title: Hypofractionated accelerated computed tomography-guided interstitial high-dose-rate brachytherapy for liver malignancies.
abstract: OBJECTIVE
  To report our results of computed tomography (CT)-guided interstitial high-dose-rate (HDR) brachytherapy (BRT) in the local treatment of inoperable primary and secondary liver malignancies.
  
  
  METHODS
  Between 2000 and 2009, 31 patients underwent a total of 42 BRT procedures for 36 hepatic lesions exceeding 4 cm and located adjacent to the liver hilum and bile duct bifurcation. The median tumor volume was 99 cm(3) (range, 46-1348 cm(3)). The median age was 64 years (range, 27-85 years). The HDR-BRT delivered a median total physical dose of 13.0 Gy (range, 7.0-32.0 Gy) in twice daily fractions of median 7.0 Gy (range, 4.0-10.0 Gy) in 14 patients and in once daily fractions of median 8.0 Gy (range, 7.0-14.0 Gy) in 17 patients.
  
  
  RESULTS
  The median followup was 13.3 months with an overall survival rate of 66% at 1 year. The local control rate for patients with metastatic lesions was 79%, 59%, and 59%, and for the subgroup with primary hepatic tumors 88%, 50%, and 50% at 1, 2, and 3 years, respectively. Severe side effects occurred in 4.7% of BRT procedures with no treatment-related deaths.
  
  
  CONCLUSIONS
  Our results confirm CT-guided interstitial HDR-BRT to be a safe procedure for the local treatment of inoperable liver malignancies unsuitable for thermal ablation.
authors.affiliation: Department of Radiation Oncology, Klinikum Offenbach, Offenbach, Germany. ntselis@hotmail.com
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tselis
authors.forename: Georgios
authors.initials: G
authors.lastname: Chatzikonstantinou
authors.forename: Christos
authors.initials: C
authors.lastname: Kolotas
authors.forename: Natasa
authors.initials: N
authors.lastname: Milickovic
authors.forename: Dimos
authors.initials: D
authors.lastname: Baltas
authors.forename: Tje Lin
authors.initials: TL
authors.lastname: Chung
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Zamboglou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome