Selective Internal Radiation Therapy (SIRT) is a way of giving chemotherapy for cancer in the Liver that can’t be removed with surgery. It is a type of internal radiotherapy. It is sometimes called radioembolization or trans Arterial Radio Embolisation (TARE). Here the doctor will put tiny radioactive beads (called microspheres) into a blood vessel (artery) that takes blood to the liver. The beads get stuck in the small blood vessels in and around the cancer, and the radiation destroys cancer cells. SIRT procedure is done in 3 parts - Plan an angiogram, Lung shunting scan, SIRT. Get verified second opinions from OncoConnect ’s curated list of international Oncologists.
Selective Internal Radiation Therapy (SIRT) is a way of giving chemotherapy for cancer in the liver that can’t be removed with surgery. This can be cancer that started in the liver or cancer that has spread to the liver from somewhere else. It is a type of internal radiotherapy. It is sometimes called as radioemboilisation or trans Arterial Radio Embolisation (TARE).
Here the doctor will put tiny radioactive beads (called microspheres) into a blood vessel (artery) that takes blood to the liver. The beads get stuck in the small blood vessels in and around the cancer, and the radiation destroys cancer cells. As the radiation only travels a few millimeters from where the beads are trapped, it should cause little damage to the surrounding healthy tissue.
This treatment is recommended for patients with Liver dominant or liver only disease.
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SIRT procedure is done in 3 parts:
- Plan an angiogram: An angiogram looks at the blood supply to the liver, which varies from person to person. The doctor (called as interventional radiologist) blocks off tiny blood vessels that lead to other areas of the body like stomach or lungs. This stops the SIRT beads from travelling to other areas of the body and damaging healthy tissue. The procedure usually takes 60-90 minutes, but may take longer.
- Lung shunting scan: After the angiogram, the doctor injects a radioactive tracer into the catheter. The tracer is similar in size to the SIRT beads. Then a scan is done to pick up the radioactive tracer This is called a lung shutting scan or SPECT CT. This takes about an hour. It shows where the beads will go during treatment. This helps the doctor to work out if it is safe to go ahead with the treatment.
- SIRT: This is done about 1-2 weeks after the planning angiogram is completed. The procedure is done under sedation to help you relax and also painkillers are given to keep you comfortable.
First another angiogram is done, then when the catheter is in the right place, radioactive beads are slowly injected into the liver. The whole process takes about an hour. After the catheter is removed, a small dressing is applied over the wound.
You may need to lie flat for approximately 6 hours as the catheter went into an artery in your groin. Most people need to stay in hospital overnight. The nurse may give you pain killers and anti-sickness medicine if you need them.
You will have a scan the day after treatment, to check the position of the radioactive beads.
They may include a raised temperature, chills, feeling sick, diarrhoea, stomach ache, a feeling or pressure in the abdomen and bowel irritation. If you have any of these symptoms or feel unwell, please discuss with your doctor at the earliest.
Most of the radiation from the beads lasts for about 2 weeks, however the beads stay on the liver permanently, but they are harmless.
Radiation safety is important after SIRT treatment. The advice about this can vary slightly between hospitals, so be sure to follow the instructions from your doctor, nurse or hospital. Examples of some instructions could include:
- For the first 24 hours after treatment, you should make sure you thoroughly wash your hands after going to the toilet.
- The range of radiation from the beads in very small. But as a precaution, you might be told to avoid close contact with young children and pregnant women for the first week after treatment.
- Your doctor might also advise you not to share a bed with your partner for the first night or two.