TheraSphere® is a medical device containing yttrium-90 (Y-90), a radioactive material that has been used previously in the treatment of liver tumors. When Y-90 is incorporated into very tiny glass beads (TheraSphere®), it can be injected into the liver through the blood vessels supplying the liver, thereby allowing a large local dose of radiation to be delivered to the tumor with less risk of toxic effects from radiation to other parts of the body or to healthy liver tissue. The radiation from TheraSphere® is contained within the body and becomes minimally active within 7 days after treatment due to physical decay. The glass beads remain in the body, but do not cause any health problems. TheraSphere® has been approved for use in the treatment of liver cancer in Canada and has been approved for humanitarian use for liver cancer in the United States by the Food and Drug Administration (Authorized by Federal Law for use in radiation treatment or as a neoadjuvant to surgery or transplantation in patients with unresectable hepatocellular carcinoma (HCC) who can have placement of appropriately positioned hepatic arterial catheters).
Indications:
1. DefinitiveTreatment of Unresectable Hepatocellular Carcinoma
2. Downstage to Resection
3. Bridge to transplant
4. Salvage Therapy for Chemorefractory Liver Metastases
5. Bridge to Chemotherapy ("chemo break") for liver metastases
6. TheraSphere may be used in the treatment of hepatic neoplasia in patients who have appropriately positioned arterial catheters
Patient Selection:
1. ECOG Performance Status 0-1, Age 19 or older
2. Unresectable Hepatocellular Carcinoma or Liver Predominent Metastatic Cancer
3. Pre-treatment laboratory findings within 15 days of treatment demonstrating:
- Absolute granulocyte count > 1,500/ul
- Platelet count > 75,000/μl
- Serum creatinine < 2.0 mg/dl
- Serum bilirubin < 2.0 mg/dl
4. No contraindications to angiography and selective visceral catheterization:
- History of severe allergy or intolerance to any contrast media, narcotics, sedatives, or atropine
- Bleeding diathesis, not correctable by usual forms of therapy
- Severe peripheral vascular disease that would preclude catheterization.
5. No substantial venous shunt away from the liver.
6. No severe liver dysfunction or pulmonary insufficiency.
7. No uncontrolled infection.
8. No significant underlying medical or psychiatric illness.
9. No pregnant women
TheraSphere Treatment Team:
Patient Coordinator: Michele Sagraves RN
Radiation Oncology: Suzanne Russo M.D.
Nuclear Medicine: Roger Vithalani M.D., Eastern Radiology
Interventional Radiology: Christopher Thomas M.D., Eastern Radiology
Referrals: Call Michele Sagraves RN 252-744-9083
