According to a new study published in the online "Radiology" magazine, a new technique which provides high doses tumors, while maintaining the surrounding normal tissue is expected to be therapeutic treatment option for patients with early-stage liver cancer.
Treatment options early stage of hepatocellular carcinoma (HCC), the most common type of liver cancer include surgery, liver transplantation and removals of radio frequencies. However, many patients are not candidates for these treatments because of other conditions. In addition, these treatments carry significant costs and potential complications.
Radiation segmentectomy (RS) is a minimally invasive embodiment which uses a radioisotope, yttrium-90 (Y90) to destroy tumors. Isotope built into tiny beads that are delivered through a catheter into a blood vessel in a liver. Then they are sent to the site of the tumor, where they delivered a radioactive effect, while retaining much of the surrounding healthy tissue.
The name of the procedure comes from the fact that surgeons divide the liver into several segments. Using the imaging method called conical beam CT, interventional radiologists prepared detailed review of the integrated liver vascular network and can focus the delivery of Y90 on the corresponding segment.
"Cone beam CT has revolutionized our ability to perform segmental injections in very small tumors, sparing most normal tissue from damage," - said a senior researcher of the study Riad Salem. "Before the conical beam CT, we were able to focus the radiation, but not with this level of accuracy."
Dr. Salem and colleagues studied the long-term results in 70 patients with early hepatocellular carcinoma who were segmentectomy radiation in the period from 2003 to 2016. They analyzed the responses of patients to the treatment based on two sets of criteria commonly used.
Based on the same criteria, 90 percent of patients showed a positive response to the therapy, of whom 59 percent showed a complete response. Based on the second criterion, 71% achieved a positive response, of which 16% achieved complete response.
Radiation segmentectomy controlled tumor target, while slowed disease progression and improved survival of a rate comparable with radiofrequency ablation, surgery and transplantation, for patients with hepatocellular carcinoma early stage.
Nearly three-quarters of patients had no progression of cancer in the target tumor five years after treatment. The median overall survival was 6.7 years, while the probability of one-, three- and five-year survival was 98%, 66% and 57% respectively. One-, three- and five-year overall survival probability of 100%, 82% and 75% in patients with baseline tumor size 3 cm or less.
"The results show that we can bring beneficial results for these patients," - Dr. Salem said. "Our numbers rentgenosektomiey meet or exceed the performance of other medical procedures in terms of tumor control, survival and recurrence."
Dr. Salem said radiation segmentectomy performed as an outpatient procedure is minimally invasive and have a low toxicity profile. Given the effectiveness of the radiation, it is superior transarterial chemoembolization, another minimally invasive procedure in which drugs kill cancer is introduced into the main artery led liver visualization and moved in the microcirculation of the tumor. Lack of transarterial chemoembolization requires hospitalization.
Scientists continue to monitor patients from the study group because they are working on ways to optimize treatment.
"We want these results were confirmed by patients in the long term," - said Dr. Salem. "We want to minimize the time of the clinic visit prior to treatment, and fine-tune the dosimetry, so we can find the optimal dose that will kill the tumor."