Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer

<p>Abstract</p> <p>Background</p> <p>Locoregional recurrence is the typical pattern of recurrence in gastric cancer, and cannot be removed by surgery in most of the patients. We aimed to evaluate the feasibility and efficacy of computed tomography (CT)-guided brachyther...

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Main Authors: Shi Liangrong, Wu Changping, Wu Jun, Zhou Wenjie, Ji Mei, Zhang Hongyu, Zhao Jiemin, Huang Yuanquan, Pei Honglei, Li Zhong, Ju Jingfang, Jiang Jingting
Format: Article
Language:English
Published: BMC 2012-07-01
Series:Radiation Oncology
Subjects:
Online Access:http://www.ro-journal.com/content/7/1/114
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spelling doaj-90283baacade48c58e2cc530aab2c7152020-11-24T22:58:12ZengBMCRadiation Oncology1748-717X2012-07-017111410.1186/1748-717X-7-114Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancerShi LiangrongWu ChangpingWu JunZhou WenjieJi MeiZhang HongyuZhao JieminHuang YuanquanPei HongleiLi ZhongJu JingfangJiang Jingting<p>Abstract</p> <p>Background</p> <p>Locoregional recurrence is the typical pattern of recurrence in gastric cancer, and cannot be removed by surgery in most of the patients. We aimed to evaluate the feasibility and efficacy of computed tomography (CT)-guided brachytherapy for patients with locoregional recurrent gastric cancer.</p> <p>Materials and methods</p> <p>We reviewed the case histories of 28 patients with locoregional recurrent gastric cancer that were selected for CT- guided brachytherapy by a multidisciplinary team. The clinical data of the patients including patient characteristics, treatment parameters, short-term effects, and survival data were collected and analyzed.</p> <p>Results</p> <p>15-75 <sup>125</sup>I seeds were implanted into each patient to produce a minimal peripheral dose (MPD) 100-160 Gy. Median day 0 dosimetry was significant for the following: V100 (the volume treated with the prescription dose) 95.8% (90.2-120.5%) and D90 (prescription dose received by at least 90% of the volume) 105.2% (98.0-124.6%) of prescription dose. No serious complications occurred during the study. Two months after brachytherapy, complete response, partial response and progressive disease were observed in 50.0%, 28.6% and 21.4% of patients, respectively. The median survival time was 22.0 ± 5.2 months, and the 1, 2,and 3-year survival rate was 89 ± 6%, 52 ± 10% and 11 ± 7%, respectively. A univariate analysis showed that the tumor size was a significant predictor of overall survival (<it>P</it> = 0.034). Patients with tumors <3 cm had relatively higher complete response rate (66.7%), compared to those with tumors >3 cm (30.8%). The PTV (planning target volume) smaller than 45 cm<sup>3</sup> was significantly correlated with achieving complete tumor eradication in the treated region (<it>P</it> = 0.020).</p> <p>Conclusions</p> <p>For selected patients with limited locoregional recurrent gastric cancer, CT-guided brachytherapy using <sup>125</sup>I seeds implantation can provide a high local control rate, with minimal trauma.</p> http://www.ro-journal.com/content/7/1/114Gastric cancerSurgeryLocoregional recurrenceBrachytherapyIodine-125 seed
collection DOAJ
language English
format Article
sources DOAJ
author Shi Liangrong
Wu Changping
Wu Jun
Zhou Wenjie
Ji Mei
Zhang Hongyu
Zhao Jiemin
Huang Yuanquan
Pei Honglei
Li Zhong
Ju Jingfang
Jiang Jingting
spellingShingle Shi Liangrong
Wu Changping
Wu Jun
Zhou Wenjie
Ji Mei
Zhang Hongyu
Zhao Jiemin
Huang Yuanquan
Pei Honglei
Li Zhong
Ju Jingfang
Jiang Jingting
Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer
Radiation Oncology
Gastric cancer
Surgery
Locoregional recurrence
Brachytherapy
Iodine-125 seed
author_facet Shi Liangrong
Wu Changping
Wu Jun
Zhou Wenjie
Ji Mei
Zhang Hongyu
Zhao Jiemin
Huang Yuanquan
Pei Honglei
Li Zhong
Ju Jingfang
Jiang Jingting
author_sort Shi Liangrong
title Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer
title_short Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer
title_full Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer
title_fullStr Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer
title_full_unstemmed Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer
title_sort computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer
publisher BMC
series Radiation Oncology
issn 1748-717X
publishDate 2012-07-01
description <p>Abstract</p> <p>Background</p> <p>Locoregional recurrence is the typical pattern of recurrence in gastric cancer, and cannot be removed by surgery in most of the patients. We aimed to evaluate the feasibility and efficacy of computed tomography (CT)-guided brachytherapy for patients with locoregional recurrent gastric cancer.</p> <p>Materials and methods</p> <p>We reviewed the case histories of 28 patients with locoregional recurrent gastric cancer that were selected for CT- guided brachytherapy by a multidisciplinary team. The clinical data of the patients including patient characteristics, treatment parameters, short-term effects, and survival data were collected and analyzed.</p> <p>Results</p> <p>15-75 <sup>125</sup>I seeds were implanted into each patient to produce a minimal peripheral dose (MPD) 100-160 Gy. Median day 0 dosimetry was significant for the following: V100 (the volume treated with the prescription dose) 95.8% (90.2-120.5%) and D90 (prescription dose received by at least 90% of the volume) 105.2% (98.0-124.6%) of prescription dose. No serious complications occurred during the study. Two months after brachytherapy, complete response, partial response and progressive disease were observed in 50.0%, 28.6% and 21.4% of patients, respectively. The median survival time was 22.0 ± 5.2 months, and the 1, 2,and 3-year survival rate was 89 ± 6%, 52 ± 10% and 11 ± 7%, respectively. A univariate analysis showed that the tumor size was a significant predictor of overall survival (<it>P</it> = 0.034). Patients with tumors <3 cm had relatively higher complete response rate (66.7%), compared to those with tumors >3 cm (30.8%). The PTV (planning target volume) smaller than 45 cm<sup>3</sup> was significantly correlated with achieving complete tumor eradication in the treated region (<it>P</it> = 0.020).</p> <p>Conclusions</p> <p>For selected patients with limited locoregional recurrent gastric cancer, CT-guided brachytherapy using <sup>125</sup>I seeds implantation can provide a high local control rate, with minimal trauma.</p>
topic Gastric cancer
Surgery
Locoregional recurrence
Brachytherapy
Iodine-125 seed
url http://www.ro-journal.com/content/7/1/114
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