Radiation lobectomy

Radiation Lobectomy is a medical procedure that involves the use of radiation therapy to induce the shrinkage and eventual functional elimination of a lobe of the liver. This technique is primarily utilized in the treatment of certain liver cancers, including both primary liver cancers like hepatocellular carcinoma (HCC) and secondary liver cancers, such as metastases from other organs. The procedure is a non-invasive alternative to traditional surgical lobectomy, which involves the physical removal of a lobe of the liver.

Overview

Radiation lobectomy leverages the principle that targeted high-dose radiation can destroy tumor cells while sparing surrounding healthy tissue to a significant extent. This is achieved through advanced radiation delivery techniques such as Stereotactic Body Radiation Therapy (SBRT) or selective internal radiation therapy (SIRT), also known as radioembolization. These methods allow for precise delivery of radiation to the tumor site, minimizing damage to the rest of the liver and surrounding organs.

Indications

Radiation lobectomy is indicated for patients with liver tumors who are not candidates for traditional surgery due to various reasons such as the location of the tumor, underlying liver disease, or other comorbidities that increase surgical risk. It is also considered for patients with a limited number of metastatic liver lesions where other systemic treatments have failed or are not suitable.

Procedure

The procedure involves detailed planning with imaging studies such as MRI or CT scan to map the liver's anatomy and the tumor's location precisely. Depending on the technique used (SBRT or SIRT), the patient may undergo a treatment planning process that includes the simulation of radiation delivery and possibly a minor procedure to map the liver's blood supply.

For SBRT, the patient will receive a series of high-dose radiation treatments over several days. In the case of SIRT, microspheres loaded with radioactive isotopes are delivered directly to the liver tumor through the hepatic artery. These microspheres lodge in the tumor's blood vessels, delivering a high radiation dose directly to the tumor while sparing most of the healthy liver tissue.

Benefits and Risks

The primary benefit of radiation lobectomy is its non-invasive nature, allowing patients to avoid the risks and recovery time associated with surgery. It can offer a treatment option for patients who are otherwise considered inoperable. However, like all medical procedures, radiation lobectomy carries risks, including the potential for radiation-induced liver disease (RILD), damage to surrounding organs, and the usual risks associated with radiation therapy such as fatigue and skin reactions.

Outcomes

The outcomes of radiation lobectomy vary depending on the patient's overall health, the size and location of the tumor, and how well the cancer responds to radiation. In many cases, this procedure can effectively control liver tumors, providing a bridge to liver transplantation or potentially curing the cancer.