South Florida Interventional Oncology Center  
SELECTIVE INTERNAL RADIATION THERAPY (SIRT) OF NON-RESECTABLE LIVER TUMORS: What are the risks and side effects of this procedure?

Risks of this treatment can be divided into those related to angiography, and those related to SIR-Sphere treatment.

Angiography itself is a routine diagnostic procedure with a well-established safety record. Complications occur in 1 out of 100 cases (1%) and are due to allergic reactions to radiographic contrast (X-ray dye), temporary injury to the kidneys from the X-ray dye, and complications from inserting a catheter into the artery (infection, bleeding and/or injury to or clotting of the artery). The chance of a serious injury or death from angiography is approximately 0.1% (1 in a 1,000 cases).

SIRT causes predictable symptoms that affect all patients to a greater or lesser extent. These symptoms consist of varying degrees of pain, nausea and daily fevers to 101-103. Most patients feel well enough to go home the day of the procedure some may stay overnight. Pain which is usually mild can be treated by oral analgesics. Fever and nausea, which may last a few days after the procedure, is usually well controlled with medication and frequently subsides with in a short time. Patients are placed on medication for the first month after treatment to alleviate symptoms of gastritis and peptic ulceration. Many patients complain of malaise and may lose some appetite for several days, this will subside with time. Because we are all unique it is impossible to predict the number or severity of side effects.

Rarely, SIR-Spheres can get in the artery supplying the duodenum, stomach, pancreas or other surrounding organs resulting in ulcerations or pancreatitis. The radiation dose is calculated for each individual patient depending on the percentage of tumor involvement to the liver. A very rare complication is radiation hepatitis (long term) damage to normal liver cells. Serious complications can occur including liver abscess and fatal acute liver failure. Both of these complications are rarely seen with modern antibiotic therapy and careful patient selection.

Although precautions are not required by the FDA following SIRT treatment they are recommended directly after the procedure.
1. There should be no travel on public transportation where the patient is sitting next to a fellow passenger for more than 2 hours for the first two weeks following treatment.
2. If you sleep in the same bed as your partner/spouse they should sleep on your left side for the first week.
3. There should be no close contact with pregnant women or infant/children for the first week.

High magnification of radioactive spheres

Spheres are trapped in the tiny vessels of the tumor giving off radiation and
blocking tumor blood supply