title: Treatment for liver metastasis from renal cell carcinoma with computed-tomography-guided high-dose-rate brachytherapy (CT-HDRBT): a case series.
abstract: OBJECTIVE
  To retrospectively analyze the clinical outcome of patients with hepatic metastases from renal cell carcinoma who were treated with computed-tomography-guided high-dose-rate brachytherapy (CT-HDRBT).
  
  
  METHODS
  Ten patients (7 men and 3 women; median age 72 ± 7.9 years) with a total number of 16 hepatic metastases from histologically proven renal cell carcinoma were treated with CT-HDRBT after discussing the case in an interdisciplinary tumor conference. All patients had underwent nephrectomy before CT-HDRBT. Three patients had extrahepatic manifestations (2 lung and 1 bone). Six patients had received immunotherapy or targeted therapy before CT-HDRBT. Follow-up included gadoxetic acid (Gd-EOB-DTPA) enhanced MRI two times within 6-8 weeks and after that every 3 months after treatment to evaluate treatment efficacy.
  
  
  RESULTS
  Mean follow-up time was 21.6 ± 13.7 months. One patient developed local and systemic (pulmonary and osseous) progression after 10.8 months which was treated with targeted therapy and died 20.3 months after CT-HDRBT. None of the remaining nine patients developed local progression or died during the follow-up period. Five patients developed systemic progression (3 pulmonary, 1 osseous and 1 locally at the site of nephrectomy) after an average of 19.7 ± 5.5 months.
  
  
  CONCLUSIONS
  CT-HDRBT is a viable alternative to hepatic resection of liver metastases from renal cell carcinoma in selected patients.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany, dominik.geisel@charite.de.
authors.forename: Dominik
authors.initials: D
authors.lastname: Geisel
authors.forename: Federico
authors.initials: F
authors.lastname: Collettini
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Christian
authors.initials: C
authors.lastname: Grieser
authors.forename: Anne
authors.initials: A
authors.lastname: Flörcken
authors.forename: Peter
authors.initials: P
authors.lastname: Wust
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gebauer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology*; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome