CT-guided brachytherapy as salvage therapy for intrahepatic recurrence of HCC after surgical resection

Dirk Schnapauff; Federico Collettini; Kerstin Hartwig; Gero Wieners; Sascha Chopra; Bernd Hamm; Bernhard Gebauer

CT-guided brachytherapy as salvage therapy for intrahepatic recurrence of HCC after surgical resection

Anticancer Res. 2015 Jan;35(1):319-23.

Authors

Dirk Schnapauff¹, Federico Collettini², Kerstin Hartwig², Gero Wieners², Sascha Chopra², Bernd Hamm², Bernhard Gebauer²

Affiliations

¹ Department of Radiology, Charité Medical School, Universitätsmedizin Berlin, Campus Virchow-Clinic, Berlin, Germany Department of Gastroenterolgy and Hepatology, Charité Medical School, Universitätsmedizin Berlin, Campus Virchow-Clinic, Berlin, Germany Department of Haematology and Oncology, Charité Medical School, Universitätsmedizin Berlin, Campus Virchow-Clinic, Berlin, Germany Department of General, Visceral and Transplant Surgery, Charité Medical School, Universitätsmedizin Berlin, Campus Virchow-Clinic, Berlin, Germany dirk.schnapauff@charite.de.
² Department of Radiology, Charité Medical School, Universitätsmedizin Berlin, Campus Virchow-Clinic, Berlin, Germany Department of Gastroenterolgy and Hepatology, Charité Medical School, Universitätsmedizin Berlin, Campus Virchow-Clinic, Berlin, Germany Department of Haematology and Oncology, Charité Medical School, Universitätsmedizin Berlin, Campus Virchow-Clinic, Berlin, Germany Department of General, Visceral and Transplant Surgery, Charité Medical School, Universitätsmedizin Berlin, Campus Virchow-Clinic, Berlin, Germany.

PMID: 25550566

Abstract

Aim: Prevalence of patients with unresectable recurrence of hepatocellular carcinoma (HCC) after previous resection is rising. The purpose of this study was to determine survival of patients undergoing computed tomography-guided brachytherapy (CT-HDRBT).

Patients and methods: Altogether 19 patients with unresectable HCC recurrence were treated with CT-HDRBT at our Institution. Patients underwent single-fraction high-dose irradiation by an iridium-192 source after CT fluoroscopy-guided catheter placement. The median tumor-enclosing target dose was 20 Gy.

Results: The median follow-up was 33 months. According to the Kaplan-Meier method, median overall survival after CT-HDRBT was 50 months, and median survival after first hepatic resection was 87 months. The median duration of local tumor control was 32 months and time to disease progression was 20 months. There were no serious complications after CT-HDRBT and no treatment-related deaths.

Conclusion: CT-HDRBT is a safe, potentially life prolonging technique in patients with recurrence of HCC who have few therapeutic options.

Keywords: Hepatocellular carcinoma; brachytherapy; local ablation; recurrence.

MeSH terms

Aged
Brachytherapy
Carcinoma, Hepatocellular / diagnostic imaging
Carcinoma, Hepatocellular / mortality
Carcinoma, Hepatocellular / pathology
Carcinoma, Hepatocellular / therapy*
Female
Humans
Kaplan-Meier Estimate
Liver / diagnostic imaging
Liver / pathology
Liver / surgery
Liver Neoplasms / diagnostic imaging
Liver Neoplasms / mortality
Liver Neoplasms / pathology
Liver Neoplasms / therapy*
Male
Middle Aged
Neoplasm Recurrence, Local / diagnostic imaging
Neoplasm Recurrence, Local / mortality
Neoplasm Recurrence, Local / prevention & control
Neoplasm Recurrence, Local / radiotherapy*
Radiotherapy, Adjuvant
Radiotherapy, Image-Guided
Tomography, X-Ray Computed