eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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5/2019
vol. 11
 
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abstract:
Original paper

Efficacy and safety of percutaneous computed tomography-guided high-dose-rate interstitial brachytherapy in treatment of oligometastatic lymph node metastases of retroperitoneal space

Constanze Heinze
1
,
Jazan Omari
1
,
Matthias Manig
1
,
Peter Hass
2
,
Marino Venerito
3
,
Robert Damm
1
,
Tomasz Jargiełło
4
,
Jens Ricke
5
,
Maciej Powerski
1
,
Maciej Pech
1, 6

1.
Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Magdeburg, Germany
2.
Department of Radiation Oncology, Otto-von-Guericke University, Magdeburg, Germany
3.
Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany
4.
Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland
5.
Department of Radiology, University Hospital Munich, Munich, Germany
6.
2nd Department of Radiology, Medical University of Gdansk, Gdansk, Poland
J Contemp Brachytherapy 2019; 11, 5: 436–442
DOI: https://doi.org/10.5114/jcb.2019.88141
Online publish date: 2019/09/20
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Purpose
To assess efficacy, safety, and outcome of computed tomography (CT)-guided high-dose-rate (HDR) interstitial brachytherapy in patients with oligometastatic lymph node metastases of the retroperitoneal space.

Material and methods
24 patients with a total of 47 retroperitoneal lymph node metastases from different primary tumors were treated with CT-guided interstitial brachytherapy using an 192Ir source (single fraction irradiation). Every three months after treatment, clinical and imaging follow-up were conducted to evaluate local control and safety.

Results
Median follow-up was 9.6 months (range, 2.9-39.0 months). Local tumor control rate was 95.7%. The median diameter of the gross tumor volume was 2.2 cm (range, 1-8.6 cm), treated with a median D100 (minimal enclosing tumor dose) of 14.9 Gy (range, 4.5-20.6 Gy). One severe adverse event (grade three) was recorded. Cumulative median progression-free survival was 4.2 months (range, 1.4-23.7 months), and cumulative median overall survival after interstitial brachytherapy was 15.9 months (range, 3.8-39.0 months).

Conclusions
CT-guided HDR interstitial brachytherapy is a safe and feasible method for local ablation of oligometastatic lymph node metastases of the retroperitoneal space, and might provide a well-tolerated additional therapeutic option in the multidisciplinary management of selected patients.

keywords:

lymph node metastases, image-guided intervention, radiation therapy/oncology, interstitial brachytherapy

  
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