Computed tomography-guided interstitial HDR brachytherapy (CT-HDRBT) of the liver in patients with irresectable intrahepatic cholangiocarcinoma

TY - JOUR

T1 - Computed tomography-guided interstitial HDR brachytherapy (CT-HDRBT) of the liver in patients with irresectable intrahepatic cholangiocarcinoma

AU - Schnapauff, Dirk

AU - Denecke, Timm

AU - Grieser, Christian

AU - Collettini, Federico

AU - Colletini, Federico

AU - Seehofer, Daniel

AU - Sinn, Marianne

AU - Banzer, Jan

AU - Lopez-Hänninen, Enrique

AU - Hamm, Bernd

AU - Wust, Peter

AU - Gebauer, Bernhard

PY - 2012/6

Y1 - 2012/6

N2 - PURPOSE: This study was designed to investigate the clinical outcome of patients with irresectable, intrahepatic cholangiocarcinoma (IHC) treated with computed tomography (CT)-guided HDR-brachytherapy (CT-HDRBT) for local tumor ablation.METHOD: Fifteen consecutive patients with histologically proven cholangiocarcinoma were selected for this retrospective study. Patients were treated by high-dose-rate internal brachytherapy (HDRBT) using an Iridium-192 source in afterloading technique through CT-guided percutaneous placed catheters. A total of 27 brachytherapy treatments were performed in these patients between 2006 and 2009. Median tumor enclosing target dose was 20 Gy, and mean target volume of the radiated tumors was 131 (±90) ml (range, 10-257 ml). Follow-up consisted of clinical visits and magnetic resonance imaging of the liver every third month. Statistical evaluation included survival analysis using the Kaplan-Meier method.RESULTS: After a median follow-up of 18 (range, 1-27) months after local ablation, 6 of the 15 patients are still alive; 4 of them did not get further chemotherapy and are regarded as disease-free. The reached median local tumor control was 10 months; median local tumor control, including repetitive local ablation, was 11 months. Median survival after local ablation was 14 months and after primary diagnosis 21 months.CONCLUSION: In view of current clinical data on the clinical outcome of cholangiocarcinoma, locally ablative treatment with CT-HDRBT represents a promising and safe technique for patients who are not eligible for tumor resection.

AB - PURPOSE: This study was designed to investigate the clinical outcome of patients with irresectable, intrahepatic cholangiocarcinoma (IHC) treated with computed tomography (CT)-guided HDR-brachytherapy (CT-HDRBT) for local tumor ablation.METHOD: Fifteen consecutive patients with histologically proven cholangiocarcinoma were selected for this retrospective study. Patients were treated by high-dose-rate internal brachytherapy (HDRBT) using an Iridium-192 source in afterloading technique through CT-guided percutaneous placed catheters. A total of 27 brachytherapy treatments were performed in these patients between 2006 and 2009. Median tumor enclosing target dose was 20 Gy, and mean target volume of the radiated tumors was 131 (±90) ml (range, 10-257 ml). Follow-up consisted of clinical visits and magnetic resonance imaging of the liver every third month. Statistical evaluation included survival analysis using the Kaplan-Meier method.RESULTS: After a median follow-up of 18 (range, 1-27) months after local ablation, 6 of the 15 patients are still alive; 4 of them did not get further chemotherapy and are regarded as disease-free. The reached median local tumor control was 10 months; median local tumor control, including repetitive local ablation, was 11 months. Median survival after local ablation was 14 months and after primary diagnosis 21 months.CONCLUSION: In view of current clinical data on the clinical outcome of cholangiocarcinoma, locally ablative treatment with CT-HDRBT represents a promising and safe technique for patients who are not eligible for tumor resection.

KW - Aged

KW - Aged, 80 and over

KW - Bile Duct Neoplasms

KW - Bile Ducts, Intrahepatic

KW - Brachytherapy/methods

KW - Chi-Square Distribution

KW - Cholangiocarcinoma/diagnostic imaging

KW - Contrast Media

KW - Female

KW - Gadolinium DTPA

KW - Humans

KW - Kaplan-Meier Estimate

KW - Liver Neoplasms/diagnostic imaging

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Radiography, Interventional/methods

KW - Retrospective Studies

KW - Tomography, X-Ray Computed/methods

KW - Treatment Outcome

U2 - 10.1007/s00270-011-0249-0

DO - 10.1007/s00270-011-0249-0

M3 - SCORING: Journal article

C2 - 21833806

VL - 35

SP - 581

EP - 587

JO - CARDIOVASC INTER RAD

JF - CARDIOVASC INTER RAD

SN - 0174-1551

IS - 3

ER -