Image-Guided Interstitial High-Dose-Rate Brachytherapy in Hepatocellular Carcinoma

2009 ◽  
Vol 27 (2) ◽  
pp. 170-174 ◽  
Author(s):  
Konrad Mohnike ◽  
Gero Wieners ◽  
Maciej Pech ◽  
Max Seidensticker ◽  
Ricarda Rühl ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Dose Rate ◽  
High Dose Rate ◽  
High Dose ◽  
High Dose Rate Brachytherapy ◽  
Image Guided

scholarly journals Hepatocellular carcinoma tumor thrombus entering the right atrium treated with combining percutaneous and intravenous high-dose-rate brachytherapy: a case report

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
F. N. Fleckenstein ◽  
M. Jonczyk ◽  
E. Can ◽  
W. M. Lüdemann ◽  
L. Savic ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Dose Rate ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Vena Cava ◽  
High Dose Rate ◽  
High Dose ◽  
High Dose Rate Brachytherapy ◽  
Ct Guided ◽  
The Right

AbstractThe presented report describes a case of a Hepatocellular carcinoma (HCC) tumor thrombus (TT) infiltrating the inferior vena cava (IVC) and the right atrium (RA) in a 66-year old male patient who initially presented with TT related symptoms. CT-guided high-dose-rate brachytherapy (HDRBT) was performed for both, the intraparenchymal primary and the TT. A marked improvement of the tumor-related symptoms and shrinkage of the tumor mass were achieved six months after treatment initiation. The combination of intravascular and percutaneous HDRBT demonstrating a promising approach to palliate tumor-related symptoms in advanced HCC with macrovascular invasion.

scholarly journals Comparison of intrahepatic progression patterns of hepatocellular carcinoma and colorectal liver metastases following CT-guided high dose-rate brachytherapy

2021 ◽  
Vol 13 ◽  
pp. 175883592110423
Author(s):  
Han Xu ◽  
Robin Schmidt ◽  
Charlie Alexander Hamm ◽  
Isabel Theresa Schobert ◽  
Yubei He ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Local Recurrence ◽  
Dose Rate ◽  
Cox Regression ◽  
High Dose Rate ◽  
High Dose ◽  
Tumor Type ◽  
High Dose Rate Brachytherapy ◽  
Ct Guided ◽  
Progression Patterns

Introduction: Given the metachronous and multifocal occurrence of hepatocellular carcinoma (HCC) and colorectal cancer metastases in the liver (CRLM), this study aimed to compare intrahepatic progression patterns after computed tomography (CT)-guided high dose-rate brachytherapy. Patients and methods: This retrospective analysis included 164 patients (114 HCC, 50 CRLM) treated with brachytherapy between January 2016 and January 2018. Patients received multiparametric magnetic resonance imaging (MRI) before, and about 8 weeks after brachytherapy, then every 3 months for the first, and every 6 months for the following years, until progression or death. MRI scans were assessed for local or distant intrahepatic tumor progression according to RECIST 1.1 and electronic medical records were reviewed prior to therapy. The primary endpoint was progression-free survival (PFS). Specifically, local and distant intra-hepatic PFS were assessed to determine differences between the intrahepatic progression patterns of HCC and CRLM. Secondary endpoints included the identification of predictors of PFS, time to progression (TTP), and overall survival (OS). Statistics included Kaplan–Meier analysis and univariate and multivariate Cox regression modeling. Results: PFS was longer in HCC [11.30 (1.33–35.37) months] than in CRLM patients [8.03 (0.73–19.80) months, p = 0.048], respectively. Specifically, local recurrence occurred later in HCC [PFS: 36.83 (1.33–40.27) months] than CRLM patients [PFS: 12.43 (0.73–21.90) months, p = 0.001]. In contrast, distant intrahepatic progression occurred earlier in HCC [PFS: 13.50 (1.33–27.80) months] than in CRLM patients [PFS: 19.80 (1.43–19.80) months, p = 0.456] but without statistical significance. Multivariate Cox regression confirmed tumor type and patient age as independent predictors for PFS. Conclusion: Brachytherapy proved to achieve better local tumor control and overall PFS in patients with unresectable HCC as compared to those with CRLM. However, distant progression preceded local recurrence in HCC. As a result, these findings may help design disease-specific surveillance strategies and personalized treatment planning that highlights the strengths of brachytherapy. They may also help elucidate the potential benefits of combinations with other loco-regional or systemic therapies.

Image guided high dose rate brachytherapy in cervical cancer

2017 ◽  
Vol 29 ◽  
pp. S5
Author(s):  
V.E. Baird ◽  
A. Drake ◽  
K. Corrigan ◽  
J. Clarke ◽  
U. McGivern ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Dose Rate ◽  
High Dose Rate ◽  
High Dose ◽  
High Dose Rate Brachytherapy ◽  
Image Guided

scholarly journals Image-Guided High-Dose Rate Brachytherapy in Cervix Carcinoma Using Balloon Catheter and Belt Immobilization System

2016 ◽  
Vol 16 (3) ◽  
pp. 257-266
Author(s):  
Qiyong Fan ◽  
Anamaria R. Yeung ◽  
Robert Amdur ◽  
Richard Helmig ◽  
Justin Park ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Dose Rate ◽  
Dose Reduction ◽  
Balloon Catheter ◽  
High Dose Rate ◽  
Magnetic Resonance Images ◽  
High Dose ◽  
Cervix Carcinoma ◽  
High Dose Rate Brachytherapy ◽  
Image Guided

Purpose: The efficacy of image-guided high-dose rate brachytherapy for cervical cancer is limited by the ineffective rectal sparing devices available commercially and the potential applicator movement. We developed a novel device using a balloon catheter and a belt immobilization system, serving for rectal dose reduction and applicator immobilization purposes, respectively. Methods: The balloon catheter is constructed by gluing a short inflatable tube to a long regular open-end catheter. Contrast agent (10) cm3 is injected into the inflatable end, which is affixed to the tandem and ring applicator, to displace the posterior vaginal wall. The belt immobilization system consists of a specially designed bracket that can hold and fix itself to the applicator, a diaper-like Velcro fastener package used for connecting the patient’s pelvis to the bracket, and a buckle that holds the fasteners to stabilize the whole system. The treatment data for 21 patients with cervical cancer using both balloon catheter and belt immobilization system were retrospectively analyzed. Computed tomography and magnetic resonance images, acquired about 30 minutes apart, were registered to evaluate the effectiveness of the immobilization system. Results: In comparison with a virtual rectal blade, the balloon decreased the rectal point dose by 34% ± 4.2% (from 276 ± 57 to 182 ± 38 cGy), corresponding to an extra sparing distance of 7.9 ± 1.1 mm. The maximum sparing distance variation per patient is 1.4 ± 0.6 mm, indicating the high interfractional reproducibility for rectum sparing. With the immobilization system, the mean translational and rotational displacements of the applicator set are <3 mm and <1.5°, respectively, in all directions. Conclusions: The rectal balloon provides significant dose reduction to the rectum and it may potentially minimize patient discomfort. The immobilization system permits almost no movement of the applicator during treatment. This work has the potential to be promoted as a standardized solution for high-dose rate treatment of cervical cancer.

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