TITLE

A Novel Endoscopic Approach to Brachytherapy in the Management of Hilar Cholangiocarcinoma

AUTHOR(S)
Simmons, Dia T.; Baron, Todd H.; Petersen, Bret T.; Gostout, Christopher J.; Haddock, Michael G.; Gores, Gregory J.; Yeakel, Peter D.; Topazian, Mark D.; Levy, Michael J.
PUB. DATE
August 2006
SOURCE
American Journal of Gastroenterology;Aug2006, Vol. 101 Issue 8, p1792
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVES: Traditionally, biliary brachytherapy sources are placed percutaneously via transhepatic drains or endoscopically via nasobiliary tubes (NBT). Another ERCP is needed for stent replacement after NBT removal. The aim of this study was to determine the feasibility and safety of endoscopic transpapillary insertion of irradiation sources through 10-Fr stents. METHODS: Medical records of Mayo Clinic Rochester patients undergoing biliary brachytherapy for hilar cholangiocarcinoma (CCA) were reviewed. Patients were part of a treatment protocol with curative intent including external beam radiation therapy (4,500 cGy), radiation sensitization (5-FU), and low dose rate (LDR) brachytherapy (<3,000 cGy) followed by liver transplantation. The 10-Fr biliary stent placed across the malignant biliary stricture was directly cannulated using a radiopaque 192Ir embedded ribbon within a 300-cm long, 5.1-Fr plastic sheath. After withdrawal of the endoscope, the external end of the brachytherapy catheter was rerouted transnasally and secured. Each patient was hospitalized in a shielded room up to 24 h after which the brachytherapy catheter was removed by hand. RESULTS: Between 1999 and 2004, 32 patients underwent biliary brachytherapy via endoscopically placed 10-Fr plastic stents (mean age 50.6 yr, 69% PSC, bilateral brachytherapy catheters 28.1%). The technical complication observed was immediate brachytherapy catheter displacement (7 of 32, 22%) managed by prompt brachytherapy catheter repositioning. CONCLUSION: LDR biliary brachytherapy administration via endoscopically placed biliary stents is technically feasible and appears reasonably safe in select patients with unresectable perihilar CCA. Unlike NBTs, stents can potentially be placed in bilateral ductal systems to accommodate dual brachytherapy catheters when indicated.
ACCESSION #
21785045

 

Related Articles

  • Patients' pressure helps bring brachytherapy to BC. Kent, Heather // CMAJ: Canadian Medical Association Journal;3/09/99, Vol. 160 Issue 5, p630 

    Reports that brachytherapy for prostate cancer patients is available at the British Columbia Cancer Agency. Comment of Dr. W. James Morris, a radiation treatment specialist; Brief description of the process in brachytherapy.

  • What is the role of the bystander response in radionuclide therapies? Brady, Darren; O'Sullivan, Joe M.; Prise, Kevin M. // Frontiers in Oncology;Aug2013, Vol. 3, p1 

    The article examines the role of the bystander response in radionuclide therapy. It mentions the important dosimetric differences between external beam or sealed source brachytherapy and unsealed radionuclide therapy in clinical radiation therapy. It states that dosimetry at the cellular and...

  • EXPERIENCE OF BRACHYTHERAPY IN CARCINOMA OF UTERINE CERVIX AT B.P.KOIRALA MEMORIAL CANCER HOSPITAL, BHARATPUR, CHITWAN, NEPAL. Prasiko, G.; Jha, A. K.; Dong, J. B.; Srivastava, R. P. // Journal of the Nepal Medical Association;Jan/Feb2004, Vol. 43 Issue 151, p19 

    Brachytherapy is primarily a treatment of a malignant disease with the use of radioactive isotope placed near or inside the target tissue. This technique plays an important role in the treatment of cancer of uterine cervix. This is a very new technique in Nepal and the department of radiation...

  • New data show brachytherapy is finally coming into its own. Overmyer, Mac // Urology Times;May98, Vol. 26 Issue 5, p1 

    Provides information on brachytherapy. Factors that contributed to the professional growth of physicians using the therapy; Origin of brachytherapy; Difficulties in learning the therapy.

  • Is Radiation the Right Option for Your Prostate Cancer?  // Cleveland Clinic Men's Health Advisor;Feb2014, Vol. 16 Issue 2, p6 

    The article discusses the advantages and disadvantages of the primary treatments for prostate cancer. External-beam radiotherapy (EBRT) is found to destroy cancerous tumors as it delivers focused radiation. Intensity modulated radiation therapy (IMRT) is noted to deliver less initial discomfort...

  • Image-guided high-dose-rate brachytherapy in inoperable endometrial cancer. DANKULCHAI, P.; PETSUKSIRI, J.; CHANSILPA, Y.; HOSKIN, P. J. // British Journal of Radiology;Jul2014, Vol. 87 Issue 1039, p1 

    Inoperable endometrial cancer may be treated with curative aim using radical radiotherapy alone. The radiation techniques are external beam radiotherapy (EBRT) alone, EBRT plus brachytherapy and brachytherapy alone. Recently, high-dose-rate brachytherapy has been used instead of low-dose-rate...

  • Dosimetric Characteristics for Brachytherapy Sources. DeWerd, Larry A.; Davis, Stephen D. // AIP Conference Proceedings;5/5/2011, Vol. 1345 Issue 1, p207 

    Brachytherapy sources are characterized by the dosimetric parameters in a protocol such as the American Association of Physicists in Medicine Task Group 43. The air-kerma strength is measured and traceable to a primary standard. Then the parameters such as dose-rate constant, radial dose...

  • New 125I brachytherapy source IsoSeed I25.S17plus: Monte Carlo dosimetry simulation and comparison to sources of similar design. Pantelis, Evaggelos; Papagiannis, Panagiotis; Anagnostopoulos, Giorgos; Baltas, Dimos // Journal of Contemporary Brachytherapy;2013, Vol. 5 Issue 4, p240 

    Purpose: To determine the relative dose rate distribution around the new 125I brachytherapy source IsoSeed I25. S17plus and report results in a form suitable for clinical use. Results for the new source are also compared to corresponding results for other commercially available 125I sources of...

  • Tumor Regression Dynamics with External Radiotherapy in Cancer Cervix and its Implications. Datta, N.R.; Rajkumar, A.; Basu, R. // Indian Journal of Cancer;Jan-Mar2004, Vol. 41 Issue 1, p18 

    BACKGROUND: To study the external radiotherapy (EXTRT) regression patterns in cancer of the cervix. AIMS: Evaluate EXTRT tumor regression doses (TRD) for 50% (TRD50) 80% response (TRD80), normalized dose response gradient (γ50) and slope (slope50) with clinical outcome. SETTINGS AND DESIGN:...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics