RFA - Liver Tumors: Embolization with microspheres (Yttrium) immediately followed by RFA - Radio Frequency Ablation show for unresectable liver tumors regardless of origin tumor successful treatment. For tumors of 5 cm. or larger. This new small study shows. Article updated April 26, 2011

April 26, 2011: Yesterday in the NOS jourrnaal was reported following forms of treating liver tumors with internal radiotherapy using microspheres, called Yttrium-90 treatment. Read the following information carefully. It is still a treatment in a study phase and not everyone can benefit eligible. There are still no results showing that this method would be preferable over classical RFA or LITT.

January 25, 2010: Source: Medscape

The treatment of liver tumors with use of microspheres embolization (see also reports of TACE with Yttrium-90 implemented in UMC Utrecht) immediately followed by an RFA - Radio Frequency Ablation shows promising results in patients with liver tumors that are too complex or too large to treated with surgery, all 19 patients were found at least 17 ​​months later, still clinical cancer. This follows from the first results of a study presented at a Symposium on Clinical Interventional Oncology this month.

All 19 patients in whom the combination was used were disease free at their last follow up (median follow-up: 17 months, 1-33 months), said lead researcher Franco Orsi, MD, assistant European Institute of Oncology in Milan, Italy.


Because of the potential risks to the liver functions by surgery, are common in patients with liver tumors not eligible for a liver resection. Many surgical cases are treated with RFA - Radio frequency ablation . But liver tumors that are too large and / or located in vital areas, such as to close to main arteries can have serious consequences when RFA is used.

why Dr. Orsi and colleagues do advanced tumors treated with RFA immediately after embolization, when the lesions are most vulnerable. Dr. Orsi commented that he does not know whether this approach can be implemented elsewhere. Meanwhile, U t is thus entitled worked with Yttrium-90 but whether they do so in the way that Dr. Orsi describes I dare not say. But this is a wonderful development. 19 participants, all clinical cancer less than 17 months later.

"The idea was to combine the two techniques to take advantage of the hypoperfusion and ischemic effect of the micro bland embolization so the necrotic effect of ablation to improve," said Dr. Orsi to the participants of the symposioum.

The micro bland embolization technique makes use of microspheres for immediate blood vessels around the tumor to block even those as small as 10 microns in diameter. "Bland" nature of the bulbs means that no chemotherapeutic component is used, he explains.

Immediately after embolization, while the same treatment is then connected and d by the surgeons performed the RFA.

Most of the liver tumors, all of which were regarded as inoperable, were metastases resulting from a variety of tumors elsewhere - colon cancer , the bile ducts, lungs , uterus , and breast. Two of the lesions were primary liver tumors.

The average age of patients was 65.3 years and half of them were men. The average tumor size was 3.8 cm.
There were two cases Dr. Orsi describes as patients with "major complications." but it survived, finally, the full follow-up period

Studies have shown that 80% to 100% of the tumors of 3 cm in diameter or smaller can be completely removed or slain by RFA - radiofrequency ablation alone. But for those tumors in the range 3.5 to 5.0 cm, have studies have shown that only 50% to 80% complete to get away with that technique. For tumors larger than 5 cm, only 25% receive a complete removal / destruction, studies have shown, said Dr. Orsi.

"This is because the type of vessel that we have embolization is about" 10 to 120 microns "and can not be closed with standard techniques, says Dr. Orsi. The microspheres can also close the smallest blood vessels.

"A combined technique in the same session is absolutely feasible and can prevent many hospitalizations are needed, so it can also be seen as cheaper than current practice, says Dr. Orsi.

The microspheres also help to visually identify the tumor, making the treatment more carefully during ablation can be performed, he told Medscape Oncology after his presentation.

If patients continue to show good results, this technique can be used more widely, said William Rilling, MD, director of vascular and interventional radiology at the Medical College of Wisconsin, Milwaukee, who attended the presentation by Dr. Orsi.

This study received no commercial support. Dr. Rilling and Dr. Orsi have disclosed no relevant financial relationship with other stakeholders.

2010 Symposium on Clinical Interventional Oncology. Presented January 16, 2010.