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目的探讨核素微球治疗晚期肝癌的量效关系。材料与方法３２磷一玻璃微球（Ｐｈｏｓｐｈｏｒｕｓ－３２ｇｌａｓｓｍｉｃｒｏｓｐｈｅｒｅｓ，３２Ｐ－ＧＭＳ）肝动脉灌注治疗２８例晚期肝癌患者，动脉血酮体比率（Ａｒｔｅｒｙｋｅｔｏｎｅｂｏｄｙｒａｔｉｏ，ＡＫＢＲ）等监测术后肝脏能量代谢变化，ＣＴ、ＥＣＴ、Ｂ超、ＡＦＰ等观察疗效，平均随访２８个月。结果６１μ的３２Ｐ－ＧＭＳ是治疗晚期肝癌安全有效的放射性栓塞材料，当靶肝组织吸收放射剂量＞５０Ｇｙ及微球量＞３ｇ时近期疗效满意，但有严重消化道反应和明显肝代谢功能损害，而２８～３７Ｇｙ组术后肝功能恢复良好，各种术后并发症明显减少，远期疗效较好。结论放疗性栓塞治疗肝硬变肝癌患者的合理靶肝吸收剂量应在３０Ｇｙ左右。
Objective To investigate the dose-effect relationship of radionuclide microspheres for advanced hepatocellular carcinoma. Materials and Methods Phosphorus-32 glass microspheres (32P-GMS) hepatic arterial infusion treatment of 28 patients with advanced hepatocellular carcinoma, arterial blood ketone body ratio (AKBR) monitoring postoperative liver energy metabolism changes, CT, ECT The efficacy was observed with B-ultrasound, AFP, etc. The average follow-up period was 28 months. Results The 61μ of 32P-GMS was a safe and effective radioactive embolization material for advanced hepatocellular carcinoma. When the target liver tissue absorbed radiation dose>50Gy and microspheres>3g, the short-term results were satisfactory, but there were severe gastrointestinal reactions and significant hepatic metabolic dysfunction. The 28-37Gy group recovered well after liver function, and all kinds of postoperative complications were significantly reduced. The long-term curative effect was better. Conclusion The dose of reasonable target liver absorbed by radiotherapy embolization for liver cirrhosis patients should be about 30Gy.