Treatment of hepatic metastases with computed tomography‑guided interstitial brachytherapy

Kieszko, Dariusz; Cisek, Paweł; Kordzińska-Cisek, Izabela; Grzybowska‐Szatkowska, Ludmiła

doi:10.3892/ol.2018.8415

Cited by 9 publications

(8 citation statements)

References 21 publications

(38 reference statements)

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“…The study by Kieszko et al evaluated the clinical outcome of 61 patients with 73 liver secondary tumors treated with HDR-BT. LC and OS rates were 88.7%, 70.7% and 96.7%, 79.6% at 6 and 12 months respectively (45). Omari et al investigated the results of 14 patients with 54 renal cell liver metastases, treated with liver BT, reporting LC rate of 92.6% at 10.1 months and median OS of 51.2 months (62).…”

Section: Clinical Resultsmentioning

confidence: 99%

Narrative Review of High-Dose-Rate Interstitial Brachytherapy in Primary or Secondary Liver Tumors

et al. 2022

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The optimal management of intrahepatic malignancies involves a multidisciplinary approach. Although surgical resection has been considered the only curative approach, the use of several minimally invasive ablative techniques has dramatically increased the last two decades, mainly due to the fact that they provide similar oncological results with significantly decreased morbidity. Among these modalities, interstitial liver brachytherapy, probably the most flexible liver ablative method, with excellent clinical data on its safety and effectiveness, is frequently not even mentioned as an option in the current peer reviewed literature and guidelines. Brachytherapy is a type of radiotherapy utilizing radionuclides that are directly inserted into the tumor. Compared to external beam radiation therapy, brachytherapy has the potential to deliver an ablative radiation dose over a short period of time, with the advantage of a rapid dose fall-off, that allows for sparing of adjacent healthy tissue. For numerous malignancies such as skin, gynecological, breast, prostate, head and neck, bladder, liver and soft-tissue tumors, brachytherapy as a monotherapy or combined with external beam radiation therapy, has become a standard treatment for many decades. This review article aims to describe the high-dose-rate liver brachytherapy technique, its selection criteria, present its advantages and disadvantages, as well as the available clinical data, in order to help physicians to explore and hopefully introduce liver brachytherapy into their clinical routine.

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Section: Clinical Resultsmentioning

confidence: 99%

Narrative Review of High-Dose-Rate Interstitial Brachytherapy in Primary or Secondary Liver Tumors

et al. 2022

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“…Kieszko et al reported on 61 patients undergoing iBT for unresectable hepatic metastases of mixed histologies [ 31 ]. They reported OS rates after 6 months and 12 months of 96.7 and 79.6%, while the PFS rates were 78.1 and 53.8%, and the LRFS rates were 88.7 and 70.7%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Interstitial High-Dose-Rate Brachytherapy of Liver Metastases in Oligometastatic Patients

Walter

Rottler

Nierer

et al. 2021

Cancers

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Local ablative treatments have emerged as a promising treatment strategy for patients with oligometastatic disease. Among others, interstitial brachytherapy (iBT) is an upcoming treatment option for unresectable liver metastases. We report the feasibility and oncologic outcome of iBT of oligometastatic liver metastases performed in patients with limited tumor burdens in a high-volume center. Patients undergoing iBT between August 2017and March 2019 were included. A retrospective analysis of patient outcomes and treatment complications was performed. Patients treated for metastatic colorectal carcinoma (CRC) were compared to other histologies. A total of 141 iBT procedures were performed in 106 patients (male:52; female:54) and 244 liver metastases. Overall, 51% (54/106) of patients had a diagnosis of metastatic CRC. The median follow-up was 9 months, and overall survival (OS) was 92.3% at 6 months and 76.3% at 12 months. Local-relapse-free survival (LRFS) was 88.4% at 6 months and 71.5% at 12 months, with a significant difference between patients with CRC (84.1% and 50.6%) versus other histologies (92.4% and 92.4%, p < 0.001). A sub-group analysis showed a significant advantage in patients with CRC receiving a minimal dose (D100) of 20 Gy to the planning target volume. Treatments of smaller total liver-tumor volumes (<18 ccm) resulted in better LRFS rates. iBT is a safe and effective treatment approach for oligometastatic liver disease. A higher treatment dose is needed for patients with CRC. Moreover, lower metastatic burdens may be favorable for LRFS. Prospective studies are needed to assess the role of iBT in the oligometastatic setting as an alternative to other local ablative treatment approaches in patients with liver metastases.

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“…In terms of toxicity, almost 20% of patients showed higher levels of gastrointestinal toxicity or liver enzymes. Additionally, mature monoinstitutional experiences with IRT demonstrated the advantage of focal high-dose-rate interstitial radiotherapy in effectivity and economics ( 31 – 35 ).…”

Section: Evidencementioning

confidence: 99%

Personalized Image-Guided Therapies for Local Malignencies: Interdisciplinary Options for Interventional Radiology and Interventional Radiotherapy

Kovács¹,

Bischoff²,

Haddad³

et al. 2021

Front. Oncol.

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Minimal-invasive interventions considerably extend the therapeutic spectrum in oncology and open new dimensions in terms of survival, tolerability and patient-friendliness. Through the influence of image-guided interventions, many interdisciplinary therapy concepts have significantly evolved, and this process is by far not yet over. The rapid progression of minimal-invasive technologies offers hope for new therapeutic concepts in the short, medium and long term. Image-guided hybrid-technologies complement and even replace in selected cases classic surgery. In this newly begun era of immune-oncology, interdisciplinary collaboration and the focus on individualized and patient-friendly therapies are crucial.

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Treatment of hepatic metastases with computed tomography‑guided interstitial brachytherapy

Cited by 9 publications

References 21 publications

Narrative Review of High-Dose-Rate Interstitial Brachytherapy in Primary or Secondary Liver Tumors

Narrative Review of High-Dose-Rate Interstitial Brachytherapy in Primary or Secondary Liver Tumors

Interstitial High-Dose-Rate Brachytherapy of Liver Metastases in Oligometastatic Patients

Personalized Image-Guided Therapies for Local Malignencies: Interdisciplinary Options for Interventional Radiology and Interventional Radiotherapy

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