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- Title
Hepatocellular carcinoma: computed-tomography-guided high-dose-rate brachytherapy (CT-HDRBT) ablation of large (5-7 cm) and very large (>7 cm) tumours.
- Authors
Collettini, Federico; Schnapauff, Dirk; Poellinger, Alexander; Denecke, Timm; Schott, Eckart; Berg, Thomas; Wust, Peter; Hamm, Bernd; Gebauer, Bernhard
- Abstract
Objectives: Evaluate the clinical outcome of CT-guided high-dose-rate-brachytherapy (CT-HDRBT) of hepatocellular carcinoma (HCC) larger than 5 cm in diameter with the goal of local tumour control (LTC). Methods: Thirty-five patients with 35 unresectable HCCs ranging in size from 5 to 12 cm (mean: 7.1 cm) were treated with CT-HDRBT. Tumours were classified into two groups according to diameter: 'large lesions' (5-7 cm) and 'very large lesions' (>7 cm). Tumour response was evaluated by Gd-EOB-DTPA-enhanced liver magnetic resonance imaging (MRI) performed before, 6 weeks after, and then every 3 months after treatment. Endpoints included local tumour control (LTC), progression-free survival (PFS) and overall survival (OS). Results: Nineteen tumours were classified as 'large' and 16 as 'very large'. Complete tumour enclosure was achieved in all patients after the first CT-HDRBT session. Five patients were lost to follow-up. At a mean follow-up of 12.8 months, two patients had local progression (6.7%), one in each group. Nine patients (30%) experienced distant progression, five (26.3%) in the 'large' and four (25%) in the 'very large' group. No patients died during the follow-up period. No major complications were recorded. Conclusions: CT-HDRBT is a promising therapy for HCCs that exceed indications for thermal ablation. Key Points: • Computed Tomography guided high-dose-rate brachytherapy offers new therapeutic options for hepatocellular carcinoma • CT-HDRBT can be safely practised in HCCs exceeding 5 cm in diameter • CT-HDRBT offers high rate of local control where thermal ablation is impossible • CT-HDRBT could be a valid alternative to TACE for intermediate stage HCC
- Subjects
LIVER cancer; TOMOGRAPHY; ABLATION techniques; ONCOLOGIC surgery; SURGICAL excision; MAGNETIC resonance imaging
- Publication
European Radiology, 2012, Vol 22, Issue 5, p1101
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-011-2352-7