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SIRT Radioembolisation — SCE Medical Oncology MCQ

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ModerateGI CancersSIRT RadioembolisationSCE Medical Oncology

A 55-year-old woman with unresectable colorectal liver metastases and no extrahepatic disease is not responding to systemic chemotherapy. She is considered for selective internal radiation therapy (SIRT/Y-90 radioembolisation). What does this treatment involve?

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Correct answer: A — Intra-arterial delivery of yttrium-90 microspheres to irradiate liver tumours from within the hepatic vasculature

SIRT (selective internal radiation therapy) delivers yttrium-90-loaded microspheres via the hepatic artery directly to liver tumours. The microspheres lodge in the tumour microvasculature and deliver high-dose beta radiation (mean penetration ~2.5 mm) with minimal systemic exposure. The SIRFLOX, FOXFIRE and EPOCH trials evaluated SIRT in CRC liver metastases. While not improving OS when added to first-line chemotherapy, SIRT may benefit selected patients with liver-dominant chemorefractory disease.

Reference: NICE IPG401 SIRT; ESMO 2024 mCRC Guidelines; SIRFLOX/FOXFIRE trials