eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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5/2021
vol. 13
 
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abstract:
Original paper

CT-guided palladium-103 seed brachytherapy for metastatic adenoid cystic carcinoma: a retrospective study to assess initial safety and effectiveness of percutaneous CT fluoroscopy-guided permanent seed brachytherapy

Stephen W. Doggett
1
,
Kelly W. Elliott
2
,
Shigeru Chino
3
,
Kevin Burns
4
,
Todd Lempert
4

1.
Mission Hospital, Mission Viejo Radiation Oncology, Mission Viejo, CA, USA
2.
Eminence Clinical Research, Inc., Colorado Springs, CO, USA
3.
Mission Hospital, Mission Viejo Thoracic Surgery, Mission Viejo, CA, USA
4.
Mission Hospital, Mission Viejo Interventional Radiology, Mission Viejo, CA, USA
J Contemp Brachytherapy 2021; 13, 5: 504–511
Online publish date: 2021/10/29
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Introduction
Multiple pulmonary metastases present treatment difficulties in available treatment techniques, which are inconvenient or may damage sufficient pulmonary tissue to cause pulmonary crippling. This retrospective study of a single-community practice evaluated responses to computed tomography (CT)-guided 103Pd permanent seed brachytherapy (CTGPSB) in adenoid cystic carcinoma (ACC) synchronous pulmonary metastases. The purpose of the current study was to document that metastatic pulmonary ACC lesions can be controlled with CTGPSB.

Material and methods
Twenty-nine discrete lesions in 14 patients were evaluated with serial CT scans. All were treated with CTGPSB. Lesions were tracked over serial CT scans and volumes measured. Primary endpoint was a reduction in tumor volume on subsequent CT scan. Secondary endpoint was occurrence of CTCAE grades 2-5.

Results
There was a 100% measured reduction in tumor volume (n = 29) at follow-up. Follow-up was a mean of 3.13 years. Baseline tumor volume was a mean of 1.85 ml (range, 0.69-9.15 ml). There were two grade 1 and one grade 2 adverse events, which did not require hospitalization.

Conclusions
CTGPSB for the treatment of multiple ACC pulmonary metastases is effective, with minimal acute complications, as shown in small cohort of subjects of the present study. Further studies evaluating specific dosimetry parameters in this free-hand technique are needed to specify minimal and maximal dose constraints.

keywords:

adenoid cystic carcinoma, pulmonary metastases, palladium-103 implants, brachytherapy

 
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