目的:报告使用SIROS通过175cmTruSelect微导管通过双冲洗方案(40ml右旋糖总量)输送树脂y90的效率。
方法:IRB批准的回顾性研究,对2019年至2022年在一个四级护理学术机构通过TruSelect接受SIROS注射y90Sir-Spheres的所有患者进行了回顾性研究,包括医疗记录.
结果:包括在11种癌症组织学中的25例患者中的48例输注。卑鄙的计划,已交付,和残留活性分别为28±17、27±17、1.1±0.56mCi(平均残留4.9%±2.8%),包括1天,2天,和3天SIROS(4/51、16/51和28/51)。在非段切除术病例中,平均肝脏治疗量为483±306ml,目标剂量平均为128±26Gy;在15/48(31%)中进行了放射段切除术。在9/48(19%)的病例中记录了动脉淤滞。使用3天预先校准的SIROS剂量,使用<10mCi的活性,肝脏体积较小(<200ml)的治疗和血瘀记录与较高的残留活性相关(分别为P=0.025,P=0.0007,P=0.0177和P=0.049),与较高的残留活性相关.
结论:将SIROS和Truselect微导管的新技术与双冲洗方案相结合,在94%的y90输注中产生<10%的残留。未来的研究可能会澄清此处看到的高残留剂量的预测因子是否可以保证在放射药物水平上对剂量测定或剂量准备进行微导管特定的考虑。
OBJECTIVE: To report efficiency of resin y90 delivery using SIROS via 175 cm TruSelect microcatheter with double-flush protocol (40 ml dextrose total).
METHODS: IRB-approved retrospective review of all patients undergoing SIROS injection of y90 Sir-Spheres via TruSelect from 2019 through 2022 at one quaternary-care academic institution, including medical records.
RESULTS: Included were 48 infusions in 25 patients across 11 cancer histologies. Mean planned, delivered, and residual activities were 28 ± 17, 27 ± 17, 1.1 ± 0.56 mCi respectively (mean residual 4.9% ± 2.8%) across flex-dosing precalibrations including 1-day, 2-day, and 3-day SIROS (4/51, 16/51, and 28/51). Mean liver treatment volume was 483 ± 306 ml with target dose mean of 128 ± 26 Gy in non-segmentectomy cases; Radiation segmentectomy was performed in 15/48 (31%). Arterial stasis was documented in 9/48 (19%) of cases. Use of a 3-day precalibrated SIROS dose, use of activity <10 mCi, treatment of smaller liver volumes (<200 ml) and documentation of stasis were associated with higher residual activity ( P = 0.025, P = 0.0007, P = 0.0177, and P = 0.049, respectively) were associated with higher residuals.
CONCLUSIONS: Combining the new technologies of SIROS and the Truselect microcatheter with a double-flush protocol yielded <10% residual in 94% of y90 infusions. Future studies may clarify if the predictors of high residual dose seen here may warrant microcatheter-specific considerations for dosimetry or dose preparation at the Radiopharmacy level.