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South
Florida Interventional Oncology Center |
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SELECTIVE
INTERNAL RADIATION THERAPY (SIRT) OF NON-RESECTABLE LIVER TUMORS:
What are the risks and side effects of this procedure?
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Risks
of this treatment can be divided into those related to angiography,
and those related to SIR-Sphere treatment.
Angiography itself is a routine diagnostic
procedure with a well-established safety record. Complications
occur in 1 out of 100 cases (1%) and are due to allergic reactions
to radiographic contrast (X-ray dye), temporary injury to the
kidneys from the X-ray dye, and complications from inserting
a catheter into the artery (infection, bleeding and/or injury
to or clotting of the artery). The chance of a serious injury
or death from angiography is approximately 0.1% (1 in a 1,000
cases).
SIRT causes
predictable symptoms that affect all patients to a greater or
lesser extent. These symptoms consist of varying degrees of pain,
nausea and daily fevers to 101-103. Most patients feel well enough
to go home the day of the procedure some may stay overnight.
Pain which is usually mild can be treated by oral analgesics.
Fever and nausea, which may last a few days after the procedure,
is usually well controlled with medication and frequently subsides
with in a short time. Patients are placed on medication for the
first month after treatment to alleviate symptoms of gastritis
and peptic ulceration. Many patients complain of malaise and
may lose some appetite for several days, this will subside with
time. Because we are all unique it is impossible to predict the
number or severity of side effects.
Rarely, SIR-Spheres
can get in the artery supplying the duodenum, stomach, pancreas
or other surrounding organs resulting in ulcerations or pancreatitis.
The radiation dose is calculated for each individual patient
depending on the percentage of tumor involvement to the liver.
A very rare complication is radiation hepatitis (long term)
damage to normal liver cells. Serious complications can occur
including liver abscess and fatal acute liver failure. Both
of these complications are rarely seen with modern antibiotic
therapy and careful patient selection.
Although precautions
are not required by the FDA following SIRT treatment they are
recommended directly after the procedure.
| 1. |
There should
be no travel on public transportation where the patient
is sitting next to a fellow passenger for more than 2 hours
for the first two weeks following treatment. |
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If you sleep
in the same bed as your partner/spouse they should sleep
on your left side for the first week. |
| 3. |
There should
be no close contact with pregnant women or infant/children
for the first week. |
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High
magnification of radioactive spheres
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Spheres
are trapped in the tiny vessels of the tumor giving
off radiation and
blocking tumor blood supply
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