Department of Radiation Oncology, Wakayama Medical University, Wakayama City, 641-8510 Japan.
J Radiat Res. 2012 Sep;53(5):807-14. doi: 10.1093/jrr/rrs047. Epub 2012 Jul 17.
We developed and evaluated the feasibility of a brachytherapy technique as a safe and effective treatment for adrenal metastasis. Adapting a paravertebral insertion technique in radiofrequency ablation of adrenal tumors, we developed an interstitial brachytherapy for adrenal metastasis achievable on an outpatient basis. Under local anesthesia and under X-ray CT guidance, brachytherapy applicator needles were percutaneously inserted into the target. A treatment plan was created to eradicate the tumor while preserving normal organs including the spinal cord and kidney. We applied this interstitial brachytherapy technique to two patients: one who developed adrenal metastasis as the third recurrence of uterine cervical cancer after reirradiation, and one who developed metachronous multiple metastases from malignant melanoma. The whole procedure was completed in 2.5 hours. There were no procedure-related or radiation-related early/late complications. FDG PET-CT images at two and three months after treatment showed absence of FDG uptake, and no recurrence of the adrenal tumor was observed for over seven months until expiration, and for six months until the present, respectively. This interventional interstitial brachytherapy procedure may be useful as a safe and eradicative treatment for adrenal metastasis.
我们开发并评估了一种近距离放射治疗技术作为治疗肾上腺转移的安全有效的方法。我们从肾上腺肿瘤射频消融的椎旁入路技术中进行了改进，开发了一种适用于门诊的肾上腺转移的间质近距离放射治疗方法。在局部麻醉和 X 射线 CT 引导下，经皮将放射性治疗施源器针插入目标。制定了治疗计划，以消灭肿瘤，同时保护包括脊髓和肾脏在内的正常器官。我们将这种间质近距离放射治疗技术应用于两名患者：一名患者是宫颈癌放疗后第三次复发出现肾上腺转移，另一名患者是恶性黑色素瘤同时发生多个转移。整个过程在 2.5 小时内完成。没有与手术或放射相关的早期/晚期并发症。治疗后 2 个月和 3 个月的 FDG PET-CT 图像显示 FDG 摄取消失，肾上腺肿瘤无复发，分别超过 7 个月，直到死亡，6 个月，直到现在。这种介入性间质近距离放射治疗方法可能是一种安全有效的治疗肾上腺转移的方法。
