CT-guided brachytherapy (CTGB) versus interstitial laser ablation (ILT) of colorectal liver metastases: an intraindividual matched-pair analysis.
OBJECTIVE
To compare local tumor control after percutaneous tumor ablation by interstitial laser therapy (ILT) or CT-guided brachytherapy (CTGB).


METHODS
In a matched pair analysis including 18 patients with 36 liver metastases of colorectal primary, both ILT and CTGB were performed in different lesions. The following matching factors were considered: (i) tumor size < or = 5 cm, and (ii) execution of chemotherapy after tumor ablation. Primary endpoint was local tumor control.


RESULTS
Treated lesions were identical in terms of tumor size and all matching criteria were fulfilled in all patients except for the performance of adjuvant chemotherapy. Median follow-up was 14 months (3-24 months) for both groups. Only five of 18 patients (28%) demonstrated local tumor progression after CTGB, whereas in ten of 18 patients (56%) tumor progression was found after ILT. Differences encountered were significant for all patients (p = 0.04), whereas in those who fulfilled all matching criteria (n = 14) the level of statistical significance was not reached (p = 0.23).


CONCLUSIONS
CTGB demonstrated superior local tumor control compared to ILT in long-term follow-up.
Pech
Maciej
M
Clinic for Radiology and Nuclear Medicine, University of Magdeburg, Leipziger Strasse 44, Magdeburg, Germany. maciej.pech@med.ovgu.de
Wieners
Gero
G
Kryza
Rafal
R
Dudeck
Oliver
O
Seidensticker
Max
M
Mohnike
Konrad
K
Redlich
Ulf
U
Rühl
Ricarda
R
Wust
Peter
P
Gademann
Günther
G
Ricke
Jens
J
D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D053208:Kaplan-Meier Estimate; D053685:Laser Therapy / Q000379:methods*; D008113:Liver Neoplasms / Q000532:radiotherapy / Q000556:secondary* / Q000601:surgery; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D011881:Radiotherapy, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*