Promising New Treatment Provides Hope to Patients with Metastatic Liver Tumors

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Tucson Medical Center is poised in the coming weeks to provide a promising, FDA-sanctioned treatment option for patients with colorectal cancer that has spread to the liver.

With her first patient signed up for the procedure in mid-May, Dr. Julie Zaetta will be the sole interventional radiologist locally using SIR-Spheres microspheres, the only fully FDA-approved microspheres therapy available for those patients.

Colorectal cancer, which develops in the large intestine, is one of the most common cancers found in industrialized countries. Unfortunately, it’s also the second most lethal malignancy after lung cancer.

It also has a tendency to spread to the liver, which happens in as many as 60 percent of the cases. Liver tumors are notoriously difficult to remove surgically, with only about a quarter of patients good candidates because of the size and location of the tumors.

Selective Internal Radiation Therapy using SIR-Spheres microspheres will deliver millions of microscropic radioactive beads – each about a third of the width of a human hair – directly to the tumor site. Because the microspheres are too large to pass through the small blood vessels within the tumor, they become permanently lodged in the tumor bed, targeting the tumor with a dose of internal radiation up to 40 times higher than conventional radiotherapy, while sparing healthy tissue.

The treatment is suitable only for patients with liver tumors and has no effect on tumors outside the liver. It is also only indicated currently for treatment of colorectal cancer that has spread to the liver, although there is some investigational research taking place to see if it is effective in treating other types of liver tumors.

Zaetta said she wanted to find a treatment for patients, and particularly for those with colorectal carcinoma, who are not being adequately treated with chemotherapy. “It improves patient prognosis and it extends life,” said Zaetta, who has worked for the past six months to bring the program live to TMC.

Additionally, she said, the quality of life with the therapy is often better as well. Although almost all treatments can produce side effects, the side effects with the microspheres are generally far less severe than with other treatments. Unlike the vomiting and nausea often associated with intravenous chemotherapy, the biggest complaint from patients is fatigue.

“This is the newest non-invasive treatment for cancer that’s showing a lot of promise,” said Zaetta, a board-certified radiologist with Radiology Ltd., who has a subspecialty in vascular/interventional radiology.

The 90-minute treatment is performed on an outpatient basis.

The microspheres emit beta radiation for a period of about two weeks, after which they become inert.

Zaetta said her first patient has already gone through a “mapping” procedure designed to prepare the liver for the treatment and minimize the potential that the microspheres will travel to areas outside of the liver.

The treatment can be used in conjunction with chemotherapy, with clinical data showing the dual-pronged approach can extend life expectancy. In a clinical trial that provided the basis of the 2002 FDA approval, survival rates, for example, were 39 percent at two years vs. 29 percent with just chemotherapy alone, and were at 17 percent at three years, vs. 6 percent with just chemotherapy.

The treatment can also be used alone for patients whose liver tumors are no longer responding to chemotherapy.

Most insurance companies cover the cost of the treatment.

It’s not a cure, Zaetta cautioned. “But what I like to tell patients is that we want to help them manage the disease or provide longer disease-free intervals. This treatment is a great alternative to help us do that.”

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Tucson Medical Center | 5301 E. Grant Road | Tucson, Arizona 85712 | (520) 327-5461
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