with micro spheres

El Dr. José Ignacio Bilbao, especialista en radiología intervencionista de la Clínica Universidad de Navarra

Radioembolisation of tumours. Treatment at the Clínica

Radioembolisation with micro spheres is a new treatment for both primary (hepatocarcinoma) and secondary inoperable hepatic tumours.

It consists in administrating radiation directly to the tumour, avoiding the healthy liver. This radiation emits microscopic radioactive spheres charged with Yttrium-90, an element which produces low penetration radiation.

The micro spheres are injected, through a catheter, into the hepatic artery from which they are directed to the tumours and are positioned inside. The radiation that the Ytrrium emits will slowly damage the tumours.

It's a complex treatment whose design included the participation of Oncology, Hepatology, Radiology and Nuclear Medicine specialists.

We are the European reference centre for the administration of this procedure and have carried out over 300 treatments.

Each >strong>procedure is unique and personalised to each patient. Apart from being used on hepatocarcinoma, it's also carried out on hepatic metastasis and other tumours like colon cancer and breast or neuroendocrine tumours.

La radioembolización es un tratamiento novedoso para los tumores hepáticos no operables. Consiste en la administración en la arteria hepática a través de un catéter de unas esferas microscópicas cargadas de Ytrio-90, un elemento emisor de radiación de escasa penetración. La radiación que emiten estas microesferas ataca lentamente al tumor,  respetando el hígado sano.
Radioembolisation is a new treatment for inoperable hepatic tumours. [Video only available in Spanish]

First, the blood vessels that supply the tumour with blood are identified and a simulation treatment is carried out with similar spheres which are not charged with radiation. The objective is to observe their behaviour and make sure that they don't attach themselves to other organs where they could cause harm.

The real treatment is performed one or several weeks later. This consists in injecting micro spheres charged with the calculated dose of radiation. Once positioned in the tumorous tissue, they will damage it by emitting radiation.

Both procedures, the simulation and the treatment, require a hospitalisation period of just one and a half days.

In general, the treatment doesn´t produce further secondary effects, of course there will be some pain from the procedure and, sometimes, tiredness or lack of appetite in the weeks that follow. 

The exact benefits depend on:

  • The type of tumour
  • What stage the disease is in
  • Response to previous treatments
  • Other individual factors for each patient

Usually, the objective is to stop the growth of the disease and improve or maintain the patient's quality of life. This is achieved in the majority of cases. In addition to reducing the size of the tumour, in some cases, it can be extracted later in surgery. 

When the treatment of primary liver tumours through radioembolisation with Yttrium-90 micro spheres is carried out on a smaller section, it increases the volume of the non-treated healthy hepatic region (hypertrophy).

If this occured, it would allow for a surgical operation in cases in which it had initially been ruled out due to the fact that extraction would leave the patient with an insufficiently sized liver for them to survive.

This technique not only controls the disease very well, it also allows the non-tumorous hepatic tissue that is still in the liver to grow sufficiently so that initially impossible surgical procedures can be considered. The possibility of carrying out liver resection surgery is increased in 30% of patients. 

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