A new study brings new hope for liver cancer therapy. Doctors have successfully used a novel radiotherapeutic technique to deliver high doses of radiation to tumors while sparing the surrounding normal tissue. The treatment shows great promise for patients with early-stage liver cancer.

Image credits: Riad Salem.

Liver cancer is a fairly uncommon but serious type of cancer (especially in its primary stage, when the cancer develops in the liver and doesn’t originate elsewhere in the body). The exact cause of primary liver cancer is unknown, but often times its linked to a problem with the liver known as cirrhosis. Cirrhosis causes the tissue of the liver to become scarred, which can promote the development of cancer.

Depending on the type and development, liver cancer is treated with medication, microwaves, surgery, or sometimes even a complete liver transplant. However, patients are often not suitable candidates for these treatments due to the presence of other conditions. In addition, these treatments carry significant costs and potential complications. This is where the new technique steps in.

Radiation segmentectomy (RS) is a minimally invasive option that uses the radioisotope yttrium-90 (Y90) to destroy tumors. Now, researchers have applied it via an approach called Cone beam CT.

“Cone beam CT has revolutionized our ability to perform segmental injections isolated to very small tumors, sparing the majority of normal tissue,” said study senior author Riad Salem, M.D., chief of vascular interventional radiology in the Department of Radiology at the Northwestern University Feinberg School of Medicine in Chicago. “Before Cone beam CT, we had the ability to focus radiation, but not with this level of accuracy.”

Here’s how it works: the isotope is embedded into tiny beads which are delivered through a catheter into a blood vessel in the liver. They travel until they reach the site of the tumor, where they stop and deliver their radioactive effect straight to the tumor while sparing the healthy surrounding cells. Medics typically divide the liver into segments, and Cone beam CT allows them to focus on exactly the liver segment they want.

To make things even better, the procedure is minimally invasive and has a low toxicity profile.

Salem and colleagues monitored the long-term outcome of the technique on 70 early-stage HCC patients who had undergone RS between 2003 and 2016. RS controlled the target tumor, slowed the time to disease progression and improved survival outcomes.

Researchers are now continuing to monitor patients’ survival rates and looking for ways to optimize the technique.

“The results show that we are able to impart curative outcomes to these patients,” Dr. Salem said. “Our numbers with radiation segmentectomy match or outperform those of other curative treatments in terms of tumor control, survival rate and recurrence.”

The study “Radiation Segmentectomy: Potential Curative Therapy for Early Hepatocellular Carcinoma” has been published in the journal Radiology.

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