title: Initial Experience with CT-Guided High-Dose-Rate Brachytherapy in the Multimodality Treatment of Neuroendocrine Tumor Liver Metastases.
abstract: OBJECTIVE
  To evaluate efficacy of computed tomography (CT)-guided high-dose-rate brachytherapy (HDRBT) of neuroendocrine liver metastases (NELM) with the goal of local tumor control (LTC).
  
  
  METHODS
  This retrospective study included all patients with unresectable NELM treated with CT-guided HDRBT between January 2007 and April 2015. Magnetic resonance imaging follow-up was performed 6 weeks after ablation and then every 3 months. The primary endpoint was LTC. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and complications.
  
  
  RESULTS
  In 27 patients, 52 NELM were treated in 40 sessions. Three patients (11.1%) developed local progression with LTC of 1.9-36.8 months (median 10.4 months, mean 16.4 months). The remaining 24 patients (89.9%) had LTC of 3.1-106.1 months (median 31.3 months, mean 32.6 months). Progression or death was observed in 19 patients (70.4%) with PFS of 1.9-55.3 months (median 7.3 months, mean 16.3 months); the remaining 8 patients (29.6%) had PFS of 3.7-50.1 months (median 13.4 months, mean 19.6 months). Four patients (14.8%) died of causes unrelated to the procedure; their OS was 11.7-52.3 months (median 48.7 months, mean 40.4 months). OS was 4.2-106.1 months (median 30.3 months, mean 34.1 months) in the 23 surviving patients (85.2%). One patient experienced pain with nausea and vomiting, and 1 patient with biliodigestive anastomosis had a hepatic abscess.
  
  
  CONCLUSIONS
  CT-guided HDRBT is a promising therapy with excellent LTC rates and low morbidity for patients with isolated/oligometastatic NELM.
authors.affiliation: Departments of Diagnostic and Interventional Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Schippers
authors.affiliation: Departments of Diagnostic and Interventional Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany. Electronic address: federico.collettini@charite.de.
authors.forename: Federico
authors.initials: F
authors.lastname: Collettini
authors.affiliation: Departments of Diagnostic and Interventional Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany.
authors.forename: Ingo G
authors.initials: IG
authors.lastname: Steffen
authors.affiliation: Departments of Diagnostic and Interventional Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany.
authors.forename: Gero
authors.initials: G
authors.lastname: Wieners
authors.affiliation: Departments of Diagnostic and Interventional Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany.
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
authors.affiliation: Gastroenterology and Hepatology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany.
authors.forename: Marianne
authors.initials: M
authors.lastname: Pavel
authors.affiliation: Radiation Oncology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Wust
authors.affiliation: Departments of Diagnostic and Interventional Radiology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Berlin 13353, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Gebauer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D003131:Combined Modality Therapy; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology*; D061089:Radiotherapy, Image-Guided; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA