Klinik für Radiologie und Nuklearmedizin, Otto-von-Guericke-University Magdeburg, Germany.
Radiother Oncol. 2011 Aug;100(2):314-9. doi: 10.1016/j.radonc.2011.03.005. Epub 2011 Apr 16.
The aim of the study was the evaluation of feasibility, safety and effectiveness of interstitial brachytherapy for the treatment of hepatic metastases of breast cancer.
Forty-one consecutive patients with 115 unresectable hepatic metastases of breast cancer were included in this phase-II-trial. They were treated in 69 interventions of CT-guided-interstitial-brachytherapy of the liver. Brachytherapy was applied as a single fraction high-dose-irradiation (15-25Gy (Gray)) using a (192)Ir-source of 10Ci. Nineteen patients presented systemically pretreated extrahepatic tumors. Primary endpoints were complications, local tumor control and progression-free survival.
The median tumor diameter was 4.6 cm (1.5-11 cm). The median irradiation time per intervention was 26.5 min (range: 7-47 min). The applied median minimal dose at the CTV (clinical target volume) margin was 18.5 Gy (12-25 Gy). In 69 interventions and during the postinterventional period, one major complication (symptomatic post-interventional bleeding) (1.5%) and six minor complications occurred (8.7%). The median follow-up time was 18 months (range: 1-56). After 6, 12 and 18 months, local tumor control was 97%, 93.5% and 93.5%, intra- and extrahepatic progression free survival was 53%, 40% and 27%, and overall survival was 97%, 79% and 60%, respectively.
CT-guided-brachytherapy is safe and effective for the treatment of liver metastases of breast cancer.
本研究旨在评估间质近距离放疗治疗乳腺癌肝转移的可行性、安全性和有效性。
本研究为 II 期临床试验，共纳入 41 例 115 处不可切除的乳腺癌肝转移灶患者，共行 69 次 CT 引导下肝脏间质近距离放疗。采用 10Ci（居里）192Ir 源单次大剂量（15-25Gy）照射，行肝内间质近距离放疗。19 例患者合并肝外远处转移灶，已接受系统治疗。主要终点为并发症、局部肿瘤控制率和无进展生存期。
肿瘤直径中位数为 4.6cm（1.5-11cm）。单次介入治疗的中位照射时间为 26.5min（7-47min）。CTV（临床靶区）边缘的中位最小照射剂量为 18.5Gy（12-25Gy）。69 次介入治疗及术后期间，1 例出现严重并发症（症状性术后出血）（1.5%），6 例出现轻微并发症（8.7%）。中位随访时间为 18 个月（1-56 个月）。6、12、18 个月时，局部肿瘤控制率分别为 97%、93.5%、93.5%，肝内和肝外无进展生存率分别为 53%、40%、27%，总生存率分别为 97%、79%、60%。
CT 引导下近距离放疗治疗乳腺癌肝转移安全有效。
