title: Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer.
abstract: BACKGROUND
  Locoregional recurrence is the typical pattern of recurrence in gastric cancer, and cannot be removed by surgery in most of the patients. We aimed to evaluate the feasibility and efficacy of computed tomography (CT)-guided brachytherapy for patients with locoregional recurrent gastric cancer.
  
  
  METHODS
  We reviewed the case histories of 28 patients with locoregional recurrent gastric cancer that were selected for CT- guided brachytherapy by a multidisciplinary team. The clinical data of the patients including patient characteristics, treatment parameters, short-term effects, and survival data were collected and analyzed.
  
  
  RESULTS
  15-75 125I seeds were implanted into each patient to produce a minimal peripheral dose (MPD) 100-160 Gy. Median day 0 dosimetry was significant for the following: V100 (the volume treated with the prescription dose) 95.8% (90.2-120.5%) and D90 (prescription dose received by at least 90% of the volume) 105.2% (98.0-124.6%) of prescription dose. No serious complications occurred during the study. Two months after brachytherapy, complete response, partial response and progressive disease were observed in 50.0%, 28.6% and 21.4% of patients, respectively. The median survival time was 22.0 ± 5.2 months, and the 1, 2,and 3-year survival rate was 89 ± 6%, 52 ± 10% and 11 ± 7%, respectively. A univariate analysis showed that the tumor size was a significant predictor of overall survival (P = 0.034). Patients with tumors <3 cm had relatively higher complete response rate (66.7%), compared to those with tumors >3 cm (30.8%). The PTV (planning target volume) smaller than 45 cm3 was significantly correlated with achieving complete tumor eradication in the treated region (P = 0.020).
  
  
  CONCLUSIONS
  For selected patients with limited locoregional recurrent gastric cancer, CT-guided brachytherapy using 125I seeds implantation can provide a high local control rate, with minimal trauma.
authors: Department of Oncology, The Third Affiliated Hospital, Soochow University, 185 Juqian Street, Changzhou 213003, Jiangsu Province, China.
authors: Liangrong
authors: L
authors: Shi
authors: Changping
authors: C
authors: Wu
authors: Jun
authors: J
authors: Wu
authors: Wenjie
authors: W
authors: Zhou
authors: Mei
authors: M
authors: Ji
authors: Hongyu
authors: H
authors: Zhang
authors: Jiemin
authors: J
authors: Zhao
authors: Yuanquan
authors: Y
authors: Huang
authors: Honglei
authors: H
authors: Pei
authors: Zhong
authors: Z
authors: Li
authors: Jingfang
authors: J
authors: Ju
authors: Jingting
authors: J
authors: Jiang
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome