16 research outputs found
Treatment of metastatic gastric adenocarcinoma with image-guided high-dose rate, interstitial brachytherapy as second-line or salvage therapy
PURPOSEWe aimed to evaluate the safety and effectiveness of image-guided high-dose rate interstitial brachytherapy (iBT) for the treatment of patients with hepatic, lymphatic, and pancreatic metastases originating from gastric cancer, an entity rarely surgically treatable with curative intent.METHODSTwelve patients with a cumulative number of 36 metastases (29 liver, 2 pancreatic, 5 lymph node) from histologically proven gastric adenocarcinoma received iBT between 2010 and 2016 and were retrospectively analyzed. Every patient underwent palliative chemotherapy prior to iBT. The iBT procedure employs a temporarily, intratumorally placed iridium-192 source in a single fraction with the goal of tumor cell eradication. Effectiveness was assessed clinically and by radiologic imaging every three months.RESULTSLocal tumor control was achieved in 32 of all treated metastases (89%). Four lesions showed a local recurrence after 7 months. Lesion sizes varied from 9 to 102 mm with a median of 20 mm. The median progression-free survival was 6.6 months (range, 1.8â46.8 months). The median overall survival was 11.4 months (range, 5â47 months). One patient suffered a major complication following iBT, hepatic hematoma and abscess (Common Terminology Criteria for Adverse Events grade 3), successfully dealt with by transcutaneous drainage.CONCLUSIONiBT is an overall safe procedure, which facilitates high rates of local tumor control in treatment of metastatic gastric adenocarcinoma. Compared with surgical metastasectomy, similar overall survival rates could be achieved in our patient collective after iBT application
Abstracts from the 20th International Symposium on Signal Transduction at the Blood-Brain Barriers
https://deepblue.lib.umich.edu/bitstream/2027.42/138963/1/12987_2017_Article_71.pd
Intra-hepatic Abscopal Effect Following Radioembolization of Hepatic Metastases
Purpose!#!To search for abscopal effects (AE) distant to the site of radiation after sequential Yittrium-90 (Y-90) radioembolization (RE) of liver malignancies.!##!Methods and materials!#!In this retrospective analysis, all patients treated by RE between 2007 and 2018 (nâ=â907) were screened for the following setting/conditions: sequential RE of left and right liver lobe in two sessions, liver-specific MRI (MRI1) acquired max. 10Â days before or after first RE (RE1), liver-specific MRI (MRI2) acquired with a minimum time interval of 20Â days after MRI1, but before second RE (RE2). No systemic tumor therapies between MRI1 and MRI2. No patients with liver cirrhosis. Metastasesâ>â5Â mm in untreated liver lobes were compared in MRI1 and MRI2 and rated as follows: same size or larger in MRI2â=âno abscopal effect (NAE);â>â30% shrinkage without Y-90 contamination in SPECT/CTâ=âabscopal effect (AE).!##!Results!#!Ninety six of 907 patients met aforementioned criteria. Median time-frame between RE1 and MRI2 was 34 (20-64) days. These 96 cases had 765 metastases which were evaluable (median 5(1-40) metastases per patient). Four patients could be identified with at least one shrinking metastasis of the untreated site: one patient with breast cancer (3 metastases: 0 NAE; 3 AE), one patient with prostate cancer (6 metastases: 3 NAE; 3 metastasesâ>â30% shrinkage but possible Y-90 contamination) and two patients with shrinkage of one metastasis each but less than 30%.!##!Conclusion!#!Our retrospective study documents AE after RE of liver tumors in 1 out of 96 cases, 3 other cases remain unclear