Application Detail

Status

Open

Description of Medical Service

TARE-Y (also known as selective internal radiation therapy; SIRT) is a medical procedure for the treatment of unresectable HCC. TARE-Y utilises the differential blood supply of the healthy and tumorous liver (80% of the blood supply to the liver is via the portal vein and almost all the blood supply to liver tumours is via the hepatic artery), and involves the delivery of yttrium-90-containing microspheres of 20-60 ìm diameter. Two types of microspheres are available: resin (SIR-Spheres/Sirtex Medical Products) and glass (TheraSphere/BTG International Asia). The yttrium-90 (Y-90) emits high energy beta radiation with a mean tissue penetration of 2.5 mm (maximum 11 mm). Thus, the microspheres deliver a cytocidal dose of beta radiation to the cancer cells with minimal irradiation of normal healthy liver tissue. Because of the small size of the microspheres, tumour necrosis is largely caused by radiation, with only a minor contribution from embolisation due to the particles.

Description of Medical Condition

Hepatocellular carcinoma (HCC) is a type of primary liver cancer arising from hepatocytes, the main cell type found in the liver. The main risk factors for developing HCC are alcohol abuse and hepatitis B virus (HBV) or C virus (HCV) infection. The causes of HCC vary across countries, with HBV being the main cause in regions where infection is endemic (e.g. parts of Asia) and cirrhosis due to alcohol abuse, HCV or obesity being the main cause in regions where HBV in not endemic (e.g., North America and Europe). HCC is the most common type of liver cancer, and one of the most common types of cancers seen worldwide, being the fifth most common in men and the ninth most common in women. Due to its high mortality to incidence ratio (0.95) it is the third largest contributor to cancer mortality overall.

Reason for Application

New Application

Medical Service Type

Therapeutic

Previous Application Number

Not Applicable

Associated Documentation

Application Form

Application Form (PDF 1127 KB)
Application Form Attachment 1 (PDF 327 KB)
Application Form (Word 201 KB)
Application Form Attachment 1 (Word 50 KB)

Ratified Final PICO Confirmation

PICO Confirmation (PDF 930 KB)
PICO Confirmation (Word 641 KB)

Assessment Report

-

Public Summary Document

Public Summary Document - July 2018 (PDF 417 KB)
Public Summary Document - July 2018 (Word 242 KB)

Public Summary Document - March 2019 (PDF 874 KB)
Public Summary Document - March 2019 (Word 152 KB)

Meetings for this Application

PASC

11 August 2017

ESC

8 June 2018

MSAC

26-27 July 2018
28-29 March 2019