Department of Radiation Oncology, Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, Germany.
Eur Radiol. 2013 Aug;23(8):2264-70. doi: 10.1007/s00330-013-2816-z. Epub 2013 Mar 21.
To evaluate the clinical outcome of computed tomography (CT)-guided interstitial (IRT) high-dose-rate (HDR) brachytherapy (BRT) in the treatment of unresectable primary and secondary liver malignancies. This report updates and expands our previously described experience with this treatment technique.
Forty-one patients with 50 tumours adjacent to the liver hilum and bile duct bifurcation were treated in 59 interventions of CT-guided IRT HDR BRT. The tumours were larger than 4 cm with a median volume of 84 cm(3) (38-1,348 cm(3)). The IRT HDR BRT delivered a median total physical dose of 20.0 Gy (7.0-32.0 Gy) in twice daily fractions of median 7.0 Gy (4.0-10.0 Gy) in 19 patients and in once daily fractions of median 8.0 Gy (7.0-14.0 Gy) in 22 patients.
With a median follow-up of 12.4 months, the local control for metastatic hepatic tumours was 89 %, 73 % and 63 % at 6, 12 and 18 months respectively. The local control for primary hepatic tumours was 90 %, 81 % and 50 % at 6, 12 and 18 months respectively. Severe side effects occurred in 5.0 % of interventions with no treatment-related deaths.
CT-guided IRT HDR BRT is a promising procedure for the radiation treatment of centrally located liver malignancies.
• Interstitial high-dose-rate brachytherapy (IRT HDR BRT) is a promising treatment for central liver tumours • CT-guided IRT HDR BRT is safe for treating extensive tumours • CT-guided IRT HDR BRT could play a role in managing unresectable hepatic malignancies.
评估计算机断层扫描（CT）引导下间质（IRT）高剂量率（HDR）近距离放疗（BRT）治疗不可切除原发性和继发性肝恶性肿瘤的临床疗效。本报告更新并扩展了我们之前对该治疗技术的描述。
41 名患者的 50 个肿瘤位于肝门和胆管分叉附近，在 59 次 CT 引导下 IRT HDR BRT 治疗中进行了治疗。肿瘤大于 4cm，中位体积为 84cm3（38-1348cm3）。IRT HDR BRT 单次治疗的中位总物理剂量为 20.0Gy（7.0-32.0Gy），19 例患者每日两次，每次 7.0Gy（4.0-10.0Gy），22 例患者每日一次，每次 8.0Gy（7.0-14.0Gy）。
中位随访 12.4 个月后，转移性肝肿瘤的局部控制率分别为 6、12 和 18 个月时的 89%、73%和 63%。原发性肝肿瘤的局部控制率分别为 6、12 和 18 个月时的 90%、81%和 50%。5.0%的治疗中发生严重不良反应，无治疗相关死亡。
CT 引导下 IRT HDR BRT 是治疗中央型肝恶性肿瘤的一种很有前途的方法。
• 间质高剂量率近距离放疗（IRT HDR BRT）是治疗中央型肝肿瘤的一种很有前途的治疗方法。• CT 引导下 IRT HDR BRT 治疗广泛肿瘤是安全的。• CT 引导下 IRT HDR BRT 可在治疗不可切除的肝恶性肿瘤中发挥作用。
