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

Treatment of hepatic metastases with computed tomography‑guided interstitial brachytherapy

Authors:
- Dariusz Kieszko
- Paweł Cisek
- Izabela Kordzińska‑Cisek
- Ludmiła Grzybowska‑Szatkowska
View Affiliations

Affiliations: Department of Brachytherapy, St. John's Cancer Center, 20‑090 Lublin, Poland, Department of Oncology, Medical University of Lublin, 20‑059 Lublin, Poland
Published online on: April 2, 2018 https://doi.org/10.3892/ol.2018.8415
Pages: 8717-8722

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

The aim of the present study was to evaluate the efficacy, safety and tolerability of local treatment of liver metastases of various types of cancer using brachytherapy with computed tomography (CT) imaging. Retrospective analysis of 61 patients with unresectable hepatic metastases treated with CT‑guided interstitial high dose rate (HDR) brachytherapy of the liver between April 2014 and December 2016 was performed. Patients were treated with a single fractional dose of 15‑25 Gy. Statistical analysis was performed on local relapse free survival (LRFS), progression free survival (PFS) and overall survival (OS) rates across the group. In the 6 and 12‑month follow‑up periods, the 6‑ and 12‑month LRFS rates were 88.7 and 70.7%, PFS rates were 78.1 and 53.8% and the OS rates were 96.7 and 79.6%, respectively. In the Cox regression analysis, the 100% isodose was a statistically significant predictor of LRFS (P=0.01) and PFS (P=0.02), but it was not significant in OS (P=0.07). The 90% isodose was a statistically significant predictor of LRFS (P=0,03) but not significant in PFS (P=0.17) or OS (P=0.25). In all patients, no serious complications were observed. Overall, 30% of patients experienced pain at the injection site, and 50% exhibited nausea or vomiting. In 2 patients, minor subcapsular bleeding occurred without clinical significance, and 1 patient was diagnosed with a pneumothorax that was not clinically significant. Brachytherapy HDR with CT imaging is an effective and safe method of local treatment of liver metastases. The effectiveness of the treatment is probably dose‑dependent, and increases with increasing dosage.

View Figures

View References

1	Turdean S, Gurzu S, Turcu M, Voidăzan S and Sin A: Liver metastases: Incidence and clinicopathological data. Acta Medica Marisiensis. 58:254–258. 2012.
2	Tarasik A, Jaroszewicz J and Januszkiewicz M: Surgical treatment of liver tumors - own experience and literature review. Clin Exp Hepatol. 3:1–8. 2017. View Article : Google Scholar : PubMed/NCBI
3	Swaid F, Downs D and Rosemurgy AS: A practical approach to liver metastasis from unknown primary cancer: What surgeons need to know. Cancer Genet. 209:559–566. 2016. View Article : Google Scholar : PubMed/NCBI
4	Hijazi H, Campeau MP, Roberge D, Donath D, Lapointe R, Vanderbroucke-Menu F, Taussky D, Boudam K, Chan G, Bujold A and Delouya G: Stereotactic body radiotherapy for inoperable liver tumors: Results of a single institutional experience. Cureus. 8:e9352016.PubMed/NCBI
5	de Baere T, Tselikas L, Yevich S, Boige V, Deschamps F, Ducreux M, Goere MD, Nguyen F and Malka D: The role of image-guided therapy in the management of colorectal cancer metastatic disease. Eur J Cancer. 75:231–242. 2017. View Article : Google Scholar : PubMed/NCBI
6	Kennedy AS: Radiation oncology approaches in liver malignancies. Am Soc Clin Oncol Educ Book. e150–e155. 2014. View Article : Google Scholar : PubMed/NCBI
7	Dawood O, Mahadevan A and Goodman KA: Stereotactic body radiation therapy for liver metastases. Eur J Cancer. 45:2947–2959. 2009. View Article : Google Scholar : PubMed/NCBI
8	Brethsneider T, Ricke J, Gebauer B and Streitparth F: Image-guided high dose rate brachytherapy of malignances in various organs-technique, indications and perspectives. J Contemp Brachytherapy. 8:251–261. 2016. View Article : Google Scholar : PubMed/NCBI
9	Kordzińska-Cisek I, Brzozowska A, Cisek P, Kijek J and Mazurkiewicz M: The role of radiotherapy in the treatment of hepatic neoplasms. Oncol Radiother. 36:53–60. 2016.
10	Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, et al: New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer. 45:228–247. 2009. View Article : Google Scholar : PubMed/NCBI
11	Picot J, Cooper K, Bryant J and Clegg AJ: The clinical effectiveness and cost-effectiveness of Bortezomib and thalidomide in combination regimens with an alkylating agent and a corticosteroid for the first-line treatment of multiple myeloma: A systematic review and economic evaluation. Health Technol Assess. 15:1–204. 2011. View Article : Google Scholar
12	Marinello G and Pierquin B: The Paris system, optimization of dose, and calculation of treatment timeA practical manual of Brachytherapy. Medical Physics Publishing; Madison, WI: pp. 53–68. 1997
13	Ricke J, Wust P, Wieners G, Beck A, Cho C, Seidensicker M, Pech M, Werk M, Rosner C, Hänninen EL, et al: Liver malignancies: CT-guided interstitial brachytherapy in patients with unfavorable lesions for thermal ablation. J Vasc Interv Radiol. 15:1279–1286. 2004. View Article : Google Scholar : PubMed/NCBI
14	U.S. Department Of Health And Human Services, . National Institutes of Health, National Cancer Institute: Common Terminology Criteria for Adverse Events (CTCAE). Version v4.03. http://www.oncology.tv/SymptomManagement/NationalCancerInstituteUpdatesCTCAEtov403.aspxJune 14–2010
15	Cisek P, Kordzińska-Cisek I, Charkot Ł, Korona P, Kieszko D, Bilski M, Brzozowska A, Janiszewski M and Grzybowska-Szatkowska L: Biochemical liver function markers after CT-guided brachytherapy for liver metastases. Oncol Radiotherap. 39:67–75. 2017.
16	Ricke J, Mohnike K, Pech M, Seidensticker M, Rühl R, Wieners G, Gaffke G, Kropf S, Felix R and Wust P: Local response and impact on survival after local ablation of liver metastases from colorectal carcinoma by computed tomography-guided high-dose-rate brachytherapy. Int J Radiat Oncol Biol Phys. 78:479–485. 2010. View Article : Google Scholar : PubMed/NCBI
17	Mohnike K, Wieners G, Pech M, Seidensticker M, Rühl R, Lopez-Haenninen E and Ricke J: Image-guided interstitial high-dose-rate brachytherapy in hepatocellular carcinoma. Dig Dis. 27:170–174. 2009. View Article : Google Scholar : PubMed/NCBI
18	Wieners G, Mohnike K, Peters N, Bischoff J, Kleine-Tebbe A, Seidensticker R, Seidensticker M, Gademann G, Wust P, Pech M and Ricke J: Treatment of hepatic metastases of breast cancer with CT-guided interstitial brachytherapy-a phase II-study. Radiother Oncol. 100:314–319. 2011. View Article : Google Scholar : PubMed/NCBI
19	Wieners G, Schippers AC, Collettini F, Schnapauff D, Hamm B and Gebauer B: CT-guided high-dose-rate brachytherapy in the interdisciplinary treatment of patients with liver metastases of pancreatic cancer. Hepatobiliary Pancreat Dis Int. 14:530–538. 2015. View Article : Google Scholar : PubMed/NCBI
20	Schippers AC, Collettini F, Steffen IG, Wieners G, Denecke T, Pavel M, Wust P and Gebauer B: Initial experience with CT-guided high-dose-rate brachytherapy in the multimodality treatment of neuroendocrine tumor liver metastases. J Vasc Interv Radiol. 28:672–682. 2017. View Article : Google Scholar : PubMed/NCBI
21	Bretschneider T, Mohnike K, Hass P, Seidensticker R, Göppner D, Dudeck O, Streipath F and Ricke J: Efficacy and safety of image-guided interstitial single fraction high-dose-rate brachytherapy in the management of metastatic malignant melanoma. J Contemp Brachytherapy. 7:154–160. 2015. View Article : Google Scholar : PubMed/NCBI
22	Ricke J and Wust P: Computed tomography-guided brachytherapy for liver cancer. Semin Radiat Oncol. 24:287–293. 2011. View Article : Google Scholar
23	Mohnike K, Wieners G, Schwartz F, Seidensticker M, Pech M, Ruehl R, Wust P, Lopez-Hänninen E, Gademann G, Peters N, et al: Computed tomography-guided high-dose-rate brachytherapy in hepatocellular carcinoma: Safety, efficacy, and effect on survival. Int J Radiat Oncol Biol Phys. 78:172–179. 2010. View Article : Google Scholar : PubMed/NCBI
24	Geisel D, Denecke T, Collettini F, Grieser C, Wust P, Thuss-Patence P, Hamm B and Gebaueret B: Treatment of hepatic metastases from gastric or gastroesophageal adenocarcinoma with computed tomography-guided high-dose-rate brachytherapy (CT-HDRBT). Anticancer Res. 32:5453–5458. 2012.PubMed/NCBI
25	Geisel D, Collettini F, Denecke T, Grieser C, Flörcken A, Wust P, Hamm B and Gebaueret B: Treatment for liver metastasis from renal cell carcinoma with computed-tomography-guided high-dose-rate brachytherapy (CT-HDRBT): A case series. World J Urol. 31:1525–1530. 2013. View Article : Google Scholar : PubMed/NCBI
26	Sharma DN, Thulkar S, Sharma S, Gandhi AK, Haresh KP, Gupta S, Rath GK and Julka PK: High-dose-rate interstitial brachytherapy for liver metastases: First study from India. J Contemp Brachytherapy. 5:70–75. 2013. View Article : Google Scholar : PubMed/NCBI
27	Joo JH, Park JH, Kim JC, Yu CS, Lim SB, Park IJ, Kim TW, Hong YS, Kim KP and Yoon SM: Local control outcomes using stereotactic body radiation therapy for liver metastases from colorectal cancer. Int J Radiat Oncol Biol Phys. 99:876–883. 2017. View Article : Google Scholar : PubMed/NCBI