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Trial of radioactive glass particles to tackle cancer

Oxford University Hospitals NHS Trust is seeking volunteer patients as part of the global EPOCH clinical trial of selective internal radiotherapy for bowel cancer that has spread to the liver and has become resistant to chemotherapy.

The EPOCH trial will investigate the use of tiny glass microspheres in patients with liver metastasis from colorectal cancer whose cancer has progressed after first line drug therapy.

At least 20 patients will take part in the Oxford trial, to start this month.

The glass microspheres are 20–30 micrometres in diameter, about a third of the width of a human hair and contain the radioactive isotope, yttrium-90.

Using a thin flexible catheter inserted via the groin, the microspheres are delivered directly into tumours in the liver through the tumour’s own blood vessels.  The microspheres become permanently lodged in the tumour’s small blood vessels.

Because the procedure delivers the treatment directly to the liver tumours, the radiotherapy destroys tumour cells with minimal impact to the surrounding healthy liver tissue.

The radioactive microspheres continue to deliver radiotherapy for weeks after the treatment.

The clinical trial will compare the new radiotherapy treatment combined with standard drug therapy (chemotherapy) to standard drug therapy alone.

Patients eligible to participate in the clinical trial have metastatic bowel cancer (also called “colorectal cancer”) with spread to the liver, when the cancer has progressed despite chemotherapy.

Professor Ricky Sharma, Honorary Consultant in Clinical Oncology at Oxford University Hospitals NHS Trust, said: “We are delighted that patients in Oxford will have the chance to participate in this clinical trial.

It offers a new radiotherapy treatment option to patients with colorectal cancer that has spread to the liver when chemotherapy has not worked.

In Oxford, we have considerable experience of this new, minimally invasive approach to treating cancer.

We are very excited to be the first centre in the UK to offer this clinical trial to patients who meet the eligibility criteria.  Within the past month, two patients have volunteered to participate and they have both been enrolled.

Common side effects of this therapy include mild to moderate fatigue, the possibility of some pain immediately after the procedure and the possibility of mild nausea.  

Doctors sometimes describe these symptoms as similar to those of mild flu. Some patients experience some loss of appetite and temporary changes in several blood tests. This therapy is already approved in the European Union for the treatment of certain types of liver cancer.