The first case in southern Zhejiang! This "nuclear weapon" for cancer treatment is here!

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Have you ever heard of a "nuclear weapon" used in tumors? Recently, Wen Medical University Hospital introduced a "nuclear weapon" for the treatment of liver malignant tumors - yttrium [90Y] radioactive microspheres, and successfully performed yttrium [90Y] radioactive microsphere injection surgery for a patient with primary liver cancer, which is also the first case of yttrium [90Y] radioactive microsphere injection in southern Zhejiang and northern Fujian. This is the first case of yttrium [90Y] radioactive microspheres for liver cancer interventional surgery in northern Fujian, southern Zhejiang.

Not long ago, Ms. Lin had vague pain in her upper abdomen. After examination in a local hospital abroad, she was found to have a giant liver cancer in her liver and decided to return to our hospital. As Ms. Lin has repeatedly expressed her expectation of radical treatment results, after multidisciplinary consultation and discussion, approved in accordance with relevant requirements and processes, and after full communication with Ms. Lin herself and her family, the interventional department of our hospital decided to perform yttrium [90Y] radiation microsphere therapy surgery for Ms. Lin, who thus became the first patient to receive yttrium [90Y] radiation microsphere therapy surgery in northern Fujian, Zhejiang Province.

To ensure the safety of Ms. Lin's treatment, before the surgery, Yu Chang, deputy director of interventional medicine, together with Li Huanbin, deputy director of nuclear medicine, Shan Yunfeng, deputy director of hepatobiliary and pancreatic surgery, and other expert teams, conducted several preoperative evaluations and careful discussions around the patient's disease and indicators, and finally determined the interventional treatment plan.

Preoperative magnetic resonance showed a large hepatocellular carcinoma with vena cava thrombosis in the right liver

Preoperative: mock injection, showing good intrahepatic lesion tracer aggregation

Postoperative: good intrahepatic lesion yttrium [90Y] deposition

The entire procedure lasted nearly 3 hours and went smoothly. Ms. Lin was conscious during the surgery, her vital signs were stable, and she was discharged from the hospital 3 days later.

Effectiveness assessment 3 weeks after surgery: complete necrosis of the right liver tumor

3 weeks later, Ms. Lin came to our hospital for a follow-up examination. Enhanced CT showed that the giant tumor in the right liver had reached complete necrosis in the imaging sense. The next step is for Ms. Lin to receive vena cava cancer embolization with the hope of achieving a curative outcome.

What is yttrium [90Y] microsphere injection therapy?

As one of the malignant tumors with a very high incidence and death rate in China, liver cancer is characterized by "many advanced stages, high recurrence, and easy metastasis," and many patients miss surgery when it is detected. How to create surgical opportunities for these advanced patients is a difficult problem for the liver tumor treatment community in China. In the past two years, yttrium [90Y] radiation microsphere therapy surgery has gradually entered the public eye.

Yttrium [90Y] radioactive microsphere injection is a liver cancer treatment drug consisting of resin microspheres containing the radionuclide yttrium [90Y]. The procedure is also known as "selective internal radiation therapy SIRT," in which a microsphere injection with the radioactive substance yttrium [90Y] is delivered directly into the liver tumor under angiographic conditions through a minimally invasive catheter intervention to deliver high-energy radiation to the tumor cells at close range for treatment by in vivo radiotherapy. The procedure is also known as "selective internal radiation therapy SIRT".

Because of the high energy of yttrium [90Y] radiation pure beta radiation, on the one hand, it can kill tumor cells due to DNA double-strand breaks; on the other hand, it can induce the production of oxygen radicals, which can further lead to DNA breaks and irreversible tumor cell necrosis. Therefore, yttrium [90Y] has a potent tumoricidal effect.

Delivering the microspheres precisely to every corner of the tumor, the tumor is killed by in vivo radiotherapy with microspheres, while yttrium [90Y] has little negative impact on normal liver tissue and the surrounding tissue environment. It kills tumors in close proximity while also inducing an increase in the size of the remaining liver, presenting an opportunity for surgical treatment of patients with advanced liver cancer.

What are the advantages of yttrium [90Y] radiation microsphere therapy?

1. Precision: During surgery, yttrium [90Y] microspheres are precisely clustered inside the tumor to maximize the protection of the normal liver.

2. High efficiency: High-dose radiotherapy to the tumor is effective in killing the tumor and has a high chance of transforming the surgery, increasing the hope of cure.

3. Safety: mature technology, high safety and mild side effects.

4. Individualization: treatment can be individualized according to the patient's tumor characteristics, or combined with other drugs to achieve optimal efficacy.

Which patients are suitable for yttrium [90Y] radiation microsphere therapy?

Overseas, yttrium [90Y] microspheres can be used to treat hepatocellular carcinoma, intrahepatic cholangiocarcinoma, liver metastases from colorectal cancer, liver metastases from neuroendocrine tumors, liver metastases from breast cancer, liver metastases from pancreatic cancer, and liver metastases from melanoma. In other words, yttrium [90Y] microspheres can treat both primary and metastatic hepatocellular carcinoma. The specific situation needs to be evaluated by the relevant specialist.

Our hospital is the third hospital in the province to apply for the yttrium [90Y] project, and is the first hospital in Wenzhou to carry out this technology.