CT-guided high-dose-rate brachytherapy in the interdisciplinary treatment of patients with liver metastases of pancreatic cancer

作     者：Gero Wieners Alexander Christian Schippers Federico Collettini Dirk Schnapauff Bernd Hamm Peter Wust Hanno Riess Bernhard Gebauer 

作者机构：Department of Diagnostic and Interventional Radiology Charité-Universit?tsmedizin Berlin Campus Virchow-Klinikum Department of Radiation Oncology Charité-Universit?tsmedizin Berlin Campus Virchow-Klinikum Department of Oncology Charité-Universit?tsmedizin Berlin Campus Virchow-Klinikum 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2015年第14卷第5期

页      面：530-538页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：brachytherapy pancreatic cancer liver metastases CT intervention 

摘      要：BACKGROUND： CT-guided high-dose-rate brachytherapy（CT-HDRBT） is an interventional radiologic technique for local ablation of primary and secondary malignomas applying a radiation source through a brachycatheter percutaneously into the targeted lesion. The aim of this study was to assess local tumor control, safety and efficacy of CT-HDRBT in the treatment of liver metastases of pancreatic cancer. METHODS： Twenty consecutive patients with 49 unresectable liver metastases of pancreatic cancer were included in this retrospective trial and treated with CT-HDRBT, applied as a single fraction high-dose irradiation（15-20 Gy） using a 192 Irsource. Primary endpoint was local tumor control and secondary endpoints were complications, progression-free survival and overall ***： The mean tumor diameter was 29 mm（range 10-73）. The mean irradiation time was 20 minutes（range 7-42）. The mean coverage of the clinical target volume was 98%（range 88%-100%）. The mean D100 was 18.1 Gy and the median D100 was 19.78 Gy. Three major complications occurred with post-interventional abscesses, three of which were seen in 15 patients with biliodigestive anastomosis（20%）and overall 15%. The mean follow-up time was 13.7 months（range 1.4-55.0）. The median progression-free survival was 4.9 months（range 1.4-42.9, mean 9.4）. Local recurrence occurred in 5（10%） of 49 metastases treated. The median overall survival after CT-HDRBT was 8.6 months（range 1.5-55.3）. Eleven patients received chemotherapy after ablation with a median progression-free survival of 4.9 months（mean 12.9）. Nine patients did not receive chemotherapy after intervention with a median progression-free survival of 3.2 months（mean 5.0）. The rate of local tumor control was 91% in both groups after 12 ***： CT-HDRBT was safe and effective for the treatment of liver metastases of pancreatic cancer.