Radioembolization (Selective Internal Radiation Therapy-SIRT). Changes in clinical practice, points of our experience.

Radioembolization (SIRT) was initially introduced in the early 21st century as a whole-liver, primarily palliative treatment, for hepatocellular carcinoma (HCC) and liver metastatic colorectal cancer (mCRC). Over time, its application expanded to include other primary and secondary liver tumors. Clinical experience and emerging studies have demonstrated a clear relationship between higher tumor-absorbed radiation doses and improved tumor response. Such dose escalation can be achieved through advanced, more precise, and synchronous dosimetric approaches (personalized dosimetry), or in selected cases, through targeted treatments such as segmentectomy or lobectomy. These strategies have been associated with improved survival outcomes and, in certain cases, have enabled a shift toward curative treatment intent.