Abstract
The purpose of the present study was to evaluate the clinical outcome of CT-guided high-dose-rate brachytherapy (CT-HDRBT) in patients with unresectable hepatocellular carcinoma (HCC). Over a 6-year period, 98patients with 212unresectable HCC underwent CT-HDRBT applying a (192)Ir source at our institution. Magnetic resonance imaging (MRI) follow-up was performed 6weeks after the intervention and then every 3months. The primary endpoint was local tumor control (LTC); secondary endpoints included progression-free survival (PFS) and overall survival (OS). Patients were available for MRI evaluation for a mean follow-up of 23.1months (range 4-64months; median 20months). Mean tumor diameter was 5cm (range 1.8-12cm). Eighteen of 212 (8.5 %) tumors showed local progression after a mean LTC of 21.1months. In all, 67patients (68.4 %) experienced distant tumor progression. The mean PFS was 15.2months. Forty-six patients died during the follow-up period. Median OS was 29.2months. Actuarial 1-, 2-, and 3-year OS rates were 80, 62, and 46 %, respectively. CT-HDRBT is an effective therapy to attain local tumor control in patients with unresectable HCC. Prospective randomized studies comparing CT-HDRBT with the standard treatments like Radiofrequency ablation (RFA) and chemoembolization (TACE) are mandatory.
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