Narrative review of the role of yttrium-90 selective internal radiation therapy in the surgical management of colorectal liver metastasesShow full item record
|Title||Narrative review of the role of yttrium-90 selective internal radiation therapy in the surgical management of colorectal liver metastases|
|Author||Moslim, Maitham A.; Jeyarajah, D. Rohan|
|Abstract||The management of colorectal liver metastasis (CRLM) is complicated and benefits from a multidisciplinary team approach. Liver-directed therapy has been emerging as a modality for better progression-free control. In its early years, selective internal radiation therapy (SIRT) with yttrium-90 (Y-90) was confined as an end-of-line therapy. However, literature has supported other roles including: a first-line treatment for CRLM alone or in combination with systemic chemotherapy; an adjunct to second or third-line chemotherapy; and a salvage treatment for chemo-refractory disease. Although future liver remnant (FLR) hypertrophy may take 3-12 months, the SIRT effect on loco-regional disease control has rendered it to be a useful tool in some pathologies with certain strategic goals. This paper reviews the use of SIRT with Y-90 in a surgical treatment pathway. This includes: (I) an element of multidisciplinary treatment of low-volume CRLMs, (II) convert an R1 to R0 resection by sterilizing the margins of tumor near critical structures, and (III) radiation lobectomy to induce contralateral hypertrophy in order to aid in a safer resection. There are many opportunities to validate the role of SIRT as a first-line therapy along with surgical resection including an umbrella clinical trial design.|
|Subject||Colorectal liver metastasis (CRLM)
selective internal radiation therapy (SIRT)
This item appears in the following Collection(s)
- Research Publications 
Showing a few items related by title, author, creator and subject.
Hepatectomy, RFA, and Other Liver Directed Therapies for Treatment of Breast Cancer Liver Metastasis: A Systematic Review Rivera, Kevin; Jeyarajah, Dhiresh Rohan; Washington, Kimberly (2021)Background: The liver is the second most common site of breast cancer metastasis. Liver directed therapies including hepatic resection, radiofrequency ablation (RFA), transarterial chemo- and radioembolization (TACE/TARE), ...
Engagement of narrative therapy and theological commitments in the form of a mutual critical conversation Ellington, Mitzi June (2011)The paper contains an exploration of the work of two pastoral theologians, Don Browning and Nancy Ramsay, who demonstrate the method of a mutually critical conversation. The implicit anthropological assumptions, ethics, ...