Selective internal radiation

Fox RA, Klemp PF, Egan G et al (1991) Dose distribution following selective internal radiation therapy. Int J Radial Oncol Biol Phys 21 463-467... 

Burton MA, Gray BN, Kelleher DK et al (1990) Selective internal radiation therapy validation of intraoperative dosimetry. Radiology 175 253-255... 

Burton MA, Gray BN, Klemp PF et al (1989) Selective internal radiation therapy distribution of radiation in the liver. Eur J Cancer Clin Oncol 25 1487-1491... 

Gray BN, Burton MA, Kelleher DK et al (1989) Selective internal radiation (SIR) therapy for treatment of liver metastases measurement of response rate. J Surg Oncol 42 192-196... 

Selective internal radiation therapy (SIRT) is based on the injection of microspheres into the hepatic artery and their microembolization of the tumoral vascular network. It has been well described that... 

Group IV patients are not candidates for SIRT. Only in cases of diffuse unilobar disease, with homogeneous MAA uptake in the tumoral and non-tumoral tissue, and good function of the healthy hepatic lobe, can radiospheres treatment be considered as a therapeutic alternative. As in group III cases, we have to reach the decision about whether or not to treat the patient by consensus. All the risks have to be evaluated and a precise calculation of the expected residual liver function after the treatment has to be made, since this non-selective internal radiation therapy of a whole lobe could be considered as a radioactive lobectomy . 

Lim L, Gibbs P, Yip D et al (2005) Prospective study of treatment with selective internal radiation therapy spheres in patients with unresectable primary or secondary hepatic malignancies. Intern Med J 35 222-227... 

Lau WY, Ho S, Leung TW et al (1998) Selective internal radiation therapy for nonresectable hepatocellular carcinoma with intraarterial infusion of 90yttrium microspheres. Int J Radiat Oncol Biol Phys 40 583-592... 

Dhabuwala A, Lamerton P, Stubbs RS (2005) Relationship of 99mtechnetium labelled macroaggregated albumin (99mTc-MAA) uptake by colorectal liver metastases to response following Selective Internal Radiation Therapy (SIRT). BMC Nucl Med 5 7... 

Welsh JS, Kennedy AS, Thomadsen B (2006) Selective internal radiation therapy (SIRT) for liver metastases secondary to colorectal adenocarcinoma. Int J Radiation Oncology Biol Phys 66[Suppl] S62-S73... 

Lim L, Gibbs P, Yip D, Shapiro JD, Dowling R, Smith D, Little A, Bailey W, Liechtenstein M (2005a) A prospective evaluation of treatment with Selective Internal Radiation Therapy (SIR-spheres) in patients with unresectable liver metastases from colorectal cancer previously treated with 5-FU based chemotherapy. BMC Cancer 5 132... 

Moroz P, Anderson JE, Van Hazel G, Gray BN (2001) Effect of selective internal radiation therapy and hepatic arterial chemotherapy on normal liver volume and spleen volume. J Surg Oncol 78 248-252... 

Popper G, Helmberger T, Munzing W, Schmid R, Jacobs TF, Tatsch K (2005) Selective internal radiation therapy with SIR-Spheres in patients with nonresectable liver tumors. Cancer Biother Radiopharm 20 200-208... 

Stubbs RS, Cannan RJ, Mitchell AW (2001) Selective internal radiation therapy (SIRT) with Yttrium microspheres for extensive colorectal liver metastases. Hepa-togastroenterology 48 333-337... 

Leung TW, Lau WY, Ho SK et al (1995) Radiation pneumonitis after selective internal radiation treatment with intraarterial yttrium-microspheres for inoperable hepatic tumors. Int J Radiat Oncol Biol Phys 33 919-924... 

Stubbs RS, O Brien I, Correia MM (2006) Selective internal radiation therapy with Y microspheres for colorectal liver metastases single-centre experience with 100 patients. ANZ J Surg 76 696-703... 

Van Hazel G, Pavlakis N, Goldstein D et al (2005) Selective internal radiation therapy (SIRT) plus systemic chemotherapy with irinotecan. A phase I dose escalation study. Proceedings of the ASCO GI Cancers Symposium 223... 

Jakobs TF, Hoffmann RT, Poepperl G et al (2007) Midterm results in otherwise treatment refractory primary or secondary liver confined tumours treated with selective internal radiation therapy using 90Yttrium resin-microspheres. Eur Radiol 17 1320-1330... 

Besides endovascular treatments in the brain, C-arm CT is also well suited to support abdominal apphca-tions. In fact, C-arm CT has aheady received considerable attention for tiimimaUy invasive liver tumor treatments. Innovative therapeutic approaches, such as local chemotherapy, chemoembolization, or selective internal radiation therapy (SIRT), may aU benefit. 

Fig. 2.1.7. a The metastases from a breast cancer, subcapsular located in the left liver lobe, were treated via an oblique access route with the skin entry point at the epigastrium (former selective internal radiation therapy i.e. SIRT caused the parenchymal irregularities in the right liver lobe where active metastases could no longer be appreciated). Note the gas within the treated lesion and gas bubbles along the electrode s pathway. Extensive capsular anaesthesia caused the soft-tissue swelling between peritoneal wall and hepatic surface, b Due to an insulation defect, a grade 3 burn occurred at the skin entry point, about 5 cm distant from the electrode s tip. The burn was not appreciated until the end of the procedure because the entry point was draped with a swab and the patient did not feel the burn due to local anaesthesia... 

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