Type:
Educational Exhibit
Keywords:
Arteries / Aorta, Liver, Oncology, Catheter arteriography, Radioembolisation, Cancer, Image guided radiotherapy, Radiotherapy techniques
Authors:
D. Duong, H. Briody, A. Hannah, S. Leong, M. J. Lee, J. Maingard, H. Asadi, H. K. Kok
DOI:
10.26044/ranzcr2022/R-0102
Background
Background
- Primary liver malignancy, of which HCC is the most common type is the sixth most common cancer worldwide [1, 2].
SIRT, also known as radioembolisation, is a locoregional treatment option for HCC that involves transarterial delivery of the β-emitter Yttrium-90 (90Y) via resin or glass microspheres to arterialised tumour vasculature, delivering a tumouricidal dose to the tumour.
- Historically, the precise role for SIRT was not consistently defined in international HCC treatment guidelines as initially there was failure of earlier RCTs (SARAH, SIRveNIB, SORAMIC) to demonstrate an overall survival benefit [3, 4].
- A number of theories for the lack of treatment superiority seen have been proposed: Use of older standard dosimetry and delivery techniques, randomisation before considering contraindications to SIRT and broad selection criteria [5].
- Despite this initial setback, the recent 2022 update to the BCLC staging and management algorithm has featured a more prominent role for locoregional treatment including the incorporation of SIRT in very early (BCLC 0) and early stage (BCLC A) disease based on the emergence of more recent data [6, 7].