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

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.