Liver Cancer Patients See Increased Survival with New Radiation Treatment
November 2, 2015
Minimally Invasive TARE Procedure Delivers Radiation Precisely to Liver
Washington, D.C. - Patients with liver cancer either as their primary malignancy or as a cancer that has spread from another organ are surviving longer thanks to a procedure called Trans-Arterial Radioembolization (TARE). TARE allows doctors to deliver radiation treatment directly to the liver using a minimally invasive technique that most patients tolerate with few side effects.
“TARE allows us to thread a catheter through a small incision in the patient’s upper thigh thru the artery that goes directly to the liver. We then use that catheter to deliver tiny beads containing particles of a radioactive element called Y-90, or Yttrium 90. This method targets the tumors more specifically and reduces the risk to the normal part of the liver, “said Alexander Kim, M.D., Chief of Vascular and Interventional Radiology at MedStar Georgetown.
“Since MedStar has a nationally -designated cancer center that treats a variety of GI cancers and also runs a very busy liver transplant center, we are seeing more and more patients who qualify for TARE. We perform more TARE cases than any hospital in the District,” said Dr. Kim.TARE works in patients who have been diagnosed with liver cancer as their primary cancer in addition to patients with colorectal and pancreatic cancer that has spread to their liver. Dr. Kim says the procedure is for patients with liver dominant disease and relatively normal liver function based on lab work.
“The treatment is a two to three step process,” said Dr. Kim. “First the patient will have a mapping angiogram where I use x-rays to look at the arterial anatomy to see if the patient is a good candidate for the TARE procedure. We treat one lobe of the liver at a time; first the side with the most cancer. The next time we see the patient, we treat the other lobe of the liver. “
In prior studies of patients no longer responding to their chemotherapy and who were expected to survive 4-6 months lived 10-12 months after having the TARE procedure.
“But now we’re expanding the variety of patients we’re treating with TARE and we’re using it in combination with chemo therapy because we think the chemo helps the radiation work better,” said Dr. Kim. “Patients can have their chemotherapy one week, then have TARE the following week on one side of the liver followed by chemo the next week, then TARE on the other side of the liver the following week.”
TARE is considered a palliative not a curative treatment.
A recent multicenter trial demonstrated improved disease control in the liver for metastatic colon cancer patients in the first line setting; survival data from that study are expected in 2017.
“People who die from colorectal and other types of cancers often do so because of cancer in their liver,” said Dr. Kim. “TARE can improve their overall Outcomes as it helps to control the disease burden in the liver.”
The side effects of the TARE procedure include fatigue, abdominal pain and nausea which usually last a week. More serious side effects include a 3% risk of GI ulceration and a 3% risk of liver injury.
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