Selective internal radiation therapy (or radioembolization) by intra‐arterial injection of radioactive yttrium‐90‐loaded microspheres is increasingly used for the treatment of patients with liver metastases or primary liver cancer. The high‐dose beta‐radiation penetrates an average of only 2.5 mm from the source, thus limiting its effects to the site of delivery. However, the off‐target diversion of yttrium‐90 microspheres to tissues other than the tumor may lead to complications. The most prominent of these complications include radiation gastritis and gastrointestinal ulcers, cholecystitis, radiation pneumonitis, and radioembolization‐induced liver disease, which may occur despite careful pretreatment planning. Thus, selective internal radiation therapy demands an expert multidisciplinary team approach in order to provide comprehensive care for patients. This review provides recommendations to multidisciplinary teams on the optimal medical processes in order to ensure the safe delivery of selective internal radiation therapy. Based on the best available published evidence and expert opinion, we recommend the most appropriate strategies for the prevention, early diagnosis, and management of potential radiation injury to the liver and to other organs. (Hepatology 2017;66:969–982).

中文翻译：

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选择性内放射治疗并发症的防治：专家指导与系统评价

通过动脉内注射放射性钇90微球进行选择性内放射治疗（或放射栓塞）越来越多地用于治疗肝转移或原发性肝癌患者。高剂量 β 辐射从源头平均只能穿透 2.5 毫米，因此限制了其对传递部位的影响。然而，钇90微球脱靶转移到肿瘤以外的组织可能会导致并发症。这些并发症中最突出的包括放射性胃炎和胃肠道溃疡、胆囊炎、放射性肺炎和放射性栓塞引起的肝病，尽管有仔细的预处理计划，这些并发症仍可能发生。因此，选择性内部放射治疗需要专家多学科团队的方法，以便为患者提供全面的护理。这篇综述为多学科团队提供了关于最佳医疗流程的建议，以确保选择性内部放射治疗的安全实施。根据现有的最佳已发表证据和专家意见，我们推荐最合适的策略来预防、早期诊断和管理对肝脏和其他器官的潜在辐射损伤。（肝病学 2017；66:969–982）。我们推荐最合适的策略来预防、早期诊断和管理对肝脏和其他器官的潜在辐射损伤。（肝病学 2017；66:969–982）。我们推荐最合适的策略来预防、早期诊断和管理对肝脏和其他器官的潜在辐射损伤。（肝病学 2017；66:969–982）。