Skip to contents
In This Issue:
Many patients with a certain type of liver or colorectal cancer have few options for treatment and care. Thanks to nearly two years of planning and collaboration among many departments, the Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) conducted its first radioembolization of the liver—a treatment that offers hope to patients with limited options.
“We are thrilled to offer this new service to a previously unmet clinical need,” said Phillip M. Devlin, MD, division chief of Brachytherapy, who, along with Nasir H. Siddiqi, MD, of Interventional Radiology, last month performed the hospital’s first radioembolization procedure. “Our aim with this compassionate and palliative treatment is to make patients more comfortable. It allows them to eat and sleep better and enjoy time with their families.”
Siddiqi noted that certain tumors that have been unresponsive to chemotherapy have responded to this treatment, which delivers radiation directly to liver tumors and relatively spares healthy tissue. “It improves survival and the quality of life for patients who can’t have surgery because of where the tumors are located on the liver or because there are too many tumors,” Siddiqi said.
A number of patients already are scheduled for the outpatient procedure, and requests for consultations are coming in steadily from referring doctors. Patients with inoperable primary liver tumors, metastatic colorectal cancer (cancer that began in the bowel and spread to the liver) and other metastatic cancers to the liver are candidates for this procedure. Liver transplants generally are not options for this group of patients because of the stage of disease, high risk of surgery for the patient and a shortage of organ donors.
During the procedure, Siddiqi guides a small catheter through the groin into the liver. Devlin then delivers tiny beads—the size of one-third the diameter of a strand of hair—loaded with the radioactive Yttrium-90 through the catheter. The bloodstream carries the beads directly to the tumors, where they lodge in the small vessels feeding the tumor, cutting off blood supply to the tumor and delivering a dose of radiation. Patients’ recovery typically lasts several hours.
BWH is one of the few hospitals in the United States that dedicates the resources to perform radioembolization of the liver. Collaboration between many departments, including Radiology, Radiation Oncology, Radiation Safety, Nuclear Medicine, Radiation Physics and Nuclear Pharmacy, is vital to the treatment’s success. In addition, staff and physicians worked closely with Sirtex, a worldwide company that researches and develops effective liver cancer treatments. Sirtex developed the radioactive particles loaded with radiation, or SIR-Spheres® microspheres, that are central to this procedure.
To ensure safety, BWH first needed to register to use Yttrium-90. De’Ann McNamara, BSN, RN, nurse educator for Radiology, in collaboration with Siddiqi, completed extensive paperwork prior to gaining approval for the first case, and created a procedural consent form, which breaks down the procedure into simple terms that all patients can understand.
The many departments involved also conducted preliminary test runs. “We needed to make sure the isotopes would be handled without anyone being exposed to radiation,” said Cassandra Earley, practice manager in Interventional Radiology.