Radioembolization also known as selective internal radiation therapy (SIRT), is a form of internal radiation therapy used to selected patients who are not candidates for surgery due to the location of their tumors or their performance (health) status.
Radioembolization is currently used by the interventional radiologist to treat primary liver cancer (HCC) and metastatic cancer (liver metastases). The most common type of cancer being treated for this is colorectal cancer, however it may also be used for breast, pancreatic, neuroendocrine tumors, and others.
The treatment involves injecting tiny microspheres with low levels of radioactive material into the arteries that supply the tumor. The radioactivity destroys the liver tumor without significantly affecting or radiating other parts of the body, thus minimizing exposure to healthy tissue. In the procedure, the radiologist inserts a catheter which deposits radioactive particles to the area of the tumor.
Microspheres target liver tumors by taking advantage of the liver's hypervascularity. For example, metastatic liver tumors greater than 3 mm receive in excess of 80% of their blood supply from the hepatic artery whereas normal liver tissue is predominantly fed by the portal vein.
The microspheres are delivered via fluoroscopy (live x-ray). Millions of 30-micron beads are infused through a catheter into the hepatic artery and become embedded in the liver. Over a period of two weeks, the therapeutic dose is delivered. The beads contain yttrium-90 (Y90). Y90 is a beta-emitting radionuclide that acts locally at the tumor site. This is the beta particles travel at most 11 mm in the liver due to their relatively low energy. This allows the beads to embed into and irradiate the tumor while healthy liver tissue is spared. Additionally, given the low distance it travels, there are minimal, if any, necessary radiation safety precautions following treatment.
Overall, the treatment is very well tolerated with minimal side effects. The most common side effect is fatigue, which lasts about 2 weeks. Schedule a consultation with one of our interventional radiologists to discuss in further detail.
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