Percutaneous interstitial brachytherapy for adrenal metastasis: technical report

• Published in: Journal of radiation research Vol. 53; no. 5; pp. 807 - 814
• Main Authors: Kishi, Kazushi, Tamura, Shinji, Mabuchi, Yasushi, Sonomura, Tetsuo, Noda, Yasutaka, Nakai, Motoki, Sato, Morio, Ino, Kazuhiko, Yamanaka, Noboru
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.09.2012
• Subjects: Ablation; Ablation (Surgery); Adrenal Gland Neoplasms - diagnostic imaging; Adrenal Gland Neoplasms - radiotherapy; Adrenal Gland Neoplasms - secondary; Aged; Aged, 80 and over; Brachytherapy; Brachytherapy - methods; Cancer metastasis; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - secondary; Care and treatment; CAT scans; Cervical cancer; Development and progression; Expiration; Female; Humans; Hyaluronic acid; Insertion; Interstitials; Kidneys; Melanoma; Melanoma - radiotherapy; Melanoma - secondary; Middle Aged; Needles; Patients; Pharyngeal Neoplasms; Positron emission tomography; Radiotherapy Planning, Computer-Assisted; Technology; Tumors; Uterine Cervical Neoplasms
• ISSN: 0449-3060; 1349-9157
• DOI: 10.1093/jrr/rrs047

We developed and evaluated the feasibility of a brachytherapy technique as a safe and effective treatment for adrenal metastasis. Adapting a paravertebral insertion technique in radiofrequency ablation of adrenal tumors, we developed an interstitial brachytherapy for adrenal metastasis achievable on an outpatient basis. Under local anesthesia and under X-ray CT guidance, brachytherapy applicator needles were percutaneously inserted into the target. A treatment plan was created to eradicate the tumor while preserving normal organs including the spinal cord and kidney. We applied this interstitial brachytherapy technique to two patients: one who developed adrenal metastasis as the third recurrence of uterine cervical cancer after reirradiation, and one who developed metachronous multiple metastases from malignant melanoma. The whole procedure was completed in 2.5 hours. There were no procedure-related or radiation-related early/late complications. FDG PET-CT images at two and three months after treatment showed absence of FDG uptake, and no recurrence of the adrenal tumor was observed for over seven months until expiration, and for six months until the present, respectively. This interventional interstitial brachytherapy procedure may be useful as a safe and eradicative treatment for adrenal metastasis.