Cancer Treatment Today

SIRT — a therapy that consists of millions of microscopic, radioactive glass microspheres (20-30 microns diameter) — is infused into the arteries that feed inoperable liver tumors or metastatic cancer to the liver, bathing the malignancy in high levels of extremely localized radiation.

Long-term outcome analysis after SIRT indicated treatment response in 62.7% of the patients, disease stabilization in 32.5%, and a survival rate of 45.0% at 3 years. Findings from an international multicenter prospective treatment registry showed that safety and response rates of SIRT and TACE were similar when evaluated at 6 months. At 12 months, the group receiving SIRT had a significantly lower response rate than the group receiving TACE (46% vs. 66%).[46] It should be noted that portal vein thrombosis and impaired liver function are not considered contraindications to SIRT, as they are for TACE and TA. This, SIRt ahs pluses and minuses as compared to TACE. TI sia generlalya ccepted treatmetn adn NCCN recommended. NCCN lists is in Pan NET-7 (Category2B)

Gibbs P, Heinemann V, Sharma N, et al. SIRFLOX: Randomized phase III trial comparing first-line mFOLFOX6 ± bevacizumab (bev) versus mFOLFOX6 + selective internal radiation therapy (SIRT) ± bev in patients (pts) with metastatic colorectal cancer (mCRC). Presented at 2015 ASCO Annual Meeting; J Clin Oncol 2015; 33 (Suppl): Abs 3502.

Michl M, Haug AR, Jakobs TF, Paprottka P, Hoffmann RT, Bartenstein P, Boeck S, Haas M, Laubender RP, Heinemann V. Radioembolization with Yttrium-90 microspheres (SIRT) in pancreatic cancer patients with liver metastases: efficacy, safety and prognostic factors. Oncology. 2014;86(1):24-32.

La Salvia A, Partelli S, Tampellini M, Tamburrino D, Falconi M, Scagliotti GV, Brizzi MP. Management of hepatic metastases of well/moderately differentiated neuroendocrine tumors of the digestive tract. J Cancer Metasta Treat 2016;2:294-303.
NCCN, Neuroendocrine Pancreatic 2017