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Prevention and treatment of complications of selective internal radiation therapy: expert guidance and systematic review

Sangro, B; Martínez-Urbistondo, D; Bester, L; Bilbao, JI; Coldwell, DM; Flamen, P; Kennedy, A; ... Sharma, RA; + view all (2017) Prevention and treatment of complications of selective internal radiation therapy: expert guidance and systematic review. Hepatology , 66 (3) pp. 969-982. 10.1002/hep.29207. Green open access

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Abstract

Selective internal radiation therapy (SIRT or radioembolisation) by intraarterial injection of radioactive yttrium-90 ((90) Y)-loaded microspheres is increasingly used for the treatment of patients with liver metastases or primary liver cancer. The high-dose beta-radiation penetrates an average of only 2.5 mm from the source so that its effects are limited to the site of delivery. However the off-target diversion of (90) Y microspheres to tissues other than the tumor may lead to complications. The most prominent ones include: radiation gastritis and gastrointestinal (GI) ulcers, cholecystitis, radiation pneumonitis, and radioembolisation-induced liver disease (REILD). Complications may occur despite careful pre-treatment planning and SIRT demands an expert multidisciplinary team (MDT) approach in order to provide comprehensive care for patients. This review provides recommendations to MDTs on the optimal medical processes in order to ensure the safe delivery of SIRT. Based on the best available published evidence and expert opinion, we recommend the most appropriate strategies for the prevention, early diagnosis and management of potential radiation injury to the liver and to other organs.

Type: Article
Title: Prevention and treatment of complications of selective internal radiation therapy: expert guidance and systematic review
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/hep.29207
Publisher version: http://dx.doi.org/10.1002/hep.29207
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: hepatocellular carcinoma; liver metastases; radioembolization; safety
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: https://discovery.ucl.ac.uk/id/eprint/1553290
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