Dosimetric and Clinical Parameters Associated with Contralateral Liver Hypertrophy after Lobar Selective Internal Radiation Therapy
Keywords: 
Materias Investigacion::Ciencias de la Salud::Radiología
Selective internal radiation therapy
SIRT
Radioembolization
Unresectable hepatic malignancies
Contralateral liver hypertrophy
Issue Date: 
14-Jan-2022
Defense Date: 
14-Dec-2021
Publisher: 
Universidad de Navarra
Citation: 
GRISANTI, Fabiana. "Dosimetric and Clinical Parameters Associated with Contralateral Liver Hypertrophy after Lobar Selective Internal Radiation Therapy". Sangro, B. y Rodríguez, M. (dirs.). Tesis doctoral. Universidad de Navarra, Pamplona, 2021.
Abstract
Selective internal radiation therapy (SIRT), also termed radioembolization, is an established treatment for primary and secondary unresectable hepatic malignancies [1], in which radioactive microspheres are injected in the arterial vasculature of the liver. 90Y, a nearly pure (99.9 %) β-emitter, is the most commonly used radionuclide, although Holmium-166 (166Ho) is also available. Since tumors have a preferentially arterial blood flow from the hepatic artery, most radioactive microspheres get embedded in the tumor microvasculature and selectively irradiate tumors rather than the surrounding liver tissue that receives the majority of its blood supply from the portal vein [1,2]. The aim of SIRT is to selectively target radiation to liver tumors while limiting the dose to normal liver parenchyma[3]. For the effectiveness of this intra-arterial treatment, optimal tumoral perfusion and blood flow is necessary for cell damage. Cell damage is performed by free radicals, which are generated by ionization of water molecules near to the tumor cells deoxyribonucleic acid (DNA). Therefore, for maximal cytoreduction by radiation, along with oxygen supply, sufficient microsphere coverage of tumors is needed to induce cell death with the high-energy β-radiation emitted [4].

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