title: Preliminary experience with CT-guided high-dose rate brachytherapy as an alternative treatment for hepatic recurrence of cholangiocarcinoma.
abstract: BACKGROUND
  Intrahepatic recurrence after resection of intrahepatic or hilar cholangiocarcinoma represents a main reason for the poor prognosis of bile duct cancer. As no standard treatment has been established so far, the aim of this study was to analyse the safety and efficacy of computed tomography-guided high-dose rate brachytherapy (CT-HDRBT) as an alternative treatment in those patients.
  
  
  METHODS
  The outcomes of 10 patients, who had been treated at least once for recurrent cholangiocarcinoma by CT-HDRBT, were retrospectively analysed.
  
  
  RESULTS
  The median survival of all patients after primary liver resection was 85 months [95% confidence interval (CI) 68.129-101.871] with overall 1- and 5-year survival rates of 100% and 78.7%, respectively. After the occurrence of intrahepatic tumour recurrence, a total of 15 CT-HDRBT procedures were performed, alone or combined with other recurrence treatments, without any major complications according to the Society of Interventional Radiology classification. The 1-year and 5-year survival rates after recurrence treatment were 77.1% and 51.4%, respectively.
  
  
  CONCLUSIONS
  CT-HDRBT represents a safe treatment option for patients with recurrent bile duct cancer. As a part of a multimodal concept, CT-HDRBT might lead to a prolongation of survival in selected patients but further studies are urgently needed to prove this concept.
authors.affiliation: Department of General, Visceral and Transplantation Surgery, Universitätsklinikum Charité, Campus Virchow Klinikum, Humboldt-Universität, Berlin, Germany. carsten.kamphues@charite.de
authors.forename: Carsten
authors.initials: C
authors.lastname: Kamphues
authors.forename: Daniel
authors.initials: D
authors.lastname: Seehofer
authors.forename: Federico
authors.initials: F
authors.lastname: Collettini
authors.forename: Marcus
authors.initials: M
authors.lastname: Bahra
authors.forename: Peter
authors.initials: P
authors.lastname: Neuhaus
authors.forename: Peter
authors.initials: P
authors.lastname: Wust
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gebauer
authors.forename: Dirk
authors.initials: D
authors.lastname: Schnapauff
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging / Q000473:pathology; D001918:Brachytherapy / Q000379:methods*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011237:Predictive Value of Tests; D011879:Radiotherapy Dosage; D011881:Radiotherapy, Computer-Assisted; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome