Hypofractionated accelerated computed tomography-guided interstitial high-dose-rate brachytherapy for liver...

Area of Science:

• Oncology
• Radiotherapy
• Interventional Radiology

Background:

• Liver malignancies pose significant treatment challenges, especially when inoperable or located near critical structures.
• Traditional therapies may have limitations for complex tumor locations or patient conditions.

Purpose of the Study:

• To evaluate the safety and efficacy of CT-guided interstitial high-dose-rate brachytherapy (HDR-BRT) for treating inoperable liver tumors.
• To assess local control and survival rates in patients undergoing HDR-BRT for primary and secondary liver malignancies.

Main Methods:

• Retrospective analysis of 31 patients undergoing 42 HDR-BRT procedures between 2000 and 2009.
• Targeted treatment of hepatic lesions exceeding 4 cm, adjacent to the liver hilum and bile duct bifurcation.
• Delivery of HDR-BRT with varying fractionation schedules (once or twice daily).

Main Results:

• Median follow-up of 13.3 months with a 1-year overall survival rate of 66%.
• Local control rates at 1, 2, and 3 years were 79%, 59%, and 59% for metastatic lesions, and 88%, 50%, and 50% for primary tumors.
• Severe side effects occurred in 4.7% of procedures, with no treatment-related deaths.

Conclusions:

• CT-guided interstitial HDR-BRT is a safe and effective local treatment option for inoperable liver malignancies.
• This technique is particularly suitable for tumors unsuitable for thermal ablation due to location or size.
• HDR-BRT provides meaningful local control and survival benefits for selected liver cancer patients.