Pediatric liver cancer affects approximately 200 children each year in the United States. Treatment options are limited if the tumor cannot be completely removed with surgery. Although chemotherapy can be used, it often has limited efficacy and is associated with significant short and long term side effects. Thus, there is an urgent need to find therapeutic strategies to help children with liver tumors. A team of physician-scientists at Baylor College of Medicine and Texas Children’s Hospital are now using a new treatment option for pediatric patients with liver tumors, called Transarterial Radioembolization (TARE).
TARE is a two-step procedure. In the first step, a dye is injected into an artery that travels to the liver and identifies and maps the blood supply to the tumor. The defined map is then used to deliver a high dose of radiation directly to the tumor via the blood vessel supplying the tumor, thereby sparing neighboring, healthy liver tissue. The procedure has been available for many years in adult liver cancer patients, and now Dr. Kamlesh Kukreja, assistant professor of radiology at Baylor, leads a team that performs this procedure in children at Texas Children’s.
“By the time pediatric patients with liver cancer present, their tumors are often too large or complex for surgical consideration,” said Kukreja, who is also division chief of interventional radiology Texas Children’s. “The TARE procedure allows us to better control the tumor to prevent it from spreading further, or to shrink the tumor to a size that can be optimized for resection.”
Because TARE enables the delivery of radioactive isotopes to the tumor directly, the therapy is better tolerated than chemotherapy. Furthermore, the treatment is done in a single visit and can occur in the outpatient setting.
“TARE may help some children with unresectable tumors by decreasing the tumor size and allowing tumor resection. For the children with liver cancer we cannot cure, TARE provides an alternative palliative care measure, giving the child more time with their family and a more comfortable therapy experience,” said Heczey, assistant professor of pediatrics-oncology at Baylor and Texas Children’s Cancer Center, and member of the Dan L Duncan Comprehensive Cancer Center at Baylor.
Very few centers in the country offer this treatment option exclusively at a pediatric facility. The Liver Tumor Program at Texas Children’s is the only center in the southwestern United States currently offering TARE to treat pediatric liver cancers.