title: Computed tomography-guided interstitial HDR brachytherapy (CT-HDRBT) of the liver in patients with irresectable intrahepatic cholangiocarcinoma.
abstract: OBJECTIVE
  This study was designed to investigate the clinical outcome of patients with irresectable, intrahepatic cholangiocarcinoma (IHC) treated with computed tomography (CT)-guided HDR-brachytherapy (CT-HDRBT) for local tumor ablation.
  
  
  METHODS
  Fifteen consecutive patients with histologically proven cholangiocarcinoma were selected for this retrospective study. Patients were treated by high-dose-rate internal brachytherapy (HDRBT) using an Iridium-192 source in afterloading technique through CT-guided percutaneous placed catheters. A total of 27 brachytherapy treatments were performed in these patients between 2006 and 2009. Median tumor enclosing target dose was 20 Gy, and mean target volume of the radiated tumors was 131 (±90) ml (range, 10-257 ml). Follow-up consisted of clinical visits and magnetic resonance imaging of the liver every third month. Statistical evaluation included survival analysis using the Kaplan-Meier method.
  
  
  RESULTS
  After a median follow-up of 18 (range, 1-27) months after local ablation, 6 of the 15 patients are still alive; 4 of them did not get further chemotherapy and are regarded as disease-free. The reached median local tumor control was 10 months; median local tumor control, including repetitive local ablation, was 11 months. Median survival after local ablation was 14 months and after primary diagnosis 21 months.
  
  
  CONCLUSIONS
  In view of current clinical data on the clinical outcome of cholangiocarcinoma, locally ablative treatment with CT-HDRBT represents a promising and safe technique for patients who are not eligible for tumor resection.
authors.affiliation: Department of Radiology, Charité, Universitätsmedizin, Augustenburger Platz 1, 13353, Berlin, Germany. dirk.schnapauff@charite.de
authors.forename: Dirk
authors.initials: D
authors.lastname: Schnapauff
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Christian
authors.initials: C
authors.lastname: Grieser
authors.forename: Federico
authors.initials: F
authors.lastname: Collettini
authors.forename: Federico
authors.initials: F
authors.lastname: Colletini
authors.forename: Daniel
authors.initials: D
authors.lastname: Seehofer
authors.forename: Marianne
authors.initials: M
authors.lastname: Sinn
authors.forename: Jan
authors.initials: J
authors.lastname: Banzer
authors.forename: Enrique
authors.initials: E
authors.lastname: Lopez-Hänninen
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Peter
authors.initials: P
authors.lastname: Wust
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gebauer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms; D001653:Bile Ducts, Intrahepatic; D001918:Brachytherapy / Q000379:methods*; D016009:Chi-Square Distribution; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA