杨宁介入医学网

1. 在4个随机试验中3个证实，肝切除后，肝动脉灌注+全身化疗 vs 单独全身化疗显著增加肝和整体DFS（Disease free survival）。 2. 肝转移癌病人的肝直接治疗（directed therapies）应该考虑特别是将不可切除的转移癌转化（conversion）为可切除病人。 3. 消...

除介入手术的一般常规准备外，下列是必需的 全血细胞计数 CBC 凝血功能检查 PT/INR 肾功能 Renal Function 肝功能试验（LFTs） CEA水平...

组织学诊断和预后因子的评估，如KRAS 和BRAF，这些因素目前影响全身治疗。了解外科手术史，以前对化疗的反应和影像学病变侵入肝脏的程度。理想的病人包括 1. 仅有肝转移，没有其它部位的转移 2. 体力评分（Eastern Cooperative OncologyGroup 02） 3. 即使是...

药物洗脱微球栓塞（DE-TACE）用于结直肠癌肝转移的原理主要是因为 1. 传统的化疗性栓塞（Conventional TACE）未能够证实生存获益 2. 药物洗脱微球技术证实伊立替康是有效的 3. 结直肠癌伊立替康栓塞（DEBIRI）被证实安全和局部有效 传统的化疗性栓塞（Conven...

结直肠癌肝转移d-TACE的结果 Outcome Parameters in DE-TACE 局部反应：RECIST vs mRECIST（EASL） study design pts. strategy RR(%) mOSmo PFSmo Martin2009 retrosp. 55 salvage 41mRECIST 6RECIST 11 8 Huppert2013 prosp. 29 salvage 72mRECIST 0RECIST...

药物洗脱微球栓塞治疗肝转移癌的适应症 Indications for DEB 不可切除的肝转移病变Non-resectable disease 热消融技术不能完全治疗的肝转移病变 Not completely treatable with thermal ablative techniques 病变累积肝脏＜70%的肝转移病变 70% liver involv...

Conclusions Administration of RE is safe Cohesive multidisciplinary working is critical There is a strong evidence base for the efficacy of RE in delaying TTP and improving median survival in first, second and subsequent lines of therapy f...

Setting up your own Multidisciplinary Team for RE Treatment at your institution Radiation/medical oncologist Nuclear medicine physician Radiopharmacy Interventional radiologistand support staff Radiation protection Mentorship programme Col...

SIR-Spherescan down-size inoperable disease to either resection or ablation Investigator n Tx line #Outcomes Tumour Type(s) Whitney 44 SIR-Spheres 2nd4th 4 R0 CRC; OeC Hoffmann 46 SIR-Spheres salvage 5 RF 3 BrC; CRC; PaC Gray 36 SIR-Spheres...

Disease status post-FOLFIRI+cetuximab Borderline volume post-chemo left lobe FOLFOX Chemo + RE Sharma RA et al. J Clin Oncol25: 1099-1106, 2007 Static Bremsstrahlung post-RE SPECT-CT Post-RE CT scan pre-and 3 months post-RE Pre-RE Post-RE...