For patients whose neuroendocrine liver metastases can be treated neither surgically nor with local ablative measures such as RITA, LITT, ethanol injection or TACE, there is a new promising method available: transarterial radioembolisation (TARE), often also called selective internal radiotherapy (SIRT). TARE is an innovative local radiation treatment of neuroendocrine liver metastases performed through the internal hepatic blood vessels.

In this procedure, very small particles that contain a very short-reaching radioactive substance, are inserted directly into the hepatic vessels supplying blood to the neuroendocrine liver metastases. The 90-yttrium-encapsulated microspheres - so-called ß emitters – are specifically injected into individual branches of the main liver artery through a catheter inserted through the groin of the patient under local anesthesia. The liver metastases are thereby subjected to a high but localized dose of radiation. At the same time the blood vessels supplying the metastasis are closed. Applying the radioactivity selectively to the liver artery or its branches is decisive; the delivery of radioactive microspheres into other abdominal arteries can produce considerable side-effects and has to be avoided.

TARE has become an established treatment modality for neuroendocrine liver metastases. However, due to its high costs and the expertise required it is not generally available. In the future, TARE will be studied in combination with other treatment modalities in clinical studies.




Prof. Dr. med. Hans Scherübl

Contact

Center of Neuroendocrine Tumors
Prof. Dr. med. Hans Scherübl
Vivantes Klinikum Am Urban
Academic Teaching Hospital of Charité-University Medicine, Berlin
Dieffenbachstraße 1
10967 Berlin, Germany
Tel: + 49 30 130 225201
Fax: + 49 30 130 225205
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