Hepatic artery radioembolization is a specialised interventional radiology technique used primarily to treat certain types of liver cancers, including hepatocellular carcinoma (HCC) and metastatic colorectal cancer. This therapeutic approach, also known as selective internal radiation therapy (SIRT), involves the targeted delivery of radiation directly to the tumour via the hepatic artery, the main blood supply to liver tumours.
The procedure begins with a thorough assessment of the patient’s overall health, liver function, and the extent of liver disease. Suitable candidates for radioembolization typically have liver tumours that cannot be removed surgically due to their size, number, or location or because the patient’s health does not permit invasive surgery. The process is minimally invasive and is performed by an interventional radiologist in a hospital setting.
During radioembolization, tiny radioactive beads called microspheres are injected into the hepatic artery using a catheter. These microspheres contain a radioactive isotope, commonly yttrium-90 (Y-90), which delivers high-dose radiation specifically to the tumour while sparing the surrounding healthy tissue. The microspheres are about the size of a grain of sand, ensuring they lodge in the small blood vessels within the tumour and deliver their radioactive payload directly to the cancer cells.
One of the key advantages of hepatic artery radioembolization is its precision. Delivering radiation directly to the tumour through the bloodstream minimizes exposure to the rest of the body, thereby reducing side effects compared to conventional external beam radiation therapy. This targeted approach allows for higher doses of radiation to be used, potentially increasing the effectiveness of the treatment.
The efficacy of radioembolization depends on several factors, including the type and size of the tumour, its location, and how much it has spread. Studies have shown that radioembolization can shrink liver tumours, alleviate symptoms, improve quality of life, and potentially extend survival for many patients.
Post-procedure, patients may experience what is known as post-embolization syndrome, characterised by mild to moderate flu-like symptoms, including fever, nausea, fatigue, and abdominal pain. These symptoms typically last a few days and are generally manageable with medications.
Radioembolization is not without risks. Potential complications include liver damage, gastrointestinal ulcers, or inflammation caused by radiation. Therefore, careful patient selection and meticulous procedural planning are crucial to maximise benefits and minimise risks.
Overall, hepatic artery radioembolization represents a significant advancement in the treatment of liver cancers. It offers an option for patients who might not be candidates for surgery and provides a targeted approach that can be customised based on the individual’s disease characteristics and overall health. As research continues and techniques evolve, the role of radioembolization in cancer treatment is expected to expand, offering hope to many patients with challenging liver tumours.
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