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KMID : 1151820120060020151
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Journal of the Korean Society of Radiology
2012 Volume.6 No. 2 p.151 ~ p.157
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Availability and Reproducibility Evaluation of High-dose-rate Intraluminal Brachytherapy for Unresectable Recurrent Cholangiocarcinoma
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Park Ju-Kyeong
Lee Seung-Hun
Cha Seok-Yong
Kim Yang-Soo
Lee Sun-Young
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Abstract
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General treatment for cholangiocarcinoma is complete surgical resection. However recurrence is common in those patients. In most of cases the purpose of the treatment for patients with recurrent is palliative. Therefore we adopt intraluminal catheter to treat a recurrent patient with high-dose-rate intraluminal brachytherapy. This study aims to evaluate the treatment procedure and set-up reproducibility of intraluminal brachytherapy in the recurrent patient. Study patient was diagnosed at rcT1N0M0 and undergone intraluminal brachytherapy after Arrow Sheath insertion. 3 Gy was delivered in every fraction with a total dose of 30 Gy. We planned dose normalization at distal, proximal and central axis point of narrowed bile duct far from 1 cm. To evaluate set-up reproducibility, we measured distance between distal, proximal treatment target volume point and anterior surface of the thoracic vertebral body respectively for five times before every treatment with dummy seed insertion. Mean distance between distal, proximal treatment target volume point and anterior surface of 10th and 11th thoracic vertebral bodies is 0.5 cm, 6.1 cm and standard deviation is 0.06, 0.08 respectively. In addition, set-up reproducibility was maintained significantly. The patient has been alive with no evidence of disease recurrence for more than a year and has not yet reported severe complications. In conclusion, high-dose-rate intraluminal brachytherapy for unresectable recurrence of cholangiocarcinoma maintains high set-up reproducibility without severe side effects.
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KEYWORD
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cholangiocarcinoma, high-dose-rate intralunimal brachytherapy, arrow sheath, set-up reproducibility
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