Metastatic Liver Carcinoma Therapy with SIR-Spheres: Radiation Safety Considerations for Patients and Personnel
J. Strzelczyk1 and T.K. Johnson2 (1University of Colorado at Denver, Radiology; 2University of Colorado, Cancer Center)
Colorectal cancer is the second most common cause of cancer death among American men and women alike. Due to venous invasion, liver is a frequent site of metastatic hypervascular tumors. While healthy liver tissue derives its blood supply predominantly from the portal vein, these tumors are fed mostly by the hepatic artery. The SIR-spheres approach in the treatment of these generally non-resectable tumors aims to deliver targeted internal therapy. By injecting 90Y microspheres (20 to 60 μm in size) in the form of colloidal suspension into hepatic artery, it is hoped that the majority of them will be selectively carried to the tumor, where they will remain lodged. In this fluoroscopically-guided permanent implant procedure the radiation dose is delivered by up to 4 GBq (108 mCi) of 90Y. Numerous logistical, dosimetric and technical considerations arise as this type of procedure carries substantial risks for both patients and personnel, and involves a multidisciplinary team. Our own experiences and those of others lead us to the conclusion that through careful planning, commitment of appropriate personnel, and diligent implementation of radiation safety procedures this therapy can be performed without unnecessary restrictions.
