Steve Biko Academic Hospital/University of Pretoria is the first in South Africa to treat liver tumours with sir-spheres microspheres
Recently South African patients have been treated at Steve Biko Academic Hospital, Pretoria, with selective internal radiation therapy (SIRT) in the form of SIR-Spheres microspheres (yttrium-90 resin microspheres; Sirtex Medical Limited, Sydney, Australia) – an innovative form of internal radiotherapy for liver cancers. This form of liver radiotherapy has been shown to be effective in treating patients with different forms of inoperable liver tumours.
Over 5,000 patients are diagnosed with colorectal cancer in South Africa every year.1 In over 40% of colorectal cancer patients the disease will spread to their liver and cannot be removed surgically.2 In addition, around 3,500 South African patients are diagnosed with primary liver cancer every year1 and approximately 85% of these will be inoperable. 3 Patients with inoperable liver tumours often have a poor prognosis even when treated with modern systemic chemotherapy and/or biological agents.
Professor Mike Sathekge, Head of Nuclear Medicine at Steve Biko Academic Hospital and University of Pretoria, said: “Selective Internal Radiation Therapy in the form of yttrium-90 resin microspheres is an exciting innovative radiation treatment for patients with inoperable liver tumours and we are very proud to be the first hospital in South Africa to introduce this form of treatment. The availability of this innovative radio-embolization therapy means new treatment options for patients, and advances in health care for the South African public.’’ These views are shared by Dr Samia Ahmad, the interventional radiologist and the rest of the team.
Selective Internal Radiation Therapy (SIRT), also known as radio-embolization, is a novel treatment for inoperable liver cancer that delivers high doses of radiation directly to the site of tumours. It is a minimally-invasive treatment, in which millions of radioactive microspheres (between 20-60 microns in diameter) are infused via a catheter into the liver, where they selectively target liver tumours with a dose of internal radiation up to 40 times higher than conventional radiotherapy, while sparing healthy tissue. There is growing interest in SIRT using yttrium-90 resin microspheres for the treatment of patients with liver metastases or with primary liver cancer. There is now substantial clinical evidence in comparative studies that SIRT in the form of SIR-Spheres microspheres is an effective and well tolerated therapy for treating patients with previously treated liver metastases from colorectal cancer. There is also mounting evidence that SIRT is an effective and well-tolerated treatment for inoperable primary liver cancer. This is a truly interdisciplinary therapy with nuclear physicians, interventional radiologist, oncologist and surgeons as part of the team.
SIR-Spheres microspheres are approved for use in Australia, the European Union (CE Mark), Switzerland, Turkey and several other countries including in Asia (e.g. India, Korea, Singapore and Hong Kong) for the treatment of inoperable liver tumours.
SIR-Spheres microspheres are also full PMA-approved by the FDA and are indicated in the U.S. for the treatment of non-resectable metastatic liver tumours from primary colorectal cancer in combination with intra-hepatic artery chemotherapy using floxuridine.
A spokesperson from CANSA confirmed that the SIRT service recently launched at Steve Biko Academic Hospital for the treatment of patients with inoperable liver tumours was great news and would allow patients access to a novel therapy which has not routinely been available in South Africa until now.
1. GLOBOCAN 2008. South African Republic estimated incidence of cancer (both sexes). http://globocan.iarc.fr/factsheet.asp#BOTH accessed 25th April 2012.
2. Van Cutsem E, Nordlinger B, Cervantes A and On behalf of the ESMO Guidelines Working Group. Advanced colorectal cancer: ESMO Clinical Practice Guidelines for treatment. Ann Oncol (2010) 21(suppl 5): v93-v97 doi:10.1093/annonc/mdq222.
3. Pleguezuelo M, et al. Expert Rev Gastroenterol Hepatol 2008;2(6):761–84.
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