SIRT-Y90 肝癌之釔90體內放射治療

What is Selective Internal Radiation Therapy (SIRT)?

Selective Internal Radiation Therapy (SIRT) is a treatment used for liver cancer that cannot be surgically removed. Unlike traditional external beam radiation therapy, SIRT delivers radiation directly into the tumor, allowing for precise targeting.

This treatment uses tiny microspheres—about one-third the diameter of a human hair—that contain a radioactive substance called Yttrium-90 (Y-90). These microspheres are injected through a catheter into the blood vessels of the liver. They travel through the bloodstream and lodge in the small vessels within the tumor, releasing radiation directly inside the tumor to kill cancer cells, while minimizing damage to healthy liver tissue.

Treatment Process

1. Evaluation and Screening
The medical team will first thoroughly assess your cancer history and physical condition, and conduct imaging and lab tests to determine if SIRT is suitable for you.

2. First Catheter Procedure (Mapping)
In the first angiography session, test microspheres will be injected into the liver's blood vessels to ensure they do not accidentally travel to the lungs. If the results are safe, a personalized dosage of Y-90 will be prepared specifically for your treatment.

3. Actual Treatment (Y-90 Microsphere Injection)
One to two weeks later, a second procedure will be scheduled to inject the radioactive Y-90 microspheres into the liver tumor. This procedure is typically performed under conscious sedation and does not require general anesthesia.

Treatment Results

The Y-90 specialist team at Taipei Veterans General Hospital (TVGH) has performed over 600 cases of SIRT for liver cancer and colorectal cancer with liver metastases. The treatment has also shown promising outcomes for neuroendocrine tumors and cholangiocarcinoma.

Using advanced imaging technologies such as angiography and CT scans, the team ensures precise delivery and tailors the best treatment plan for each patient.

什麼是選擇性體內放射治療（SIRT）

選擇性體內放射治療（簡稱 SIRT），是一種用來治療無法開刀切除的肝癌的方法。和傳統從外部照射的放射線治療不同，SIRT 是將放射性物質直接送到腫瘤裡，對腫瘤做精準打擊。

這項治療會使用一種非常細小的微球（大約是頭髮的三分之一粗細），這些微球裡含有「釔-90」這種放射性物質。微球會經由導管注入肝臟的血管中，隨著血流進入腫瘤內的小血管，然後停留在腫瘤區，直接釋放放射線來殺死癌細胞，同時減少對正常肝臟組織的傷害。

治療流程是如何進行

1. 評估與檢查
   首先，醫療團隊會詳細了解您的癌症病史與身體狀況，並安排檢查，確保您是否適合接受 SIRT。

2. 第一次導管檢查（標記）
   在第一次的血管攝影中，我們會將「試驗用微球」注入肝臟血管，來觀察這些微球是否會不小心流到肺部。如果結果安全，就會為您量身訂做所需的 Y-90 劑量。

3. 正式治療（Y-90 微球注射）
   約一到兩週後，安排第二次治療，這時會正式將含放射線的微球注入肝臟腫瘤區。整個過程會在清醒鎮靜的狀況下進行，不需要全身麻醉。

治療成果

臺北榮總的 Y-90 專業團隊已經累積超過 600 例肝癌或大腸癌肝轉移的治療經驗，也對神經內分泌腫瘤與膽管癌有不錯的效果。使用先進的影像技術（如血管攝影與電腦斷層）來幫助精準治療，為每位病患設計最合適的療程。

台北榮總亦是亞洲最有經驗的 Y-90 治療中心之一，曾有許多國際醫療機構來院學習與交流經驗。