title: Treatment of hepatic metastases of breast cancer with CT-guided interstitial brachytherapy - a phase II-study.
abstract: OBJECTIVE
  The aim of the study was the evaluation of feasibility, safety and effectiveness of interstitial brachytherapy for the treatment of hepatic metastases of breast cancer.
  
  
  METHODS
  Forty-one consecutive patients with 115 unresectable hepatic metastases of breast cancer were included in this phase-II-trial. They were treated in 69 interventions of CT-guided-interstitial-brachytherapy of the liver. Brachytherapy was applied as a single fraction high-dose-irradiation (15-25Gy (Gray)) using a (192)Ir-source of 10Ci. Nineteen patients presented systemically pretreated extrahepatic tumors. Primary endpoints were complications, local tumor control and progression-free survival.
  
  
  RESULTS
  The median tumor diameter was 4.6 cm (1.5-11 cm). The median irradiation time per intervention was 26.5 min (range: 7-47 min). The applied median minimal dose at the CTV (clinical target volume) margin was 18.5 Gy (12-25 Gy). In 69 interventions and during the postinterventional period, one major complication (symptomatic post-interventional bleeding) (1.5%) and six minor complications occurred (8.7%). The median follow-up time was 18 months (range: 1-56). After 6, 12 and 18 months, local tumor control was 97%, 93.5% and 93.5%, intra- and extrahepatic progression free survival was 53%, 40% and 27%, and overall survival was 97%, 79% and 60%, respectively.
  
  
  CONCLUSIONS
  CT-guided-brachytherapy is safe and effective for the treatment of liver metastases of breast cancer.
authors.affiliation: Klinik für Radiologie und Nuklearmedizin, Otto-von-Guericke-University Magdeburg, Germany.
authors.forename: Gero
authors.initials: G
authors.lastname: Wieners
authors.forename: Konrad
authors.initials: K
authors.lastname: Mohnike
authors.forename: Nils
authors.initials: N
authors.lastname: Peters
authors.forename: Joachim
authors.initials: J
authors.lastname: Bischoff
authors.forename: Anke
authors.initials: A
authors.lastname: Kleine-Tebbe
authors.forename: Ricarda
authors.initials: R
authors.lastname: Seidensticker
authors.forename: Max
authors.initials: M
authors.lastname: Seidensticker
authors.forename: Günther
authors.initials: G
authors.lastname: Gademann
authors.forename: Peter
authors.initials: P
authors.lastname: Wust
authors.forename: Maciej
authors.initials: M
authors.lastname: Pech
authors.forename: Jens
authors.initials: J
authors.lastname: Ricke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D008875:Middle Aged; D016634:Radiosurgery; D061089:Radiotherapy, Image-Guided; D014057:Tomography, X-Ray Computed