Computed-tomography-guided high-dose-rate brachytherapy (CT-HDRBT) ablation of metastases adjacent to the liver hilum

Collettini, Federico; Singh, Ashutosh; Schnapauff, Dirk; Powerski, Maciej; Denecke, Timm; Wust, Peter; Hamm, Bernd; Gebauer, Bernhard

doi:10.1016/j.ejrad.2013.04.046

Cited by 44 publications

(23 citation statements)

References 21 publications

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“…The radiation can be administered either with brachytherapy techniques or external beam radiation. Some specialized centers have practiced interstitial brachytherapy for liver tumors for over a decade (12)(13)(14)(15), showing that one year local control rates above 90% can be achieved with this approach. However, Longer-term reports of interstitial brachytherapy are not available.…”

Section: Overview Of Liver-directed Therapy Optionsmentioning

confidence: 99%

Management of unresectable intrahepatic cholangiocarcinoma: how do we decide among the various liver-directed treatments?

Koay¹,

Odisio²,

Javle³

et al. 2017

Hepatobiliary Surg. Nutr.

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Intrahepatic cholangiocarcinoma often causes death due to obstruction of the biliary system or interruption of the vascular supply of the liver. This fact emphasizes the critical need for local tumor control in this disease. Successful local tumor control has traditionally been achievable through surgical resection for the small proportion of patients with operable tumors. Technological advances in radiation oncology and in interventional radiology have enabled the delivery of ablative radiation doses or other cytotoxic therapies for tumors in the liver. In some cases, this has translated into substantial prolongation of life for patients with this disease, but the indications for these different treatment options are still the subject of ongoing debate. Here, we review the technological advances and clinical studies that are changing the way intrahepatic cholangiocarcinoma is managed, and discuss ways to achieve individualized treatment of patients.

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Section: Overview Of Liver-directed Therapy Optionsmentioning

confidence: 99%

Management of unresectable intrahepatic cholangiocarcinoma: how do we decide among the various liver-directed treatments?

Koay¹,

Odisio²,

Javle³

et al. 2017

Hepatobiliary Surg. Nutr.

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“…CT-HDRBT is a novel local radioablative procedure that may be carried out safely. For liver lesions [27, 31] as well as extrahepatic locations (i.e., adrenal [32], lung [33]), the feasibility, safety, and effectiveness of CT-HDRBT has been proven. A major advantage in comparison to thermal-based local ablative techniques (i.e., radiofrequency ablation) is the applicability of CT-HDRBT to tumors in close proximity to or even with circumferential growth around heat-sensitive structures (i.e., superior mesenteric artery/vein), a condition commonly present in ILMs.…”

Section: Discussionmentioning

confidence: 99%

Combined Systemic Chemotherapy and CT-Guided High-Dose-Rate Brachytherapy for Isolated Local Manifestation of Pancreatic Cancer after Surgical Resection

et al. 2018

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Background: Prospective data on the optimal management of patients with pancreatic ductal adenocarcinoma (PDA) and isolated local manifestation (ILM) after surgery are lacking. Hence, no statements with respect to this entity have been released from most international guidelines including European Society for Medical Oncology, National Comprehensive Cancer Network, and American Society for Clinical Oncology. Methods: We report for the first time a case-series of 3 patients with PDA and ILM receiving combined systemic chemotherapy and CT-guided high-dose-rate interstitial brachytherapy (CT-HDRBT). Results: CT-HDRBT allowed in all patients with pronounced chemotherapy-induced side effects either a pause of cytostatic treatment or de-escalation to a “maintenance” therapy (dose reduction, interval prolongation, scheme modification with withdrawal of most toxic drugs). Conclusion: Combining CT-HDRBT to systemic chemotherapy in patients with PDA and ILM is feasible and safe. As for patients with PDA and ILM no standard of care exists, designing an appropriate randomized prospective trial for this highly selected group of patients is challenging.

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“…Reports describing image guided brachytherapy predominantly concern liver, rectal, and lung cancers [15, 16, 17, 18, 19, 20, 21]. Studies concerning image guided brachytherapy in patients with head and neck cancer are singular.…”

Section: Discussionmentioning

confidence: 99%

Image-guided high-dose-rate brachytherapy of head and neck – a case series study

Cisek

Kieszko

Brzozowska

et al. 2016

jcb

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PurposeThe aim of the study was the evaluation of image guided transdermal application of interstitial brachytherapy in patients undergoing repeated irradiation for relapsed local tumor of the head and neck area.Material and methodsThe article describes transdermal application of interstitial high-dose-rate (HDR) brachytherapy in 4 patients treated due to relapsed local tumor in soft palate, submandibular area, laryngopharynx, as well as pterygoid muscles and maxillary sinus. The application was conducted under continuous computed tomography (CT)-image guidance (CT fluoroscopy). Patients qualified for this type of treatment had neoplastic lesions located deep under the skin surface. Because of their location, access to the lesions was limited, and the risk of damaging the adjacent tissues such as vessels and nerves was high. The following parameters have been evaluated: clinical response using RECIST 1.1, incidence of perisurgical complications using CTCAE 4.0 and the frequency of occurrence of radiotherapy related early morbidity using RTOG.ResultsVarious radiation schemes were used, from 3 to 5 fractions of 3.5-5 Gy. The median total dose (D90) was 20.6 Gy. Biologic effective dose (BED) and equivalent 2 Gy (DEQ2) median doses were 30.4 Gy and 25.3 Gy, respectively. In the follow-up period of 3-7 months (the median value of 3.5 months), 2 patients had partial regression of the disease and in 2 others the neoplastic process was stabilized. None of the patients had serious complications of treatment (of 3rd degree or higher).ConclusionsComputed tomography-image guided brachytherapy proved to be a safe method of treatment in patients with local relapse in sites, in which traditional visually controlled application was impossible due to risk of complications. Despite short observation period and small study group, it seems justified to conduct prospective studies for the evaluation of efficacy and safety of CT-image guided brachytherapy.

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Computed-tomography-guided high-dose-rate brachytherapy (CT-HDRBT) ablation of metastases adjacent to the liver hilum

Cited by 44 publications

References 21 publications

Management of unresectable intrahepatic cholangiocarcinoma: how do we decide among the various liver-directed treatments?

Management of unresectable intrahepatic cholangiocarcinoma: how do we decide among the various liver-directed treatments?

Combined Systemic Chemotherapy and CT-Guided High-Dose-Rate Brachytherapy for Isolated Local Manifestation of Pancreatic Cancer after Surgical Resection

Image-guided high-dose-rate brachytherapy of head and neck – a case series study

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