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. 2021 Oct;13(5):504-511.
doi: 10.5114/jcb.2021.110346. Epub 2021 Oct 29.

CT-guided palladium-103 seed brachytherapy for metastatic adenoid cystic carcinoma: a retrospective study to assess initial safety and effectiveness of percutaneous CT fluoroscopy-guided permanent seed brachytherapy

Stephen W Doggett  1 , Kelly W Elliott  2 , Shigeru Chino  3 , Kevin Burns  4 , Todd Lempert  4
Affiliations

CT-guided palladium-103 seed brachytherapy for metastatic adenoid cystic carcinoma: a retrospective study to assess initial safety and effectiveness of percutaneous CT fluoroscopy-guided permanent seed brachytherapy

Stephen W Doggett et al. J Contemp Brachytherapy. 2021 Oct.

Abstract

Purpose: Multiple pulmonary metastases present treatment difficulties in available treatment techniques, which are inconvenient or may damage sufficient pulmonary tissue to cause pulmonary crippling. This retrospective study of a single-community practice evaluated responses to computed tomography (CT)-guided 103Pd permanent seed brachytherapy (CTGPSB) in adenoid cystic carcinoma (ACC) synchronous pulmonary metastases. The purpose of the current study was to document that metastatic pulmonary ACC lesions can be controlled with CTGPSB.

Material and methods: Twenty-nine discrete lesions in 14 patients were evaluated with serial CT scans. All were treated with CTGPSB. Lesions were tracked over serial CT scans and volumes measured. Primary endpoint was a reduction in tumor volume on subsequent CT scan. Secondary endpoint was occurrence of CTCAE grades 2-5.

Results: There was a 100% measured reduction in tumor volume (n = 29) at follow-up. Follow-up was a mean of 3.13 years. Baseline tumor volume was a mean of 1.85 ml (range, 0.69-9.15 ml). There were two grade 1 and one grade 2 adverse events, which did not require hospitalization.

Conclusions: CTGPSB for the treatment of multiple ACC pulmonary metastases is effective, with minimal acute complications, as shown in small cohort of subjects of the present study. Further studies evaluating specific dosimetry parameters in this free-hand technique are needed to specify minimal and maximal dose constraints.

Keywords: adenoid cystic carcinoma; brachytherapy; palladium-103 implants; pulmonary metastases.

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Conflict of interest statement

The authors report no conflict of interest. Eminence Clinical Research, Inc. received unrestricted grants from ACC Research Foundation (ACCRF) and Theragenics (Buford, GA, USA) for software license fees, study administration, and data collection and analyses.

Figures

Fig. 1
Fig. 1
Right lung lesion post-implant dosimetry
Fig. 2
Fig. 2
DVH at implanted lesion
Fig. 3
Fig. 3
Right lung lesion at 29 months post-implant
See this image and copyright information in PMC

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