Treatment of hepatic metastases of breast cancer with CT-guided interstitial brachytherapy – A phase II-study

Abstract

PurposeThe aim of the study was the evaluation of feasibility, safety and effectiveness of interstitial brachytherapy for the treatment of hepatic metastases of breast cancer. Materials and methodsForty-one consecutive patients with 115 unresectable hepatic metastases of breast cancer were included in this phase-II-trial. They were treated in 69 interventions of CT-guided-interstitial-brachytherapy of the liver. Brachytherapy was applied as a single fraction high-dose-irradiation (15–25Gy (Gray)) using a 192Ir-source of 10Ci. Nineteen patients presented systemically pretreated extrahepatic tumors. Primary endpoints were complications, local tumor control and progression-free survival. ResultsThe median tumor diameter was 4.6cm (1.5–11cm). The median irradiation time per intervention was 26.5min (range: 7–47min). The applied median minimal dose at the CTV (clinical target volume) margin was 18.5Gy (12–25Gy). In 69 interventions and during the postinterventional period, one major complication (symptomatic post-interventional bleeding) (1.5%) and six minor complications occurred (8.7%). The median follow-up time was 18months (range: 1–56). After 6, 12 and 18months, local tumor control was 97%, 93.5% and 93.5%, intra- and extrahepatic progression free survival was 53%, 40% and 27%, and overall survival was 97%, 79% and 60%, respectively. ConclusionCT-guided-brachytherapy is safe and effective for the treatment of liver metastases of breast cancer.