title: CT-guided high-dose-rate brachytherapy of unresectable hepatocellular carcinoma.
abstract: OBJECTIVE
  The purpose of the present study was to evaluate the clinical outcome of CT-guided high-dose-rate brachytherapy (CT-HDRBT) in patients with unresectable hepatocellular carcinoma (HCC).
  
  
  METHODS
  Over a 6-year period, 98 patients with 212 unresectable HCC underwent CT-HDRBT applying a (192)Ir source at our institution. Magnetic resonance imaging (MRI) follow-up was performed 6 weeks after the intervention and then every 3 months. The primary endpoint was local tumor control (LTC); secondary endpoints included progression-free survival (PFS) and overall survival (OS).
  
  
  RESULTS
  Patients were available for MRI evaluation for a mean follow-up of 23.1 months (range 4-64 months; median 20 months). Mean tumor diameter was 5 cm (range 1.8-12 cm). Eighteen of 212 (8.5 %) tumors showed local progression after a mean LTC of 21.1 months. In all, 67 patients (68.4 %) experienced distant tumor progression. The mean PFS was 15.2 months. Forty-six patients died during the follow-up period. Median OS was 29.2 months. Actuarial 1-, 2-, and 3-year OS rates were 80, 62, and 46 %, respectively.
  
  
  CONCLUSIONS
  CT-HDRBT is an effective therapy to attain local tumor control in patients with unresectable HCC. Prospective randomized studies comparing CT-HDRBT with the standard treatments like Radiofrequency ablation (RFA) and chemoembolization (TACE) are mandatory.
authors.affiliation: Department of Diagnostic and Interventional Radiology, CharitéUniversitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany, federico.collettini@charite.de.
authors.forename: Federico
authors.initials: F
authors.lastname: Collettini
authors.forename: Nadja
authors.initials: N
authors.lastname: Schreiber
authors.forename: Dirk
authors.initials: D
authors.lastname: Schnapauff
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.forename: Peter
authors.initials: P
authors.lastname: Wust
authors.forename: Eckart
authors.initials: E
authors.lastname: Schott
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 / Q000379:methods; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000532:radiotherapy*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*