Radiation therapy

Radiation therapy usually plays a relatively minor role in the treatment of liver cancer. Most primary tumors that metastasize to the liver are resistant to radiation therapy, while the healthy liver is susceptible to radiation damage. Radiation therapy is often used to treat patients who have tumors of the bile duct/ gallbladder.

Most radiation therapy for liver cancer is used in conjunction with other forms of treatment/ surgery. Sometimes radiation therapy will be administered at the time of surgery and is called Intraoperative Radiation. Radiation may also be used as a palliative treatment to shrink tumors and relieve pain.

Liver cancer radiation therapy is administered in different ways. The way the liver cancer radiation therapy is given depends on the type/ stage of liver cancer being treated.

Radiation may be delivered to the tumor using radio labeled antibodies. Radioactive substances are attached to antibodies made in the lab. These antibodies, which target tumor cells, are injected into the body and the tumor cells are killed by the substance.

External radiation therapy uses a machine outside the body to send radiation toward the cancer. External beam radiotherapy has traditionally not been worthwhile for the patient with either primary cancer of or metastatic to the liver. Radiation can certainly injure tumor cells.

However, the doses necessary to kill tumor cells severely injure the surrounding normal liver cells, resulting in radiation induced hepatitis in a significant percentage of patients. New computer generated dosing techniques such as conformal radiation will allow a tighter focus on the diseased liver, allowing sparing of radiographically uninvolved liver.

However, at present, radiation is still a second to third line therapy.
Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
Two companies now produce radioactive Yttrium for intra-arterial injection. Y-90 delivers high dose radiation to the areas of liver which are exposed to tiny beads composed either of glass or rosin with the Yttrium attached to these beads. It is not yet known where the Yttrium intra-arterial radiation will fit in the the schema of second-line treatment for liver cancers. Yttrium microspheres have only been approved by the FDA recently.

The side effects of liver cancer radiation therapy depend mainly on the treatment dose and the part of the body that is treated. Patients are likely to become really tired during radiation therapy, especially in the later weeks of treatment. Resting is quite important, but doctors usually advise patients to try to stay as active as they can.

Radiation therapy to the chest and abdomen may sometimes cause nausea, vomiting, diarrhea, or urinary discomfort. Radiation therapy also may cause a decrease in the number of healthy white blood cells -- cells that help protect the body against infection. Although side effects of liver cancer radiation therapy can be distressing, the doctor can usually treat or control them.

Of late, there has been a new kind of radiation for liver cancer that works from the inside out.