Selective Internal Radiation Therapy - Principles

Principles

Radiation therapy is used to kill cancer cells; however, normal cells are also damaged in the process. Currently, therapeutic doses of radiation can be targeted to tumors with great accuracy using linear accelerators (see radiation oncology); however, the normal liver tissue is very sensitive to external beam radiotherapy. Fortunately, malignancies (including primary and metastatic liver cancers) are often hypervascular; tumor blood supplies are often increased compared to those of normal tissue. Furthermore, the liver has a dual blood supply, receiving blood from both the hepatic artery and the portal vein. Hepatic malignancies derive most of their blood supply from the hepatic artery; whereas the normal liver derives most of its blood supply from the portal vein. Therefore, delivery of radioembolic particles through the branch of the hepatic artery supplying a tumor will preferentially lead to deposition of the particles in the tumor, while sparing normal liver from harmful side effects.

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