Tiny beads offer big hope to liver cancer patients

06/14/04

Northwestern Memorial Hospital first in Illinois to offer new minimally-invasive endovascular radiation treatment

Northwestern Memorial Hospital is the first in Illinois, and one of about 15 hospitals across the country, to offer a new radiation treatment for inoperable liver tumors. The technique uses tiny radioactive glass beads or microspheres carrying high doses of radiation (yttrium-90) to kill cancerous tumors within the liver.

"This technique represents a novel way of delivering radiation therapy to liver tumors, which may prolong and improve the quality of life for the growing number people who are diagnosed with liver cancer," said Riad Salem, M.D., M.B.A, and Director of Interventional Oncology at Northwestern Memorial Hospital. Northwestern Memorial's departments of radiology, hepatology, and medical and surgical oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University coalesce to offer this procedure to patients.

This new treatment consists of injecting millions of tiny microspheres into the artery supplying blood to the liver. The interventional radiologist guides a small catheter into the liver's hepatic artery and then delivers the microspheres that carry the radioactive yttrium directly to malignant cells in liver tumors.

"The secret to the bead's success is their ability to deliver bigger, more potent doses of radiation to the tumor," explains Eric Russell, M.D., chair of the Department of Radiology at Northwestern Memorial Hospital. "Because the radiation travels only 2.5 mm in tissue, healthy tissue is spared despite this high concentration of radiation."

The beads are 15 to 35 microns in diameter, smaller than a human hair. When the beads are placed inside a nuclear reactor for several days, the yttrium becomes radioactive. The radioactive beads are then injected into the liver, where they irradiate the liver for a period of approximately 12 days, after which they are no longer radioactive.

"While surgical removal of liver cancer offers the best chance for a cure, fewer than 15 percent of patients are suitable surgical candidates, either because their cancer is too far advanced upon detection or because of other medical considerations," explains Dr. Salem.

For cancer patients, this outpatient procedure offers a chance to be treated without facing radiation's other possible side effects - loss of hair, weakness, burns or nausea. "This offers patients with liver cancer a new option that has few side effects and is well tolerated," adds Mary Mulcahy, M.D., a gastrointestinal oncologist at Northwestern Memorial Hospital. "While systemic chemotherapy continues to be the frontline treatment for most cancers in the liver, directed radioactive therapy may provide additional benefit and shows great promise. For primary liver cancer, systemic chemotherapy has been very ineffective and liver directed therapies are our main treatment."

The therapy has been used to treat hundreds of patients with liver cancer in Canada, Australia, New Zealand, Hong Kong, Singapore and Thailand.

"There is the potential for this technology to be applied to other organs, such as the brain or kidneys, but much more research in this field is required," said Steven Rosen, M.D., Director of Oncology at Northwestern Memorial Hospital and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

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