Liver Malignancies: CT-Guided Interstitial Brachytherapy in Patients with Unfavorable Lesions for Thermal Ablation

Ricke, Jens; Wust, Peter; Wieners, Gero; Beck, Alexander; Cho, Chie Hee; Seidensticker, Max; Pech, Maciej; Werk, Michael; Rosner, Christian; Hänninen, Enrique Lopez; Freund, Torsten; Félix, R.

doi:10.1097/01.rvi.0000141343.43441.06

Cited by 108 publications

(79 citation statements)

References 30 publications

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“…The role of interstitial radiotherapy has been an area of active research in last two decades. In the past, two similar approaches have been described for liver brachytherapy namely seldinger catheter replacement technique and proguide round needle technique with mean local tumour control of 88-100% at 1year follow up and severe toxicity occurred in less than 5% of patient [5,6]. But there has been a challenge to use these techniques amongst radiation oncologists due to the complex technique, lack of precision in brachytherapy catheter insertion and placement,…”

Section: Discussionmentioning

confidence: 99%

“…A recent meta-analysis showed the pooled local control rates of SBRT and charged particle therapy to be 87% and 86%, respectively, and the rates of acute hepatic toxicities of grade >3 to be 4.9% and 3.1%, respectively [4]. Similar to precise SBRT and charged particle radiotherapy, investigators have used computer tomography (CT) guided Interstitial High Dose Rate Brachytherapy to treat unresectable liver tumours which showed increasing median survival to 14-36months with 11-20% mild and <5% severe complication rate [5,6]. The CT guided iHDRBT for HCC may be an effective alternative modality for non-transplant candidates, unresectable cases and patients unsuitable/ refractory for radiofrequency ablation (RFA), SBRT, Trans-Arterial Chemo-Embolisation (TACE) or sorafenib.…”

Section: Introductionmentioning

confidence: 99%

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Image guided robotic interstitial brachytherapy, a new innovative treatment for malignancies

Vishwanathan¹,

Mandal²,

Kumar³

et al. 2018

Hematol Med Oncol

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Introduction: The evolution of brachytherapy has been refined over years, but many of the techniques remain unchanged. The limited utilisation of brachytherapy in comparison to conformal external radiotherapy may be due to its invasive approach, operative risk, technical challenge, time consuming, long learning curve and poor technological advancements. However, there is growing evidence for practicing hypo-fractionated regimes in many solid malignancies. The present article focus on the similar roles of image guided -robotic interstitial high dose rate brachytherapy with hepatocellular carcinoma (HCC) as prototype.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Image guided robotic interstitial brachytherapy, a new innovative treatment for malignancies

Vishwanathan¹,

Mandal²,

Kumar³

et al. 2018

Hematol Med Oncol

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“…Feasibility, safety and benefit of this minimally invasive type of radiation has been proven by numerous retro-and prospective studies and analyses in the mean time [26,31,81,82], which thus occupies an established place in the reporting department. This has become possible by the close collaboration with interventional radiologists and all the transfering oncological disciplines in medicine, in particular, with abdominal surgery.…”

Section: Brachytherapy In Intraluminal Tumor Lesionsmentioning

confidence: 99%

“…Primary aim was to achieve local symptom control by radiationinduced cytoreduction with palliative intention at the beginning [26] but the study results showed that in numerous cases, a sustainable local control sometime even an improvement of the overall prognosis became possible.…”

Section: Brachytherapy In Intraluminal Tumor Lesionsmentioning

confidence: 99%

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Value of Brachytherapy as Part of Interdisciplinary Therapeutic Concepts for Solid Tumor Lesions – Brachytherapeutic Options and Spectrum of Treatment Results at the Center of Radiology (Department of Radiotherapy - University Hospital of Magdeburg)

Hass¹

2016

Austin J Radiat Oncol & Cancer

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As in many other medical disciplines, a substantial change of paradigms in oncology and oncotherapy can be observed. In particular, for the treatment of solid tumor lesions the former rather rigid approach to differentiate between curative (no detection of distant metastases) and palliative intention (including systemic advancement of tumor disease) has been increasingly overcome. The concept of oligometastases has been getting more and more attention. Oligometastatic status can be classified if in first diagnosis or in follow-up investigation for tumor staging only a few distant metastases are found. According to the former guidelines, this might only lead to initiation of a palliative treatment, in the majority of cases to a systemic type of therapy! Interestingly, there has been substantial evidence that local ablation of the small number of filiae can favorably influence quality of life (the main intent of "palliative care" according to the definition by WHO) and prognosis. However, there are no predictive markers yet such as laboratory parameters, which allow to assess prognosis of a certain tumor stage / disease including oligometastases.Surgical resection was and is the gold standard of local ablation but only a certain percentage of patients with oligometastases can be approached with surgical intervention since several of them areunresectable from a technical or inoperable from an anesthesiological point of view. In addition to surgical ablation, there have been a number of non-or minimally invasive techniques available such as thermo-, chemo-and radioablading procedures.This review aims at Brachytherapy (BT) as radioablating method, its indications as part of curative concepts, the possible treatment spectrum shown in detail at the University Hospital of Magdeburg (Germany), and, in particular, indicating what is feasible and achievable from a qualitative and quantitative point of view. Finally, exemplary and representative cases document the potential benefit in radioablation of metastases.

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Neuroendocrine Tumors of the Pancreas

Carolan

Chung

2015

Yamada' S Textbook of Gastroenterology

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Liver Malignancies: CT-Guided Interstitial Brachytherapy in Patients with Unfavorable Lesions for Thermal Ablation

Cited by 108 publications

References 30 publications

Image guided robotic interstitial brachytherapy, a new innovative treatment for malignancies

Image guided robotic interstitial brachytherapy, a new innovative treatment for malignancies

Value of Brachytherapy as Part of Interdisciplinary Therapeutic Concepts for Solid Tumor Lesions – Brachytherapeutic Options and Spectrum of Treatment Results at the Center of Radiology (Department of Radiotherapy - University Hospital of Magdeburg)

Neuroendocrine Tumors of the Pancreas

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