Treatment of hepatic metastases from gastric or gastroesophageal adenocarcinoma with computed tomography-guided high-dose-rate brachytherapy (CT-HDRBT)

Anticancer Res. 2012 Dec;32(12):5453-8.

Abstract

Background: This retrospective analysis was performed to evaluate the clinical outcome of patients with hepatic metastases from gastric or gastroesophageal adenocarcinoma who were treated with computed tomography-guided high-dose-rate brachytherapy (CT-HDRBT).

Patients and methods: Eight patients with a total number of 12 isolated hepatic metastases from histologically-proven adenocarcinoma of the lower oesophagus or stomach, were treated with CT-HDRBT. Gadoxetic acid-enhanced magnetic resonance imaging (MRI) was performed 6 and 12 weeks after CT-HDRBT and then every 3 months to evaluate treatment efficacy.

Results: The median follow-up time was 6.1±6.8 months. Lesion size ranged from 14 to 68 mm in diameter with a median of 46±21 mm. No patient developed a local recurrence. Five patients developed systemic progression after a median time of 3.7±3.6 months (three in the liver, one in liver and bone and one in liver and resection margin from gastrectomy). One patient died 3.4 months after CT-HDRBR because of liver progression with cholestasis. No major complications associated with the treatment occurred.

Conclusion: CT-HDRBT might be a feasible alternative to surgical resection of liver metastases from gastric or gastroesophageal adenocarcinoma in selected patients and seems to have similar outcome rates as surgical resection in our small collective.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / radiotherapy*
  • Adenocarcinoma / secondary*
  • Aged
  • Aged, 80 and over
  • Brachytherapy / adverse effects
  • Brachytherapy / methods*
  • Esophageal Neoplasms / pathology*
  • Esophageal Neoplasms / radiotherapy
  • Follow-Up Studies
  • Humans
  • Liver Neoplasms / radiotherapy*
  • Liver Neoplasms / secondary*
  • Middle Aged
  • Radiography, Interventional / adverse effects
  • Radiography, Interventional / methods
  • Retrospective Studies
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / radiotherapy
  • Tomography, X-Ray Computed / adverse effects
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome