| 1 | 早期乳腺癌保乳术后部分乳腺高剂量率后装加速照射的毒性反应及美容效果显示文摘目的介绍早期乳腺癌保乳术后单独行局部高剂量率组织间插植加速照射的方法、副作用及美容效果。方法46例Ⅰ、Ⅱ期乳腺癌的47个乳腺在肿瘤局部扩大切除后使用了高剂量率^192Ir组织间插植瘤床区加速照射(APBI)。符合条件的患者包括年龄>40岁、T1~T2N0~N1(≤3阳性淋巴结),手术切缘>1~2mm,小叶癌和炎性乳腺癌除外。术后接受高剂量率近距离放疗,2次/d,间隔至少6h,总量34Gy分10次5d完成。治疗后1、6、12个月及以上观察毒性反应及美容效果。结果全组患者随访18~46个月(中位随访34个月),治疗期间急性反应包括红斑、水肿、乳腺触痛和感染共21例(46%),均为1~2级,无3~4级发生。晚期毒性包括皮肤纤维化、乳腺触痛、脂肪坏死及毛细血管扩张1+2级加例(43%),3级2例(4%),其中1例疗后接受6个周期系统化疗。美容效果达到极好和良好的在6、12个月分别为95%、98%,无一局部复发。结论早期乳腺癌保乳术后APBI后装组织间插植技术具有良好美容功效,急性和晚期毒性作用小,局部控制率有待于长期随访观察。 | 修霞 Tripuraneni Prabhakar Giap Huan Lin Ray Chu Colin | 2007 | 中华放射肿瘤学杂志2007，16，1： | 7 |
| 2 | Hepatic intra-arterial infusion of yttrium-90 microspheres in the treatment of recurrent hepatocellular carcinoma after liver transplantation: A case report显示文摘Hepatocellular carcinoma (HCC) recurs with a reported frequency of 12%-18% after liver transplantation. Recurrence is associated with a mortality rate exceeding 75%. Approximately one-third of recurrences develop in the transplanted liver and are therefore amenable to local therapy. A variety of treatment modalities have been reported including resection, transarterial chemo- embolization (TACE), radiofrequency ablation (RFA), ethanol ablation, cryoablation, and external beam irradiation. Goals of treatment are tumor control and the minimization of toxic effect to functional parenchyma. Efficacy of treatment is mitigated by the need for ongoing immunosuppression. Yttrium-90 microspheres have been used as a treatment modality both for primary HCC and for pre-transplant management of HCC with promising results. Twenty-two months after liver transplantation for hepatitis C cirrhosis complicated by HCC, a 42-year old man developed recurrence of HCC in his transplant allograft. Treatment of multiple right lobe lesions with anatomic resection and adjuvant chemotherapy was unsuccessful. Multifocal recurrence in the remaining liver allograft was treated with hepatic intra-arterial infusion of yttrium-90 microspheres (SIR-Spheres, Sirtex Medica Inc., Lake Forest, IL, USA). Efficacy was demonstrated by tumor necrosis on imaging and a decrease in alpha-fetoprotein (AFP) level. There were no adverse consequences of initial treatment. | Louis Rivera Huan Giap William Miller Jonathan Fisher Donald J Hillebrand Christopher Marsh Randolph L Schaffer | 2006 | World Journal of Gastroenterology2006，12，35： | 6 |
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