TARE is the short form of Transarterial Radioembolization. Transarterial Radioembolization is a technique by which we inject radioisotope directly into a liver tumor by cannulating the hepatic artery and then delivering the radioisotope directly into the tumor.
Now these radioisotopes may be alpha emitting radioisotopes or beta emitting radioisotopes. The most common kind of radioisotopes which are used in this kind of technique is Yttrium which is Y90 which is a beta emitting radioisotope.
Now, what we do is that we cannulate the hepatic artery by the interventional radiologist will puncture the femoral artery and then put the catheter right upto the hepatic artery cannulate the hepatic artery, cannulate the specific artery which is supplying a tumor and then deliver the radioisotope directly through that feeding artery and that is the reason why this often also called as SIRT or Selective Intra Arterial Radio Therapy.
Now the advantage of TARE over other procedures like TACE is that TARE can be done even where a person has portal vein thrombosis which often becomes a contraindication for doing other techniques like a TACE.
The second major advantage of TARE is that the post embolization syndrome which means that the decompensation or the worsening of the liver function which often happens after a person undergoes a TACE or a Transarterial chemoembolization does not happen with TARE or Transarterial Radioembolization.
What are the Patients who can actually benefit from a TARE?
Patients of hepatocellular carcinoma, some patients of metastasis to the liver specially from a kind of tumors which arise from the colon. So, patients with colonic cancers who have metastasis to their liver which are not operatable right which cannot be removed in such situation using TARE or SIRT along with the chemotherapy can often augment the effect of chemotherapy on the tumor especially in the liver, and can increase the overall survival of the patient as well as give a period where the patient does not need to take chemotherapy. And this is especially true in patients with colorectal cancer.
For Hepatocellular Carcinomas where a person has a HCC which is not resectable, TARE can actually not just be used for as a bridging procedure to a transplant but can also be used as a definitive procedure and in some patients who have portal vein thrombosis can be actually combined with external radiotherapy for the portal vein thrombosis or can be combined with certain immunotherapy drugs to give a synergistic effect on the patient and often patients with very large tumor which are not amenable to any kind other procedure comfort TARE and they have a good progression free survival post TARE.
TARE can also be repeated after a certain period and it can overall help in the treatment of these patients of unresectable hepatocellular carcinoma.