Selective internal radiation therapy: 90Y (yttrium) labeled microspheres for liver malignancies (primary and metastatic).

Selective Internal Radiation Therapy is a relatively new technique that irradiates malignant liver lesions using microscopic beads. It provides micro-embolization coupled with high-dose interstitial radiotherapy. Besides colorectal cancers, this therapy has shown benefit in patients with a variety of other tumors including carcinoid tumors, lung, breast, sarcoma, colon, hepatocellular and ocular melanoma. Its clinical benefit can be as much as 85%, survival can be doubled and patients with extensive colorectal metastases not amenable to resection or ablation can be offered a 32% chance of surviving for 18 months. Ongoing and future studies will refine our understanding of optimizing patient eligibility, dosage, frequency as well as novel applications.