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Journal of Contemporary Brachytherapy
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vol. 10
Original paper

Image-guided interstitial high-dose-rate brachytherapy in the treatment of metastatic esophageal squamous cell carcinoma

Jazan Omari, Constanze Heinze, Antje Wilck, Peter Hass, Max Seidensticker, Robert Damm, Katharina Fischbach, Jens Ricke, Maciej Pech, Maciej Powerski

J Contemp Brachytherapy 2018; 10, 5: 439–445
Online publish date: 2018/10/23
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To evaluate the efficacy of computed tomography (CT)- and magnetic resonance imaging (MRI)-guided interstitial high-dose-rate brachytherapy (HDR IBT = IBT) in patients with metastatic esophageal squamous cell carcinoma.

Material and methods
Eleven patients with 21 unresectable metastases of histologically proven esophageal squamous cell carcinoma were included in this retrospective study. Fourteen visceral and 7 lung metastases were treated with image-guided (CT or open MRI guidance) IBT using a 192Iridium source (single fraction irradiation). Clinical and imaging follow-up were performed every 3 months after treatment. Primary endpoint was local tumor control (LTC) and safety. Furthermore, we analyzed safety, progression-free survival (PFS), and overall survival (OS).

The median diameter of the target lesions was 2.2 cm (range: 0.7-6.8 cm), treated with a median D100 of 20.1 Gy (range: 10-25 Gy). During a median follow-up of 6.3 months (range: 3-21.8 months), three patients displayed local recurrences, resulting in LTC of 85.7%. Median PFS was 3.4 months and median OS after IBT was 13.7 months. No severe adverse events (grade 3+) requiring hospitalization or invasive intervention were recorded.

Image-guided IBT is a safe and effective treatment in patients with metastasized esophageal squamous cell carcinoma.


esophageal cancer, image-guided intervention, interventional oncology, interstitial brachytherapy, metastases

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