精确的钇-90(90Y)微球剂量对治疗肝脏恶性肿瘤至关重要,这与临床疗效和不良反应密切相关.剂量的计算主要基于不同的90YY载体:玻璃微球(TheraSpheres)或树脂微球(SIR-Spheres).玻璃微球的剂量是以肝脏预期的辐射剂量和微球能够均匀分布于整个肝脏的假设为基础计算的,而树脂微球的剂量是以微球非均匀分布于整个肝脏的假设为基础计算的,这种非均匀分布的程度取决于正常肝脏被肿瘤组织取代的程度.许多其他因素也可能会潜在影响90Y微球的治疗剂量.本综述将介绍90Y微球剂量的计算方法,以及为了获得最大疗效并尽量避免不良反应发生而需要考虑的各种因素.%Accurate doses of yttrium-90 (90Y) microspheres are critical for the treatment of liver malignancies,because it is closely related to the clinical efficacy and adverse reactions.The dose calculationis primarily based on the type of ~Y delivery medium,whether it is glass microsphere (TheraSpheres) or resin microsphere (SIR-Spheres).The dose calculation of glass microspheres is based on the assumption that the expected radiation dose of the liver and the microspheres can be evenly distributed throughout the liver,while the dose calculation of resin microspheres is based on the assumption that the microspheres are not uniformly distributed throughout the liver,and the degree of this inhomogeneous distribution depends on the extent to which the normal liver is replaced by the tumor tissue.Many other factors may also potentially affect the therapeutic dose of 90Y microspheres.This review will introduce the calculation methods of 90Y microsphere dose,and describe the factors that need to be considered in order to achieve maximum efficacy and avoid adverse effects.
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