉,侯金林.原发性肝癌高危人群的早期预警和精准筛查[J]. 临床肝胆病杂志, 2022, 38(6): 499-504.
[2] 安澜,曾红梅,冉显会,等.肝细胞癌和肝内胆管细胞癌流行病学研究进展[J]. 中国肿瘤, 2020, 29(11): 879-884.
[3] 濮天,方强,陈子祥,等.肝内胆管癌发病机制及治疗相关进展[J]. 中华消化外科杂志, 2020, 19(6): 697-702.
[4] 黄莉莉,夏勇,沈锋.肝内胆管癌新辅助治疗难点及策略[J]. 中国实用外科杂志, 2023, 43(3): 291-298.
[5] 曾琦惠,李富宇.腹腔镜肝内胆管癌根治手术的可行性及安全性[J]. 临床肝胆病杂志, 2024, 40(12): 2358-2360.
[6] Jiang C, Hou G M, Zhang Z H, et al. Anatomic versus nonanatomic resection for intrahepatic cholangiocarcinoma: a systematic review and meta-analysis[J]. Int J Surg, 2025, 111(1): 1440-1453.
[7] 刘康寿,曹明溶,孙健.钇-90选择性内放射治疗肝内胆管癌的现状与展望[J/OL]. 中华肝脏外科手术学电子杂志,2025,14(2): 197-202. http://dx.chinadoi.cn/10.3877/cma.j.issn.2095-3232.2025027.
[8] Oh D Y, He A R, Qin S, et al.Durvalumab plus chemotherapy in advanced biliary tract cancer: 3-year overall survival update from the phase Ⅲ TOPAZ-1 study[J]. J Hepatol, 2025, 83(5): 1092-1101.
[9] Gujarathi R, Peshin S, Zhang X,et al.Intrahepatic cholangiocarcinoma: insights on molecular testing, targeted therapies, and future directions from a multidisciplinary panel[J]. Hepatol Commun, 2025, 9(7): e0743.
[10] 王玉峰,曾嘉,武娟,等.经肝动脉灌注化学治疗在肝脏恶性肿瘤中的应用及研究进展[J]. 肿瘤, 2022, 42(10): 708-714.
[11] 牛惠敏,王志恒,高石鑫,等.钇-90放射性微球在肝脏恶性肿瘤中的应用及进展[J/OL]. 肝癌电子杂志, 2021, 4(5): 36-40. http://dx.chinadoi.cn/10.3969/j.issn.2095-7815.2021.04.008.
[12] 郑致远.钇90放射性微球治疗肝脏恶性肿瘤的应用进展[J]. 复旦学报(医学版), 2020, 47(4): 622-627.
[13] 张琳,冯晓彬,黄鑫,等.钇-90微球选择性内放射治疗在肝癌降期转化移植中的应用进展[J]. 中华消化外科杂志, 2024, 23(12): 1566-1570.
[14] Salem R, Johnson G E, Kim E, et al.Yttrium-90 radioembolization for the treatment of solitary, unresectable hepatocellular carcinoma: the LEGACY study[J]. Hepatology, 2021, 74(5): 2342-2352.
[15] 张辉,付颖,谭斌彬,等.钇-90微球选择性内放射治疗在原发性肝癌中的临床应用及进展[J]. 中华消化外科杂志, 2024, 23(2): 242-247.
[16] 牛娜. ⁹⁰Y微球选择性内放射治疗在肝细胞癌中的应用及研究进展[J]. 中国癌症杂志, 2021, 31(7): 428-434.
[17] 张迎强,林岩松. ⁹⁰Y微球选择性内放射治疗在结直肠癌肝转移中的应用及研究进展[J]. 中国癌症杂志, 2021, 31(8): 762-768.
[18] 陈婕,蔡恬静,赵骅,等. X射线激活氧化应激诱导DNA损伤及HaCaT发生细胞早衰研究[J]. 中国医学装备, 2024, 21(2): 174-178.
[19] 唐凡,骆银根,欧爱鑫,等. 钇-90微球放射栓塞治疗肝脏恶性肿瘤研究的全球现状与发展趋势:一项文献计量学分析[J/OL]. 肝癌电子杂志, 2023, 10(3): 38-47. http://dx.chinadoi.cn/10.3969/j.issn.2095-7815.2023.03.007.
[20] 谭家铖,李承志,张艳,等. 钇-90树脂微球选择性内放射治疗后切除肝右叶巨块型肝癌1例[J]. 介入放射学杂志, 2024, 33(3): 335-337.
[21] 姜忠昊,王万祥,杨帆. 钇-90在肝细胞癌治疗中的研究进展[J]. 癌症进展, 2023, 21(20): 2224-2228.
[22] Schaarschmidt B M, Kloeckner R, Dertnig T, et al. Real-life experience in the treatment of intrahepatic cholangiocarcinoma by ⁹⁰Y radioembolization: a multicenter retrospective study[J]. Q J Nucl Med, 2023, 64(4): 529-535.
[23] Ness J R, Molvar C. Radioembolization of intrahepatic cholangiocarcinoma: patient selection, outcomes, and competing therapies[J]. Semin Intervent Radiol, 2021, 4(7): 438-444.
[24] Cocozza M A, Dajti E, Braccischi L, et al. Survival after transarterial radioembolization in patients with unresectable intrahepatic cholangiocarcinoma: an updated meta-analysis and meta-regression[J]. CardioVasc Inter Radiol, 2024, 47(10): 1313-1324.
[25] Liu J J, Zhou M, Yuan T, et al. Conversion treatment for advanced intrahepatic cholangiocarcinoma: opportunities and challenges[J]. World J Gastroentero, 2025, 31(15): 104901-104901.
[26] Zhao K, Erinjeri J, Sotirchos V, et al.Factors affecting outcomes of Yttrium-90 radioembolization in heavily pretreated patients with intrahepatic cholangiocarcinoma[J]. Abdom Radiol, 2023, 48:2434-2442.
[27] 张勇创,李威,满文玲,等.钇-90经动脉放射栓塞在肝癌中的应用价值[J]. 实用放射学杂志, 2023,39(11): 1890-1893.
[28] Olkus A, Tomczak A, Berger A K, et al.Durvalumab plus gemcitabine and cisplatin in patients with advanced biliary tract cancer: an exploratory analysis of real-world data[J]. Target Oncol, 2024, 19(2): 213-221.
[29] Buettner S, Braat A J A T, Margoin G A, et al.Yttrium-90 radioembolization in intrahepatic cholangiocarcinoma: a multicenter retrospective analysis[J]. J Vasc Interv Radiol, 2020, 31(7): 1035-1043.e2.
[30] Edeline J, Touchefeu Y, Guiu B, et al.Radioembolization plus chemotherapy for first-line treatment of locally advanced intrahepatic cholangiocarcinoma: a phase 2 clinical trial[J]. JAMA Oncol, 2020,6(1): 51-59.
[31] Gupta A N, Gordon A C, Gabr A, et al.Yttrium-90 radioembolization of unresectable intrahepatic cholangiocarcinoma: long-term follow-up for a 136-patient cohort[J]. CardioVasc Inter Radiol, 2022, 45(8): 1117-1128.
[32] 赵曼,倪倩雯,朴贤杰,等.钇-90选择性内放射治疗在不可切除肝细胞癌转化治疗中的研究进展[J]. 海军军医大学学报, 2025, 46(2): 189-197.
[33] Damanakis A I, Gebauer F, Bruns C .New insights into benefits of combination treatment with yttrium-90 and gemcitabine in patients with intrahepatic cholangiocarcinoma[J]. J Gastrointest Oncol, 2020,11(5): 833-835.
[34] Abou-Alfa G K, Sahai V, Hollebecque A, et al.Pemigatinib for previously treated, locally advanced or metastatic cholangiocarcinoma: a multicentre, open-label, phase 2 study[J]. Lancet Oncol, 2020, 21(5): 671-684.
[35] James E. F. Ivosidenib: a review in advanced cholangiocarcinoma[J]. Target Oncol, 2023, 18(6): 973-980.
[36] Tselikas L, Ronot M.Trans-arterial radioembolisation for HCC: personalised dosimetry beyond yttrium-90[J]. Liver Int, 2025, 45(4): e16184.
[37] Akkas B E, Sin C, Akgun E, et al.Tumoricidal dosing approach with parenchymal sparing using voxel-based dosimetry in ⁹⁰Y glass microspheres treatment of hepatocellular carcinoma[J]. Nucl Med Commun, 2025, 46(8): 692-699.
[38] 吴逸超,刘治坤,徐骁.肝内胆管细胞癌肝移植研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2020, 9(2): 111-115. http://dx.chinadoi.cn/10.3877/cma.j.issn.2095-3232.2020.02.005.
[39] 梁子威,张田田,廖勇,等.钇-90微球选择性内放射治疗在肝细胞癌降期转化中的应用1例报告[J]. 中国临床医学, 2025, 32(1): 41-45.
[40] Li J, Xian L, Wang X, et al.The role of TACE in the era of immune-targeted therapy for hepatocellular carcinoma: a meta-analysis based on PSM[J]. Front Immunol, 2025, 16:1576834.
[41] 梁礼聪,梁钰婵,黄文薮,等.钇-90微球选择性内放射治疗在肝细胞癌降期转化中的研究进展[J]. 中国临床医学, 2025, 32(1): 9-14.
[42] Gabr A, Kulik L, Mouli S, et al. Liver transplantation following yttrium-90 radioembolization:15-year experience in 207-patient cohort[J]. Hepatology, 2021, 73(3): 998-1010.