Display options
Cite
Drewes R, Omari J, Manig M, et al. Treatment of hepatic pancreatic ductal adenocarcinoma metastases with high-dose-rate image-guided interstitial brachytherapy: a single center experience. J Contemp Brachytherapy. 2019;11(4):329-336doi: 10.5114/jcb.2019.87269.
Drewes, R., Omari, J., Manig, M., Seidensticker, M., Hass, P., Ricke, J., Powerski, M., & Pech, M. (2019). Treatment of hepatic pancreatic ductal adenocarcinoma metastases with high-dose-rate image-guided interstitial brachytherapy: a single center experience. Journal of contemporary brachytherapy, 11(4), 329-336. https://doi.org/10.5114/jcb.2019.87269
Drewes, Ralph, et al. "Treatment of hepatic pancreatic ductal adenocarcinoma metastases with high-dose-rate image-guided interstitial brachytherapy: a single center experience." Journal of contemporary brachytherapy vol. 11,4 (2019): 329-336. doi: https://doi.org/10.5114/jcb.2019.87269
Drewes R, Omari J, Manig M, Seidensticker M, Hass P, Ricke J, Powerski M, Pech M. Treatment of hepatic pancreatic ductal adenocarcinoma metastases with high-dose-rate image-guided interstitial brachytherapy: a single center experience. J Contemp Brachytherapy. 2019 Aug;11(4):329-336. doi: 10.5114/jcb.2019.87269. Epub 2019 Aug 29. PMID: 31523233; PMCID: PMC6737574.
Copy Download .nbib Format: NLM
Share it on

J Contemp Brachytherapy. 2019 Aug;11(4):329-336. doi: 10.5114/jcb.2019.87269. Epub 2019 Aug 29.

Treatment of hepatic pancreatic ductal adenocarcinoma metastases with high-dose-rate image-guided interstitial brachytherapy: a single center experience.

Journal of contemporary brachytherapy

Ralph Drewes, Jazan Omari, Matthias Manig, Max Seidensticker, Peter Hass, Jens Ricke, Maciej Powerski, Maciej Pech

Affiliations

  1. Department of Radiology and Nuclear Medicine, Otto-von-Guericke University, Magdeburg, Germany.
  2. Clinic and Department of Radiology, Munich University, Munich, Germany.
  3. 2 Department of Radiology, Medical University of Gdansk, Gdansk, Poland.

PMID: 31523233 PMCID: PMC6737574 DOI: 10.5114/jcb.2019.87269

Abstract

PURPOSE: To evaluate the efficacy and safety of image-guided (computed tomography/magnetic resonance imaging - CT/MRI) high-dose-rate (HDR) interstitial brachytherapy (iBT) as a salvage maneuver for the treatment of hepatic metastases originating from hepatic pancreatic ductal adenocarcinoma (PDAC). PDAC metastases present a major and unresolved problem, and any surgical approach or local therapeutic intervention remains extremely controversial.

MATERIAL AND METHODS: A cumulative number of 45 hepatic PDAC metastases in 16 patients were treated and retrospectively analyzed. Synchronous metastatic spread was observed in five patients, metachronous in eleven. 14 patients had resection of the pancreatic primary prior to iBT: eight Whipple/PPPD and six distal pancreatectomy procedures. The hepatic metastases were progressing under chemotherapy, thus iBT was applied as a salvage maneuver with the intention of local tumor control and prolonged survival. iBT is applied interstitially, with temporarily introduced

RESULTS: Local tumor control was achieved in 87% of all treated metastases. The median diameter of the irradiated lesions was 2.2 cm (range, 1-11.2 cm), the median irradiation dose was 21 Gy (range, 5-29.1 Gy). Median progression-free survival (PFS) after iBT was 3.4 months (range, 1.5-19.6 months), the median overall survival (OS) after iBT was 8.9 months (range, 3.1-29.3 months). Three major complications (CTCAE grade 3) occurred following iBT: three cases of liver abscess, which were successfully resolved with drainage and antibiotics.

CONCLUSIONS: Overall, iBT is a safe procedure, which enables excellent rates of local tumor control and presents a viable anti-neoplastic treatment option as a salvage therapy for metastatic PDAC patients.

Keywords: PDAC; interstitial brachytherapy; local ablation; local tumor control; salvage

Conflict of interest statement

Authors report no conflict of interest.

References

  1. IEEE Trans Inf Technol Biomed. 1997 Dec;1(4):229-42 - PubMed
  2. J Vasc Interv Radiol. 2004 Nov;15(11):1279-86 - PubMed
  3. AJR Am J Roentgenol. 2005 Jun;184(6):1860-7 - PubMed
  4. J Gastrointest Surg. 2006 Apr;10(4):511-8 - PubMed
  5. Int J Radiat Oncol Biol Phys. 2006 Aug 1;65(5):1479-86 - PubMed
  6. Surgery. 2006 Nov;140(5):764-72 - PubMed
  7. J Gastrointest Surg. 2006 Nov;10(9):1199-210; discussion 1210-1 - PubMed
  8. Cancer. 2007 Sep 15;110(6):1227-34 - PubMed
  9. Cancer. 2007 Dec 1;110(11):2484-92 - PubMed
  10. Oncology. 2007;72(5-6):314-21 - PubMed
  11. HPB (Oxford). 2006;8(2):85-8 - PubMed
  12. Ann Surg. 2008 Mar;247(3):456-62 - PubMed
  13. Ann Surg. 2010 Jul;252(1):142-8 - PubMed
  14. J Surg Oncol. 2010 Sep 1;102(3):256-63 - PubMed
  15. J Clin Oncol. 2010 Oct 10;28(29):4450-6 - PubMed
  16. N Engl J Med. 2011 May 12;364(19):1817-25 - PubMed
  17. Anticancer Res. 2011 Aug;31(8):2597-602 - PubMed
  18. Radiat Oncol. 2011 Sep 05;6:107 - PubMed
  19. Cell. 2012 Jan 20;148(1-2):349-61 - PubMed
  20. J Vasc Interv Radiol. 2012 May;23(5):635-41 - PubMed
  21. Gastroenterol Res Pract. 2012;2012:939350 - PubMed
  22. JAMA. 2013 Oct 9;310(14):1473-81 - PubMed
  23. N Engl J Med. 2013 Oct 31;369(18):1691-703 - PubMed
  24. J Natl Cancer Inst. 2014 Mar;106(3):dju011 - PubMed
  25. Cancer Radiother. 2014 Jun;18(3):191-7 - PubMed
  26. Ann Oncol. 2015 Sep;26 Suppl 5:v56-68 - PubMed
  27. Hepatobiliary Pancreat Dis Int. 2015 Oct;14(5):530-8 - PubMed
  28. J Clin Oncol. 2016 Aug 10;34(23):2784-96 - PubMed
  29. J Contemp Brachytherapy. 2016 Jun;8(3):251-61 - PubMed
  30. J Natl Compr Canc Netw. 2017 Aug;15(8):1028-1061 - PubMed
  31. Chirurg. 1996 Apr;67(4):366-70 - PubMed
  32. Hepatogastroenterology. 1997 Mar-Apr;44(14):567-73 - PubMed

Publication Types