SIRT in Colorectal Cancer With Liver Metastases

Michael Cusnir, MD:Selective internal radiation therapy is a technique that has been used for several years. This is something that I remember we started using when I was still in fellowship in the early 2000s. It entails giving a high dose of radiation internally to an organ, using that radiation as a treatment method for isolated areas of disease.

The advantage of using this in the liver, and the Yttrium-90 technology that has been developed since then, with a lot of different treatment modalities is twofold. We take advantage of the double circulation of the liver. The liver derives the nutrition from the portal vein, but the tumors derive their nutrition from the hepatic artery. That selectivity allows us to give certain treatments directly to the liver, like selective internal radiation. Using the technology of Yttrium-90 that has a wavelength of a beta emitter that is extremely short, that doesn’t cross into the surrounding tissues much more, allows you to be able to treat the liver in a selective fashion. We are able to selectively embolize the tumors and create an effect in the surrounding area that’s as close, in some cases, to being described as doing segmentectomy of the liver without damaging much of the healthy tissue.

This is a technology that has truly changed the way we approach patients who have nonresectable liver tumors that are able to undergo this technique safely, by having a good liver reserve.

Transcript edited for clarity.