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Radiation lobectomy: shrinking one side of the liver to grow the other | CION Cancer Clinics
Radiation lobectomy uses Y-90 to treat the side of the liver holding the tumour, so that side shrinks and the healthy side grows. It is for people whose tumour could be removed, except that the liver left behind would be too small to be safe. This page explains who it suits, what happens, how it compares with portal vein embolisation, and who it does not suit. At CION Cancer Clinics, a multidisciplinary tumour board weighs your liver function and your scans before recommending any treatment.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed October 2026, next review due October 2027
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On this page
- What is radiation lobectomy, and who is it for?
- What does the team look at before suggesting radiation lobectomy?
- What happens, step by step, in a radiation lobectomy plan?
- How is radiation lobectomy different from portal vein embolisation?
- Who does radiation lobectomy not suit?
- What this page cannot tell you
- Common questions about radiation lobectomy
The short answer
What is radiation lobectomy, and who is it for?
Radiation lobectomy is a way of using Y-90 to treat the side of the liver that holds the tumour, so that side slowly shrinks and the healthy side grows. It is meant for people whose tumour could be removed by surgery, except that the part of the liver left behind would be too small to keep them safe.
Why the size of the leftover liver matters
After a liver operation, the remaining liver has to do all the work on its own. If too little is left, the person can develop liver failure after surgery. Surgeons call the part that stays behind the future liver remnant, and they measure it on a CT scan before deciding to operate. The future liver remnant page explains how that is judged.
How Y-90 makes the other side grow
Y-90, also called TARE or radioembolisation, places tiny radioactive beads into the arteries feeding one side of the liver. That side is treated and gradually shrinks. The liver responds by growing the untreated side, the same way it regrows after part is removed. The tumour is being treated during the wait, which is the main difference from other approaches.
This page covers primary liver cancer, mostly hepatocellular carcinoma (HCC). Cancer that spread to the liver from the bowel is planned on the colon cancer pages.Before anything is offered
What does the team look at before suggesting radiation lobectomy?
The tumour board weighs three things together. A good answer on one does not make up for a poor answer on another.
The tumour
It needs to sit mainly on one side of the liver, usually the right, with the other side clear. The team checks whether it has spread outside the liver and whether it has grown into the main blood vessels.
The liver itself
A liver with mild or no cirrhosis can grow well. A badly scarred liver grows less and copes worse with surgery later. Blood tests such as bilirubin and albumin, and scores such as Child-Pugh, help show this.
Often checked
- Liver blood tests and clotting (INR)
- Signs of high pressure in the liver veins
- Volume of each side on a CT scan
The person
Fitness for a major operation later matters as much as fitness for Y-90 now. Heart, lung and kidney health, and how active someone is day to day, all count.
The mapping scan
Before any Y-90, a mapping scan checks where the beads would travel. If too many would reach the lungs or the stomach, Y-90 may not be safe.
Not sure whether this applies to you?
Ask an oncologistFrom plan to operation
What happens, step by step, in a radiation lobectomy plan?
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Tumour board review and volume scan
Your scans are reviewed and the size of each side of the liver is measured. The surgeon says whether the leftover liver would be too small for a safe operation today.
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Mapping and then Y-90
A mapping procedure comes first. Y-90 is then given to the side holding the tumour, through a thin tube in an artery. Most people go home within a day.
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The waiting period
The treated side shrinks and the other side grows over the following months. Growth is slower than with some other methods. Your oncologist sees you during this time and checks blood tests.
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The repeat scan
A new CT or MRI measures how much the healthy side has grown and how the tumour has responded. It also shows whether any new tumour has appeared elsewhere.
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The decision about surgery
If enough liver has grown and the cancer has stayed in one place, the surgical oncologist plans the operation. Your team will tell you where the operation takes place. If not, the plan changes.
Side by side
How is radiation lobectomy different from portal vein embolisation?
Radiation lobectomy (Y-90)
Portal vein embolisation
Treats the tumour while the healthy side grows
Grows the healthy side but does not treat the tumour
Growth usually takes longer
Growth usually happens faster
Needs a mapping scan and a specialised radiation team
More widely available interventional procedure
Radiation changes can make later surgery more demanding
Fewer tissue changes around the operation site
Evidence comes mostly from specialised centres
Longer track record before major liver surgery
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Not for everyone
Who does radiation lobectomy not suit?
It does not suit people whose tumour is on both sides of the liver, because the side meant to grow would also need treatment. It does not suit people whose cancer has already spread outside the liver. In both cases, an operation is not the goal, so growing the liver has no purpose.
When the liver cannot grow or cope
A liver with advanced cirrhosis, high bilirubin, fluid in the abdomen or bleeding varices may not grow enough and may be harmed by radiation. For these people, other options such as TACE or TARE without surgery, medicines, or a transplant assessment are usually considered instead.
When surgery is already safe
If the leftover liver is already large enough, there is no need to grow it, and the surgeon may operate directly. If speed matters most, portal vein embolisation may be preferred because growth is faster.
When the wait shows something new
Sometimes the repeat scan shows new tumours. That is hard news, but it spares the person a major operation that would not have helped. The team then plans a different treatment.
Being straight with you
What this page cannot tell you
It cannot tell you whether radiation lobectomy is right for you. That depends on measurements from your own scans, the state of your liver and your fitness for surgery. Only a tumour board that has seen all of these together can make that call.
The evidence is still growing
Radiation lobectomy is a newer approach. Much of what is known comes from a limited number of specialised centres, and it is not yet a standard first choice everywhere. Y-90 is available at only some hospitals in India, and the cost is quoted separately by each one. Ask for a written, itemised estimate before you agree.
What CION does and coordinates
CION's oncologists and tumour board review your scans and plan the sequence. CION's surgical oncologists assess whether the operation is possible. Y-90 and the volume scans are coordinated through NABH-accredited partner hospitals with interventional radiology teams.
If you have been told your tumour is "too big to operate", ask whether the problem is the tumour or the size of the liver left behind. The answer changes the options.Questions we are asked
Common questions about radiation lobectomy
Is radiation lobectomy the same as removing a lobe of the liver?
No. Despite the name, nothing is cut out at this stage. Y-90 treats one side of the liver with radiation so it shrinks over time. The word lobectomy describes that effect. If the healthy side grows enough, a real operation to remove the treated side may follow later.
How long does the healthy side take to grow?
It usually takes several months, which is slower than portal vein embolisation. The speed varies from person to person and depends on how healthy the liver is. Your team repeats the scan at the point they judge useful and measures the growth before deciding on surgery.
Does the tumour get treated during the wait?
Yes. That is the main reason this approach is chosen. The radiation acts on the tumour while the other side grows. With portal vein embolisation, the tumour is not treated by the procedure itself, so some teams add another treatment during the wait.
What if the healthy side does not grow enough?
Then a major operation may still not be safe. The tumour board looks at other options, such as further liver-directed treatment, medicines like immunotherapy or targeted therapy, or a transplant assessment where that fits. The Y-90 already given may have controlled the tumour in the meantime.
Is surgery harder after radiation lobectomy?
It can be. Radiation can cause scarring around the treated side, which may make the operation more demanding. Surgeons experienced in liver surgery take this into account when planning. It is a fair question to ask the surgeon directly before you agree to the plan.
Can I have radiation lobectomy if I have cirrhosis?
Sometimes, if the cirrhosis is mild and liver function is good. A badly scarred liver grows less and is more easily harmed by radiation. The team uses blood tests, the Child-Pugh score and signs of high pressure in the liver veins to decide whether it is safe.
Is radiation lobectomy available in Hyderabad?
Y-90 is offered at a limited number of hospitals in India, and availability can change. CION can coordinate assessment and Y-90 through NABH-accredited partner hospitals. Ask your CION oncologist what is currently possible and request a written estimate for the whole plan.
How do I find out if this applies to me?
Bring your latest CT or MRI, the report and your blood test results to a CION oncologist. The tumour board reviews whether surgery is possible and whether the leftover liver is the problem. Call the helpline if you are unsure which documents to bring.
Your Specialists
Meet CION's liver cancer specialists. Bring your scan reports and liver blood tests.
Our medical and surgical oncologists plan liver cancer care together, weighing the tumour and how well your liver works before choosing surgery, a liver-directed procedure or medicines.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
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Sources
- RadiologyInfo.org (RSNA/ACR) — Radioembolization (Y90)
- American Cancer Society — Embolization Therapy for Liver Cancer
- American Cancer Society — Surgery for Liver Cancer
- Cancer Research UK — Surgery for liver cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Portal vein embolisation to grow the remaining liverThe faster alternative, and when it is preferredFuture liver remnantHow surgeons decide how much liver must stayY-90 as a bridge to transplant or surgeryOther ways Y-90 is used before an operationWho is suitable for Y-90?The checks that come before any Y-90 plan
Talk to us
Told the tumour is too big to operate on?
Send us your latest scan and report, and the tumour board can look at whether the problem is the tumour or the size of the liver left behind. We will explain the options honestly, including when this approach does not fit. One helpline serves every CION centre.