Computed tomography-guided interstitial high dose rate brachytherapy for centrally located liver tumours: a single institution study

Tselis, Nikolaos; Chatzikonstantinou, Georgios; Kolotas, Christos; Milickovic, N.; Baltas, Dimos; Zamboglou, Nikolaos

doi:10.1007/s00330-013-2816-z

Cited by 33 publications

(19 citation statements)

References 30 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%

“…One report for HCC included large liver tumors (mean size of 7.1 cm), and achieved a local control rate of 93% at one year (14). Reports of this technique with metastatic lesions have also been published (12,13,15). To date, there are no dedicated studies describing the efficacy of this technique specifically for intrahepatic cholangiocarcinoma.…”

Section: Brachytherapymentioning

confidence: 99%

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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%

Section: Brachytherapymentioning

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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“…Tseliset al investigated the rate of acute side effects after hypo fractionated iBT of unrespectable primary and secondary hepatic metastases close to the hilus in 41 patients. The incidence for grade-III/-IV side effects was 5% [88].…”

Section: Disadvantages Side Effects Complications Of Brachytherapy mentioning

confidence: 96%

Value of Brachytherapy as Part of Interdisciplinary Therapeutic Concepts for Solid Tumor Lesions – Brachytherapeutic Options and Spectrum of Treatment Results at the Center of Radiology (Department of Radiotherapy - University Hospital of Magdeburg)

Hass¹

2016

Austin J Radiat Oncol & Cancer

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As in many other medical disciplines, a substantial change of paradigms in oncology and oncotherapy can be observed. In particular, for the treatment of solid tumor lesions the former rather rigid approach to differentiate between curative (no detection of distant metastases) and palliative intention (including systemic advancement of tumor disease) has been increasingly overcome. The concept of oligometastases has been getting more and more attention. Oligometastatic status can be classified if in first diagnosis or in follow-up investigation for tumor staging only a few distant metastases are found. According to the former guidelines, this might only lead to initiation of a palliative treatment, in the majority of cases to a systemic type of therapy! Interestingly, there has been substantial evidence that local ablation of the small number of filiae can favorably influence quality of life (the main intent of "palliative care" according to the definition by WHO) and prognosis. However, there are no predictive markers yet such as laboratory parameters, which allow to assess prognosis of a certain tumor stage / disease including oligometastases.Surgical resection was and is the gold standard of local ablation but only a certain percentage of patients with oligometastases can be approached with surgical intervention since several of them areunresectable from a technical or inoperable from an anesthesiological point of view. In addition to surgical ablation, there have been a number of non-or minimally invasive techniques available such as thermo-, chemo-and radioablading procedures.This review aims at Brachytherapy (BT) as radioablating method, its indications as part of curative concepts, the possible treatment spectrum shown in detail at the University Hospital of Magdeburg (Germany), and, in particular, indicating what is feasible and achievable from a qualitative and quantitative point of view. Finally, exemplary and representative cases document the potential benefit in radioablation of metastases.

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“…There is over a decade of literature regarding the use of this technique to treat liver metastases as well as primary liver tumors . Collettini et al treated patients with large hepatocellular carcinomas (mean, 7.1 cm [range, 5‐12 cm]) to a mean dose of 15.8 grays with a mean of 2.7 catheters .…”

mentioning

confidence: 99%

“…In another study, Ricke et al treated patients with unfavorable large liver metastases (mean, 7.7 cm [range, 5.5‐10.8 cm]) and found LC rates of 74% at 6 months and 40% at 1 year . For patients with metastatic lesions adjacent to the liver hilum, one study reported a LC rate of 88% at 1.5 years with a median overall survival of 20 months, whereas another study of liver lesions measuring >4 cm that were adjacent to the hilum demonstrated 1‐year LC rates of 81% and 73% for primary and secondary lesions, respectively . Severe toxicities were observed in <5% of interventions, with no treatment‐related deaths reported.…”

mentioning

confidence: 99%

Another solution that enables ablative radiotherapy for large liver tumors: Percutaneous interstitial high‐dose rate brachytherapy

Patel

Ragab

Kamrava

2016

Cancer

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Computed tomography-guided interstitial high dose rate brachytherapy for centrally located liver tumours: a single institution study

Abstract: • Interstitial high-dose-rate brachytherapy (IRT HDR BRT) is a promising treatment for central liver tumours • CT-guided IRT HDR BRT is safe for treating extensive tumours • CT-guided IRT HDR BRT could play a role in managing unresectable hepatic malignancies.

Cited by 33 publications

References 30 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?

Value of Brachytherapy as Part of Interdisciplinary Therapeutic Concepts for Solid Tumor Lesions – Brachytherapeutic Options and Spectrum of Treatment Results at the Center of Radiology (Department of Radiotherapy - University Hospital of Magdeburg)

Another solution that enables ablative radiotherapy for large liver tumors: Percutaneous interstitial high‐dose rate brachytherapy

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