BackgroundLocoregional recurrence is the typical pattern of recurrence in gastric cancer, and cannot be removed by surgery in most of the patients. We aimed to evaluate the feasibility and efficacy of computed tomography (CT)-guided brachytherapy for patients with locoregional recurrent gastric cancer.Materials and methodsWe reviewed the case histories of 28 patients with locoregional recurrent gastric cancer that were selected for CT- guided brachytherapy by a multidisciplinary team. The clinical data of the patients including patient characteristics, treatment parameters, short-term effects, and survival data were collected and analyzed.Results15-75 125I seeds were implanted into each patient to produce a minimal peripheral dose (MPD) 100-160 Gy. Median day 0 dosimetry was significant for the following: V100 (the volume treated with the prescription dose) 95.8% (90.2-120.5%) and D90 (prescription dose received by at least 90% of the volume) 105.2% (98.0-124.6%) of prescription dose. No serious complications occurred during the study. Two months after brachytherapy, complete response, partial response and progressive disease were observed in 50.0%, 28.6% and 21.4% of patients, respectively. The median survival time was 22.0 ± 5.2 months, and the 1, 2,and 3-year survival rate was 89 ± 6%, 52 ± 10% and 11 ± 7%, respectively. A univariate analysis showed that the tumor size was a significant predictor of overall survival (P = 0.034). Patients with tumors <3 cm had relatively higher complete response rate (66.7%), compared to those with tumors >3 cm (30.8%). The PTV (planning target volume) smaller than 45 cm3 was significantly correlated with achieving complete tumor eradication in the treated region (P = 0.020).ConclusionsFor selected patients with limited locoregional recurrent gastric cancer, CT-guided brachytherapy using 125I seeds implantation can provide a high local control rate, with minimal trauma.
To assess the value of transarterial embolization/chemoembolization (TAE/TACE) therapy via adrenal artery for patients with hepatocellular carcinoma (HCC). Patients with HCC who underwent TAE/TACE therapy via adrenal artery between May 2003 and October 2015 across 4 medical centers were identified. Clinical information, procedural data, and imaging data were analyzed to assess technical success, disease control, and survival rates. A t test was used to compare the differences in serum alpha-fetoprotein before and after treatment. A total of 23 patients (23 men; mean age, 54.6 ± 7.5 years; range, 37–72 years) were included in this study. All tumors were located under the capsule of the liver and adjacent to the adrenal gland (median tumor diameter, 8.2 cm). Lesions fed by the adrenal artery were demonstrated during initial TAE/TACE in 7 patients and during repeat TAE/TACE in 16 patients. The superior, middle, and inferior adrenal arteries were involved in 14, 3, and 6 patients, respectively. The technical success rate was 100%. The disease control rate at 3 months was 100%, with partial tumor response seen in 16 (69.6%) patients and stable disease seen in 7 (30.4%) patients. The cumulative survival rate from the time of TAE/TACE was 100% at 1 year. There were no embolization-related complications. TAE/TACE therapy via the adrenal arteries can improve the therapeutic efficacy of TAE/TACE and reduce the incidence of HCC recurrence and/or presence of residual HCC.
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