What Is Yttrium-90 Selective Internal Radiation Therapy (SIRT)?

Yttrium-90 Selective Internal Radiation Therapy (SIRT) is known as radioembolisation, and its purpose is to eliminate tumours located in the liver. It involves the injection of small radioactive particles directly into the liver artery. These beads emit short-range radiation, which targets the tumour but minimises damage to the surrounding tissues.

How Effective Is Yttrium-90 Selective Internal Radiation Therapy (SIRT)?

The effect of radioembolisation depends on several factors, including the disease burden underlying liver function and the technique used for dosimetric evaluation. Overall, studies have demonstrated improvements in disease-free progression, reduction in symptoms and improvements in overall survival. 

What Are the Side Effects of Yttrium-90 Selective Internal Radiation Therapy (SIRT)?

In approximately one-third of patients, SIRT administration causes immediate short-term abdominal pain, requiring narcotic analgesia, and is typically self-limiting.

Post-SIRT in the treatment of liver cancer therapy sees lethargy and nausea are common symptoms and can last up to two weeks and may require medication. Most patients develop a mild to a moderate fever that may last for several days following SIRT administration. This fever does not usually require treatment.

The most common and potentially severe complications of SIRT result from either: 

• Inadvertent administration of SIR-Spheres into the gastrointestinal tract resulting in gastritis/duodenitis
• Radiation-induced liver disease resulting from a radiation overdose to the normal liver parenchyma

The incidence of gastritis/duodenitis can be reduced by careful attention to the administration procedure to ensure a minimal chance of SIR-Spheres entering the numerous small arteries supplying the gastrointestinal tract.

Radiation-induced liver disease is largely, but not entirely, preventable by using appropriate SIRT doses and making allowances for dose reduction when there is an increased risk of causing radiation damage. Such cases include patients with pre-existing liver damage, poor liver reserve or small volume tumour mass in the liver. 

The reported incidence of gastritis/duodenitis is less than 10%, while the reported rate of radiation-induced liver disease is less than 1%.

The incidence of Radiation Pneumonitis (inflammation of the lungs due to radiation) is expected to be low where appropriate pre-therapy workup and dose reductions are followed. The risk of radiation pneumonitis nevertheless exists and has been reported.

Does Yttrium-90 Selective Internal Radiation Therapy (SIRT) Extend Your Life Expectancy?

While outcomes following radioembolisation depend on various clinical and technical factors, some studies show improvements in progression-free survival, symptoms and overall survival. 

How Many Yttrium-90 Selective Internal Radiation Therapy (SIRT) Treatments Can You Have?

Typically most patients will undergo a single treatment with radioembolisation, but repeated treatments can be done, depending on the clinical needs. 

What Happens After Yttrium-90 Selective Internal Radiation Therapy (SIRT)?

After treatment, the patient will be transferred to a recovery area where they will remain for approximately 1 to 4 hours. During this period, the catheter is removed from the bladder. 

Yttrium-90 Selective Internal Radiation Therapy (SIRT) treatment has several reported side effects. These include: 

• A fever of more than 38 ° C
• Abdominal pain
• Nausea and vomiting

Our specialist will indicate if antipyretic, analgesic and antiemetic medications are necessary.

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