SIRT Referrer’s Check List
Dr Eisen Liang, Interventional Radiology, SAH
Indication (Medicare Benefit Schedule):
Treatment of colorectal cancer patients
with inoperable and non-ablatable secondary liver cancer,
in combination with systemic chemotherapy (5FU and leucovorin).
| Colorectal Ca: | Yes/No | | Hepatic metastases: | Yes/No | | Suitable for surgical resection: | Yes/No | | Suitable for ablation: single tumour ≤5cm; 2 or 3 each ≤3cm | Yes/No | | Chemotherapy: 5-fluorouracil (5FU) and leucovorin; others: | Yes/No |
Exclusion Criteria:
| Extensive extrahepatic disease | Yes/No | | Previous external beam radiation to liver | Yes/No | | Capecitabine (Xeloda) within previous two months. | Yes/No | | Liver failure: | Yes/No | | Portal vein thrombosis and ascites | Yes/No | | Contrast allergy | Yes/No | | Severe cardiopulmonary disease | Yes/No | | Severe renal impairment (Cr>200mmol/l) | Yes/No | | Private Health Fund: | Yes/No |
SIRT was listed on the Private Health Insurance Prostheses List from 1 March 2006, providing privately insured patients with a benefit for both the procedure and SIR-Spheres microspheres
Unfunded patient need to contact SAN radiology 94879840 for hospital charge quotation
| SIR-sphere DVD viewed by patient and family | Yes/No
| | SIR-spheres pamphlet and pre-consultation info given | Yes/No | | Secretary or patient to book consult with Dr Eisen Liang | Secretary/Patient |
SAN Radiology Booking: 9487 9850 Eisen Liang Mobile: 0416 236018
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