Liver resection after selective internal radiotherapy (SIRT): Proof of concept, initial survival, and safety

Abstract

The combination of SIRT with state-of-the-art liver surgery opens up new therapeutic options in patients with liver metastases.

Histopathological changes resulting from selective internal radiotherapy (SIRT)

“…Even though a measurable number of microspheres were found in healthy liver tissue, we did not find typical signs of radiation‐induced hepatitis, such as VOD. This is in accordance with the results of different groups and our clinical findings . The lack of radiation injury, together with the described effect on tumor tissue, supports the idea that SIRT has a role in preoperative downsizing of liver malignancies …”

“…As most patients with metastatic cancer or primary liver tumors treated by SIRT are not scheduled for liver surgery, little tissue is available for studying the effects of internal radiation on both tumor and non‐tumor liver tissues. Our group recently published a series of patients who had liver surgery after SIRT . Here, we report our analysis of the histopathological changes in liver tumors and healthy liver tissue after internal radiotherapy and liver resection.…”

MiR-29a and miR-652 Attenuate Liver Fibrosis by Inhibiting the Differentiation of CD4+ T Cells

“…Patients suffering from liver fibrosis are easy to developing into liver cirrhosis, which was associated with severe mortality (Pellicoro et al, 2014;Kochanek et al, 2016). Although much improvement has been made on the patients with liver fibrosis based on the prevalent therapeutic methods, such as radiotherapy, chemotherapy and surgery, the prognosis remains poor (Justinger et al, 2015;Li et al, 2012a;Moretto et al, 2012). However, to fully understand the pathogenesis of fibrosis is necessary for its further treatment.…”

Liver Resection for Colorectal Hepatic Metastases after Systemic Chemotherapy and Selective Internal Radiation Therapy with Yttrium-90 Microspheres: A Systematic Review

“…These data summate to 802 patients. Removal of the 11 patients in the report by Justinger et al [22] from the 120 patients undergoing SIRT left 109 patients undergoing conversion to liver resection from initial unresectable liver metastatic disease after systemic chemotherapy and SIRT (conversion rate = 109/802 = 13.6%). Individual studies report a range of conversion rates from 14 to 21%.…”

“…In order to calculate the conversion rate to liver resection in patients with initially inoperable liver metastases, the patient reported in duplicate was removed from both the numerator and the denominator of the series. The study of Justinger et al [22] was excluded, as it represents a series of patients undergoing resection after chemotherapy and SIRT without reference to a denominator population. For all other studies, the original population of patients with unresectable disease is available, either as a cohort series or as the SIRT intervention arm of a randomised trial.…”