Perspective on therapeutic application of selective internal radiotherapy in colorectal cancer liver metastasis

The liver is a predominant site of metastasis from a wide variety of neoplasms, and 60–80% of patients from colorectal cancer (CRC). Minority of liver metastasis are resectable which mandate an alternative option to take place in order to achieve good quality of live and improve overall survival. Selective internal radiation therapy (SIRT), has been evolving in various liver tumors, particularly hepatocellualr carcinoma (HCC) and liver metastasis from colorectal cancer (CRC). The main principle of SIRT technology is in its delivery and of its radiation treatment rather than embolization. It allows distal trap of yttrium-90 resin microspheres at the arteriolar end of feeding vessel. Which make it precise in targeting tumor cell and thus normal tissue could be spared that otherwise may sacrifice. SIRT has accomplished great success in the field of HCC and been administered recently along with chemotherapy in liver metastasis from different primaries and showed efficient improvement in term of disease free survival and quality of live. Hence then, SIRT is a valid surrogated option for liver metastasis draws surgeon attention for a serious consideration in the future. Therefore, we believe that SIRT is a well designed treatment modality for CRCLM with promising results that deserve to take part in a well randomized trial for further analysis.