PDF(Pubmed)
Abstract：
Primary liver tumours (i.e. hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (ICC)) are among the most frequent cancers worldwide. However, only 10-20% of patients are amenable to curative treatment, such as resection or transplant. Liver metastases are most frequently caused by colorectal cancer, which accounts for the second most cancer-related deaths in Europe. In both primary and secondary tumours, radioembolization has been shown to be a safe and effective treatment option. The vast potential of personalized dosimetry has also been shown, resulting in markedly increased response rates and overall survival. In a rapidly evolving therapeutic landscape, the role of radioembolization will be subject to changes. Therefore, the decision for radioembolization should be taken by a multidisciplinary tumour board in accordance with the current clinical guidelines. The purpose of this procedure guideline is to assist the nuclear medicine physician in treating and managing patients undergoing radioembolization treatment. PREAMBLE: The European Association of Nuclear Medicine (EANM) is a professional non-profit medical association that facilitates communication worldwide among individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. These guidelines are intended to assist practitioners in providing appropriate nuclear medicine care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by medical professionals taking into account the unique circumstances of each case. Thus, there is no implication that an approach differing from the guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set out in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources or advances in knowledge or technology subsequent to publication of the guidelines. The practice of medicine involves not only the science but also the art of dealing with the prevention, diagnosis, alleviation and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment. Therefore, it should be recognised that adherence to these guidelines will not ensure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources and the needs of the patient to deliver effective and safe medical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective.
摘要：
原发性肝肿瘤(即肝细胞癌(HCC)或肝内胆管癌(ICC))是全世界最常见的癌症之一。然而,只有10-20%的患者可以接受治愈性治疗，如切除或移植。肝转移最常见的原因是结直肠癌，这是欧洲癌症相关死亡人数第二多的国家。在原发性和继发性肿瘤中，放射性栓塞已被证明是一种安全有效的治疗选择.个性化剂量测定的巨大潜力也已被证明，导致显着增加的应答率和总生存率。在快速发展的治疗环境中，放射栓塞的作用会发生变化。因此,放射栓塞的决定应由多学科肿瘤委员会根据当前的临床指南做出.本程序指南的目的是协助核医学医师治疗和管理接受放射性栓塞治疗的患者。欧洲核医学协会（EANM）是一个专业的非营利性医学协会，旨在促进全球范围内追求核医学临床和研究卓越的个人之间的交流。EANM成立于1985年。这些指南旨在帮助医生为患者提供适当的核医学护理。它们不是不灵活的规则或实践要求，也不是有意的，也不应该使用它们，建立合法的护理标准。关于任何特定程序或行动过程的适当性的最终判断必须由医疗专业人员考虑到每个案例的独特情况。因此，这并不意味着一种不同于指导方针的方法，独自站立,低于护理标准。相反,在以下情况下，有责任心的从业者可以负责任地采取与准则中规定的行动方针不同的行动方针：在从业者的合理判断中，这种行动过程是由病人的情况表明的，指南发布后可用资源的限制或知识或技术的进步。医学实践不仅涉及科学，还涉及处理预防的艺术，诊断,缓解和治疗疾病。人类疾病的多样性和复杂性使得不可能总是达到最合适的诊断或肯定地预测对治疗的特定反应。因此,应该认识到,遵守这些指南并不能确保准确的诊断或成功的结果.所有应该期望的是，从业者将根据当前的知识遵循合理的行动方针，现有资源和患者提供有效和安全医疗服务的需求。这些指南的唯一目的是帮助从业者实现这一目标。
