Liver-Directed Therapies

Liver cancer is the most common cancer in the world. There are two basic types of the disease: primary liver cancer originates in the tissues of the liver itself, while metastatic liver cancer occurs when cancer cells spread from other parts of the body, most commonly from the stomach, pancreas, breast or lung. Ultimately, about a third of all cancers will spread to the liver.

Surgery usually provides the best chance for a cure, and our surgical specialists are among the best in the country. In some cases, however, tumors develop internally within the liver and complete surgical removal is not possible.

The University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center (UMGCCC) offers a comprehensive Liver-Directed Therapies Program, providing the most advanced treatments available -- from complete or partial surgical removal to systemic, combination therapies to regional, targeted treatment options -- to provide the very best outcomes possible for patients with all forms of liver cancer.

Our multidisciplinary Liver-Directed Therapies Program team consists of experts in medical oncology, radiation oncology, surgical oncology, interventional radiology, nuclear medicine, gastroenterology, hepatology and pathology. These specialists meet and consult regularly to develop the best plan of treatment for each individual patient.

Some of the advanced therapies offered in our Liver-Directed Therapies Program include:

Selective Internal Radiation Therapy (SIRT)

Selective Internal Radiation Therapy (SIRT) is a type of internal radiation therapy that uses millions of microscopic beads injected into the liver, directly to the site of the tumor. UMGCCC is one of the select few state-of-the-art facilities that provide this treatment in the United States. Our team of experts has one of the largest experiences in the United States treating patients with Yttrium-90 microspheres (SIR-Spheres) for inoperable liver cancer. To date, we have treated more than 140 patients with SIRT, and our experts have presented the results of our SIRT research and treatment at both national and international meetings.

Radiofrequency Ablative Therapy

Radiofrequency ablation (RFA) is a very localized treatment that kills the tumor with heat, while sparing the rest of the liver. RFA involves inserting a thin needle, guided by imaging techniques such as ultrasound or computed tomography, through the skin, (or in some cases, through a laparoscopic incision) and into the core of a tumor. Alternating current is then used to heat or "cook" the tumor to about 100 degrees Celsius, destroying the tumor and hopefully, any cancer cells in the tissue immediately surrounding it. The heat, while fatal to the tumor, does not travel far, eliminating the possibility of liver disease.

Hepatic Arterial Infusion chemotherapy (HAI)

Hepatic Arterial Infusion Chemotherapy (HAI) is a therapy that delivers chemotherapy drugs to the liver through a catheter placed in the hepatic artery, the main pathway through which liver tumors receive their blood supply.


Chemoembolization is a method of delivering chemotherapy directly to the tumor while blocking blood flow to the liver. A thin tube is inserted in the hepatic artery, and chemotherapy drugs are injected into the tumor, along with an agent that blocks the artery. This allows the chemotherapy to attack the tumor at a higher concentration and for a longer period of time, while minimizing exposure in the rest of the body. It also cuts off the blood supply to the tumor, depriving it of the oxygen and nutrients it needs to grow.

Stereotactic Body Radiation Therapy

Stereotactic Body Radiation Therapy, or SBRT, is a method of delivering external beam radiation to the site of a tumor using high-dose, precisely focused beams of radiation. Once only used for the brain, stereotactic radiation therapy can now be used to treat tumors in other regions of the body, including otherwise inoperable tumors of the liver, thanks to recent advances in imaging, dose delivery and patient positioning techniques. SBRT, also known as fractionated radiosurgery (because a fraction of the dose is delivered at each session), destroys tumors with high doses of radiation, while sparing healthy surrounding tissue. UMGCCC is the first medical center in the Mid-Atlantic region to offer the Trilogy System, the most advanced technology available for providing stereotactic body radiation therapy.


For additional information about any of these therapies or for more information about treatment options for liver cancer, call the Liver-Directed Therapies Program at UMGCC at 1-800-888-8823.

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