CardioVascular and Interventional Radiology

, Volume 35, Issue 3, pp 581–587

Computed Tomography-Guided Interstitial HDR Brachytherapy (CT-HDRBT) of the Liver in Patients with Irresectable Intrahepatic Cholangiocarcinoma

  • Dirk Schnapauff
  • Timm Denecke
  • Christian Grieser
  • Federico Colletini
  • Daniel Seehofer
  • Marianne Sinn
  • Jan Banzer
  • Enrique Lopez-Hänninen
  • Bernd Hamm
  • Peter Wust
  • Bernhard Gebauer
Clinical Investigation

DOI: 10.1007/s00270-011-0249-0

Cite this article as:
Schnapauff, D., Denecke, T., Grieser, C. et al. Cardiovasc Intervent Radiol (2012) 35: 581. doi:10.1007/s00270-011-0249-0

Abstract

Purpose

This study was designed to investigate the clinical outcome of patients with irresectable, intrahepatic cholangiocarcinoma (IHC) treated with computed tomography (CT)-guided HDR-brachytherapy (CT-HDRBT) for local tumor ablation.

Method

Fifteen consecutive patients with histologically proven cholangiocarcinoma were selected for this retrospective study. Patients were treated by high-dose-rate internal brachytherapy (HDRBT) using an Iridium-192 source in afterloading technique through CT-guided percutaneous placed catheters. A total of 27 brachytherapy treatments were performed in these patients between 2006 and 2009. Median tumor enclosing target dose was 20 Gy, and mean target volume of the radiated tumors was 131 (± 90) ml (range, 10–257 ml). Follow-up consisted of clinical visits and magnetic resonance imaging of the liver every third month. Statistical evaluation included survival analysis using the Kaplan–Meier method.

Results

After a median follow-up of 18 (range, 1–27) months after local ablation, 6 of the 15 patients are still alive; 4 of them did not get further chemotherapy and are regarded as disease-free. The reached median local tumor control was 10 months; median local tumor control, including repetitive local ablation, was 11 months. Median survival after local ablation was 14 months and after primary diagnosis 21 months.

Conclusion

In view of current clinical data on the clinical outcome of cholangiocarcinoma, locally ablative treatment with CT-HDRBT represents a promising and safe technique for patients who are not eligible for tumor resection.

Keywords

Interventional oncology Non-vascular interventions Ablation Radiation Liver/hepatic 

Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2011

Authors and Affiliations

  • Dirk Schnapauff
    • 1
  • Timm Denecke
    • 1
  • Christian Grieser
    • 1
  • Federico Colletini
    • 1
  • Daniel Seehofer
    • 2
  • Marianne Sinn
    • 3
  • Jan Banzer
    • 1
  • Enrique Lopez-Hänninen
    • 1
  • Bernd Hamm
    • 1
  • Peter Wust
    • 4
  • Bernhard Gebauer
    • 1
  1. 1.Department of RadiologyCharité, UniversitätsmedizinBerlinGermany
  2. 2.Department of SurgeryCharité, UniversitätsmedizinBerlinGermany
  3. 3.Department of Hematology/OncologyCharité, UniversitätsmedizinBerlinGermany
  4. 4.Department of Radiation OncologyCharité, Universitätsmedizin BerlinBerlinGermany