Schippers Alexander C, Collettini Federico, Steffen Ingo G, Wieners Gero, Denecke Timm, Pavel Marianne, Wust Peter, Gebauer Bernhard
Departments of Diagnostic and Interventional Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany.
Departments of Diagnostic and Interventional Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany.
J Vasc Interv Radiol. 2017 May;28(5):672-682. doi: 10.1016/j.jvir.2016.07.011. Epub 2016 Sep 16.
To evaluate efficacy of computed tomography (CT)-guided high-dose-rate brachytherapy (HDRBT) of neuroendocrine liver metastases (NELM) with the goal of local tumor control (LTC).
This retrospective study included all patients with unresectable NELM treated with CT-guided HDRBT between January 2007 and April 2015. Magnetic resonance imaging follow-up was performed 6 weeks after ablation and then every 3 months. The primary endpoint was LTC. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and complications.
In 27 patients, 52 NELM were treated in 40 sessions. Three patients (11.1%) developed local progression with LTC of 1.9-36.8 months (median 10.4 months, mean 16.4 months). The remaining 24 patients (89.9%) had LTC of 3.1-106.1 months (median 31.3 months, mean 32.6 months). Progression or death was observed in 19 patients (70.4%) with PFS of 1.9-55.3 months (median 7.3 months, mean 16.3 months); the remaining 8 patients (29.6%) had PFS of 3.7-50.1 months (median 13.4 months, mean 19.6 months). Four patients (14.8%) died of causes unrelated to the procedure; their OS was 11.7-52.3 months (median 48.7 months, mean 40.4 months). OS was 4.2-106.1 months (median 30.3 months, mean 34.1 months) in the 23 surviving patients (85.2%). One patient experienced pain with nausea and vomiting, and 1 patient with biliodigestive anastomosis had a hepatic abscess.
CT-guided HDRBT is a promising therapy with excellent LTC rates and low morbidity for patients with isolated/oligometastatic NELM.
评估计算机断层扫描（CT）引导下高剂量率近距离放射治疗（HDRBT）对神经内分泌肝转移瘤（NELM）实现局部肿瘤控制（LTC）的疗效。
这项回顾性研究纳入了2007年1月至2015年4月期间接受CT引导下HDRBT治疗的所有不可切除NELM患者。消融术后6周进行磁共振成像随访，之后每3个月进行一次。主要终点是LTC。次要终点包括无进展生存期（PFS）、总生存期（OS）和并发症。
27例患者中，共40个疗程治疗了52个NELM。3例患者（11.1%）出现局部进展，LTC为1.9 - 36.8个月（中位10.4个月，平均16.4个月）。其余24例患者（89.9%）的LTC为3.1 - 106.1个月（中位31.3个月，平均32.6个月）。19例患者（70.4%）出现进展或死亡，PFS为1.9 - 55.3个月（中位7.3个月，平均16.3个月）；其余8例患者（29.6%）的PFS为3.7 - 50.1个月（中位13.4个月，平均19.6个月）。4例患者（14.8%）死于与手术无关的原因；其OS为11.7 - 52.3个月（中位48.7个月，平均40.4个月）。23例存活患者（85.2%）的OS为4.2 - 106.1个月（中位30.3个月，平均34.1个月）。1例患者出现疼痛伴恶心呕吐，1例胆肠吻合患者发生肝脓肿。
对于孤立/寡转移NELM患者，CT引导下HDRBT是一种有前景的治疗方法，具有出色的LTC率和低发病率。
