Efficacy and safety of percutaneous computed tomography-guided high-dose-rate interstitial brachytherapy in treatment of oligometastatic lymph node metastases of retroperitoneal space

Heinze, Constanze; Omari, Jazan; Manig, Matthias; Hass, Peter; Venerito, Marino; Damm, Robert; Jargiełło, Tomasz; Ricke, Jens; Powerski, Maciej; Pech, Maciej

doi:10.5114/jcb.2019.88141

Cited by 7 publications

(2 citation statements)

References 34 publications

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“…CT-guided pelvic nodal ISBT can be performed safely. Although safety and feasibility of CT-guided HDR ISBT for oligometastatic retroperitoneal nodes from different primary tumors has been reported in the past (15), the novelty of our study is that it was carried out in a relatively uniform subset of patients using the best currently available imaging technology. The excellent outcome reported in this small retrospective study supports further investigation and development of this technique.…”

Section: Discussionmentioning

confidence: 99%

CT-Guided Pelvic Lymph Nodal Brachytherapy

et al. 2021

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PurposeThis is a report of our initial experience using computed tomography (CT)-guided interstitial high dose rate (HDR) brachytherapy to treat bulky pelvic nodal metastases as a part of definitive radiotherapy.Material and methodsBetween February 2015 and April 2019, 14 cervical/endometrial cancer patients presenting with bulky pelvic node(s) underwent nodal interstitial brachytherapy boost in our institution. In total, 17 nodes were treated. The median maximum diameters of the positive nodes at the time of diagnosis and at the first nodal implant were 25 mm (range: 10–65 mm) and 16 mm (range: 9–51 mm), respectively. Dosimetry data of the lymph nodal target volume and small bowel were collected and compared using the paired-sample t-test. Treatment-related toxicities were classified using the Common Terminology Criteria for Adverse Events version 4.0.ResultsThe median follow-up time for all patients was 26 months. Local recurrence in pelvic nodes occurred in one patient (7%) after 16 months. One patient experienced grade 3 bladder bleeding, and one patient experienced grade 2 pubic bone fracture. No patient had grade 2 or greater gastrointestinal toxicity. In the dosimetric analysis, the mean nodal brachytherapy D90% in terms of the total equivalent dose of 2 Gy (EQD2) was 65.6 Gyαβ10. The mean small bowel dose (SBD)0.1cc and SBD1cc in terms of the total EQD2 were 60.4 and 56.5 Gyαβ3, respectively. Nodal D90% was significantly higher in terms of the total EQD2 than the SBD0.1cc (p = 0.003) and SBD1cc (p < 0.001). The Kaplan-Meier 2-year pelvic control estimate was 90%.ConclusionsCT-guided interstitial HDR pelvic nodal brachytherapy appears to be well tolerated with excellent local control in cervical or endometrial cancer patients with bulky pelvic nodes. This approach may offer a useful therapeutic option for unresected bulky pelvic nodes.

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Section: Discussionmentioning

confidence: 99%

CT-Guided Pelvic Lymph Nodal Brachytherapy

et al. 2021

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“…Roddiger et al reported on 53 patients treated with HDR ISBT as neoadjuvant radiotherapy [7]. However, little is known about the clinical value of computed tomography (CT)-guided breast ISBT, especially for breast cancer patients with unresectable bulky tumors, even though CT-guided ISBT is a safe and feasible treatment approach for many cancer types [8][9][10]. Here, we describe the technique of CT-guided HDR ISBT and the efficacy of ISBT plus EBRT with hormonal therapy as a therapeutic option in patients with unresectable chest wall recurrence of breast cancer.…”

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confidence: 99%

Unresectable bulky chest wall recurrent breast cancer controlled with CT-guided interstitial high-dose-rate brachytherapy and external beam radiotherapy with adjuvant hormonal therapy – case report

Kunogi¹,

Hsu²,

Sasai³

2021

jcb

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Purpose: Bulky chest wall recurrence after mastectomy presents a therapeutic challenge because of high-dose of radiation required to control the disease, and its proximity to low-tolerance organs at risk. We report a case of successful computed tomography (CT)-guided high-dose-rate (HDR) salvage interstitial brachytherapy (ISBT) boost.Material and methods: A 70-year-old female initially presented with a tumor in right breast, and was treated with mastectomy and adjuvant chemotherapy, followed by hormonal therapy for 5 years without adjuvant radiotherapy. In 2018, 20 years after the initial treatment, she developed unresectable chest wall recurrence that measured 10.5 cm × 7.3 cm × 4.5 cm, with bone and parietal pleura invasion. Biopsy revealed invasive pleomorphic lobular carcinoma [estrogen receptor (ER)-positive, progesterone receptor (PR)-negative, HER2-negative]. There was no evidence of metastatic disease.Results: The patient underwent external beam radiotherapy (EBRT) plus ISBT. After EBRT of 50 Gy in 25 fractions was completed, CT-guided ISBT was performed as an outpatient treatment. HDR dose was 16 Gy delivered in 2 fractions with 2 implants. Dose was prescribed to gross tumor volume. ISBT plans were created using inverse planning simulated annealing (IPSA) algorithm. Gross tumor volume D 90% plus EBRT dose was 82 Gy equivalent dose of 2 Gy (EQD 2 ), assuming α/β of 4 for breast carcinoma. The patient continued on hormonal therapy. At the 30-month follow-up, the patient remains in remission. The tumor could not be detected by magnetic resonance imaging (MRI) or positron emission tomography (PET). There were no severe treatment-related complications.Conclusions: CT-guided HDR ISBT boost can be a useful modality in individualizing treatment strategies for breast cancer patients with unresectable bulky chest wall recurrence.

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Image-Guided HDR Brachytherapy of Abdominal Lymph Nodes, Pancreatic, and Peritoneal Neoplasms

Hass

2021

Manual on Image-Guided Brachytherapy of Inner Organs

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Efficacy and safety of percutaneous computed tomography-guided high-dose-rate interstitial brachytherapy in treatment of oligometastatic lymph node metastases of retroperitoneal space

Cited by 7 publications

References 34 publications

CT-Guided Pelvic Lymph Nodal Brachytherapy

CT-Guided Pelvic Lymph Nodal Brachytherapy

Unresectable bulky chest wall recurrent breast cancer controlled with CT-guided interstitial high-dose-rate brachytherapy and external beam radiotherapy with adjuvant hormonal therapy – case report

Image-Guided HDR Brachytherapy of Abdominal Lymph Nodes, Pancreatic, and Peritoneal Neoplasms

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