Radioembolization for Liver Cancer
What is it?
This procedure offers targeted radiation treatment (known as brachytherapy) for cancers arising from the liver, as well as most types of cancer that have spread to the liver.
A radioactive isotope called Ytrium (called Y-90), which has been bonded to microspheres, is injected via a catheter into the arteries feeding the tumour(s). Because the radiation is focused on the tumour, a higher dose can be safely administered without additional side effects.
Typically this treatment is recommended for patients with liver cancer who are not responding to chemotherapy. However, there is growing evidence worldwide that radioembolization can provide considerable benefit if performed earlier in combination with chemotherapy.
How does it work?
This procedure is performed in two stages, both of which are performed in one of our angiography suites.
The first stage is the planning procedure, where the arteries supplying the tumour are identified, and the radiation dose which is to be administered is determined.
An Interventional Radiologist will access either the radial artery in the wrist, or femoral artery in the groin, after local anaesthetic is adminstered. A thin tube (called a catheter) is then navigated into the main arteries in the upper abdomen, under X-ray guidance. Images of those arteries are then made, using contrast material, and this identifies which arteries are feeding the tumour. A diagnostic radioactive tracer (called Technetium) is then injected into the main artery from which treatment will be performed. This helps us determine the dose which can be safely administered during the treatment stage. This first stage is almost always performed as a day case.
The second stage is the treatment stage.
Under local anaesthetic, a thin catheter is navigated via either the radial artery in the arm, or the femoral artery in the groin, into the artery from where treatment will be performed. Once in position, the Y-90 bonded microspheres are injected into the blood vessels supplying the tumour. The powerful radiation dose is targeted directly at the tumour rather than the surrounding healthy tissue. Although there is no pain involved in the procedure, the radiation may make one feel nauseous, and cause fatigue. Medication is prescribed to help combat these side effects. In the majority of patients, this part of the procedure is also performed as a day case.
What are the advantages?
The procedure is very well tolerated and has a low side effect profile, with excellent results in patients who no longer qualify for curative treatments.