Brachytherapy for liver tumors

Liver brachytherapy is a minimally invasive procedure where by needles are directly placed in-side liver tumors to deliver high dose of radiation in order to kill the cancerous cells. While surgery is the mainstay of treatment for patients who are not suitable for surgery, local therapy such as brachytherapy can be used as an alternative.

Liver brachytherapy can be used to treat both:

1. Primary cancer of the liver (Hepatocellular carcinoma)

2. Metastatic cancers to liver (eg: cancer that has spread from other organs such as colon, rectum, breast, lung or other cancers in the body).

While there are other local liver directed therapy such as

High-dose rate (HDR) brachytherapy is a form of minimally invasive, radio-ablative liver directed therapy [other available options include surgery, radiofrequency ablation (RFA), microwave ablation, ethanol injection, selective intra-arterial irradiation (SIRT) and transarterial chemoembolization (TACE).

Applicable for both primary liver hepatocellular carcinoma (HCC) and metastatic tumors to the liver.

Advantages of liver directed HDR brachytherapy include:

•No issue with heat sink effect as in RFA

•Size and number lesions is not an absolute limiting factor

•High response rates even at lower doses of radiation due to the known radiosensitivity of HCCs

•Able to target difficult anatomical locations such as sub-diaphragmatic tumors