title: Computed tomography-guided interstitial high dose rate brachytherapy for centrally located liver tumours: a single institution study.
abstract: OBJECTIVE
  To evaluate the clinical outcome of computed tomography (CT)-guided interstitial (IRT) high-dose-rate (HDR) brachytherapy (BRT) in the treatment of unresectable primary and secondary liver malignancies. This report updates and expands our previously described experience with this treatment technique.
  
  
  METHODS
  Forty-one patients with 50 tumours adjacent to the liver hilum and bile duct bifurcation were treated in 59 interventions of CT-guided IRT HDR BRT. The tumours were larger than 4 cm with a median volume of 84 cm(3) (38-1,348 cm(3)). The IRT HDR BRT delivered a median total physical dose of 20.0 Gy (7.0-32.0 Gy) in twice daily fractions of median 7.0 Gy (4.0-10.0 Gy) in 19 patients and in once daily fractions of median 8.0 Gy (7.0-14.0 Gy) in 22 patients.
  
  
  RESULTS
  With a median follow-up of 12.4 months, the local control for metastatic hepatic tumours was 89 %, 73 % and 63 % at 6, 12 and 18 months respectively. The local control for primary hepatic tumours was 90 %, 81 % and 50 % at 6, 12 and 18 months respectively. Severe side effects occurred in 5.0 % of interventions with no treatment-related deaths.
  
  
  CONCLUSIONS
  CT-guided IRT HDR BRT is a promising procedure for the radiation treatment of centrally located liver malignancies.
  
  
  CONCLUSIONS
  • Interstitial high-dose-rate brachytherapy (IRT HDR BRT) is a promising treatment for central liver tumours • CT-guided IRT HDR BRT is safe for treating extensive tumours • CT-guided IRT HDR BRT could play a role in managing unresectable hepatic malignancies.
authors.affiliation: Department of Radiation Oncology, Klinikum Offenbach, Starkenburgring 66, 63069, Offenbach am Main, 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: Nikolaos
authors.initials: N
authors.lastname: Zamboglou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000473:pathology; D001918:Brachytherapy / Q000379:methods*; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012306:Risk; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome