The Department of Radiation Oncology anticipates completion of the linear accelerator project in Spring 2008. When operational, the new linear accelerator, named the Trilogy^TM by Varian Medical Systems, will be capable of providing conformal radiation therapy, Intensity Modulated Radiation Therapy (IMRT), stereotactic radiosurgery, and Image Guided Radiation Therapy (IGRT) using on-board imaging and respiratory gating. More about the Trilogy^TM can be found at Varian's website.

Hepatic Intra-arterial Brachytherapy with TheraSphere® (also called Selective Internal Radiation Therapy, SIRT)

Thanks to the combined efforts of physicians, staff, and administrators from the Section of Hepatobiliary Surgery, Radiation Oncology, Interventional Radiology, Nuclear Medicine, and others, UCI Medical Center can now offer an innovative treatment to patients with unresectable hepatocellular cancers (HCC) or liver metastases.  For HCCs, the treatment is intra-arterial brachytherapy with TheraSphere®.  These new treatment utilize targeted delivery of millions of glass microspheres imbedded with radioactive Y-90. Because the radio-isotope’s radiation (beta particles) travels a limited distance in tissue, the side effects the radiation safety issues are minimized. Patients can undergo the treatment and be sent home with in a few hours.

Patients are selected according to specific criteria set as outlined by both the product manufacturers, MDS Nordion, Inc. (TheraSphere) and the treating physicians. These include meeting specific criteria such as location, blood supply factors, and residual liver capacity. The treatment itself is done in the interventional radiology suite. The radiologist performs the angiography through the femoral artery to isolate the blood vessels feeding the target lesions. The treatment dose is carefully prepared by radiation specialists and injected directly into the arteries feeding the affected part(s) of the liver.  Microspheres become entrapped in the tumor giving off the radiation dosage over the course of several days. The radiation is so short ranged that no special radiation precautions are necessary once the procedure is completed.

Because the TheraSphere® is a relatively new treatment limited to specialist centers, treatment results are only preliminary. In a report on a Phase II trial, Dancey et al reported a 20% overall, objective response rate and a 12.6 month median survival among their 22 patients. TheraSphere® is available only through specialty centers and only under a Humanitarian Device Exemption status from the FDA. Interested patients and physicians may learn more about TheraSpheres at UCI Medical Center by contacting the Section of Hepatobiliary Surgery, Department of Surgery at 714-456-3884.

More about TheraSphere®:

MDS Nordion on Therasphere

Doctor's Guide on Liver Cancer