BACKGROUND： CT-guided high-dose-rate brachytherapy（CT-HDRBT） is an interventional radiologic technique for local ablation of primary and secondary malignomas applying a radiation source through a brachycatheter per...BACKGROUND： CT-guided high-dose-rate brachytherapy（CT-HDRBT） is an interventional radiologic technique for local ablation of primary and secondary malignomas applying a radiation source through a brachycatheter percutaneously into the targeted lesion. The aim of this study was to assess local tumor control, safety and efficacy of CT-HDRBT in the treatment of liver metastases of pancreatic cancer. METHODS： Twenty consecutive patients with 49 unresectable liver metastases of pancreatic cancer were included in this retrospective trial and treated with CT-HDRBT, applied as a single fraction high-dose irradiation（15-20 Gy） using a 192 Irsource. Primary endpoint was local tumor control and secondary endpoints were complications, progression-free survival and overall survival.RESULTS： The mean tumor diameter was 29 mm（range 10-73）. The mean irradiation time was 20 minutes（range 7-42）. The mean coverage of the clinical target volume was 98%（range 88%-100%）. The mean D100 was 18.1 Gy and the median D100 was 19.78 Gy. Three major complications occurred with post-interventional abscesses, three of which were seen in 15 patients with biliodigestive anastomosis（20%）and overall 15%. The mean follow-up time was 13.7 months（range 1.4-55.0）. The median progression-free survival was 4.9 months（range 1.4-42.9, mean 9.4）. Local recurrence occurred in 5（10%） of 49 metastases treated. The median overall survival after CT-HDRBT was 8.6 months（range 1.5-55.3）. Eleven patients received chemotherapy after ablation with a median progression-free survival of 4.9 months（mean 12.9）. Nine patients did not receive chemotherapy after intervention with a median progression-free survival of 3.2 months（mean 5.0）. The rate of local tumor control was 91% in both groups after 12 months.CONCLUSION： CT-HDRBT was safe and effective for the treatment of liver metastases of pancreatic cancer.展开更多
BACKGROUND Pancreatic metastases account for only a small proportion of all pancreatic malignancies.Isolated pancreatic metastasis from renal cell cancer(isPM-RCC)is extremely rare and may be difficult to differentiat...BACKGROUND Pancreatic metastases account for only a small proportion of all pancreatic malignancies.Isolated pancreatic metastasis from renal cell cancer(isPM-RCC)is extremely rare and may be difficult to differentiate from more common primary neoplasms.A history of nephrectomy is crucial for the diagnosis.CASE SUMMARY We report the case of a 64-year-old Asian man who was diagnosed with a mass in the pancreatic head using computed tomography.He had no related symptoms,and his medical history was unremarkable,except for unilateral nephrectomy performed to remove a“benign”tumor 19 years ago.All preoperative imaging findings suggested a diagnosis of pancreatic neuroendocrine tumor.However,ultrasound-guided biopsy revealed features of clear cell renal cell carcinoma(ccRCC).Re-examination of the specimen resected 19 years ago confirmed that he had a ccRCC.The pancreatic mass was resected and pathological examination confirmed isPM-RCC.CONCLUSION Misdiagnosis of isPM-RCC is common because of its rarity and the long interval from resection of the primary tumor and manifestation of the metastasis.The history of the previous surgery may be the only clue.展开更多
文摘BACKGROUND： CT-guided high-dose-rate brachytherapy（CT-HDRBT） is an interventional radiologic technique for local ablation of primary and secondary malignomas applying a radiation source through a brachycatheter percutaneously into the targeted lesion. The aim of this study was to assess local tumor control, safety and efficacy of CT-HDRBT in the treatment of liver metastases of pancreatic cancer. METHODS： Twenty consecutive patients with 49 unresectable liver metastases of pancreatic cancer were included in this retrospective trial and treated with CT-HDRBT, applied as a single fraction high-dose irradiation（15-20 Gy） using a 192 Irsource. Primary endpoint was local tumor control and secondary endpoints were complications, progression-free survival and overall survival.RESULTS： The mean tumor diameter was 29 mm（range 10-73）. The mean irradiation time was 20 minutes（range 7-42）. The mean coverage of the clinical target volume was 98%（range 88%-100%）. The mean D100 was 18.1 Gy and the median D100 was 19.78 Gy. Three major complications occurred with post-interventional abscesses, three of which were seen in 15 patients with biliodigestive anastomosis（20%）and overall 15%. The mean follow-up time was 13.7 months（range 1.4-55.0）. The median progression-free survival was 4.9 months（range 1.4-42.9, mean 9.4）. Local recurrence occurred in 5（10%） of 49 metastases treated. The median overall survival after CT-HDRBT was 8.6 months（range 1.5-55.3）. Eleven patients received chemotherapy after ablation with a median progression-free survival of 4.9 months（mean 12.9）. Nine patients did not receive chemotherapy after intervention with a median progression-free survival of 3.2 months（mean 5.0）. The rate of local tumor control was 91% in both groups after 12 months.CONCLUSION： CT-HDRBT was safe and effective for the treatment of liver metastases of pancreatic cancer.
文摘BACKGROUND Pancreatic metastases account for only a small proportion of all pancreatic malignancies.Isolated pancreatic metastasis from renal cell cancer(isPM-RCC)is extremely rare and may be difficult to differentiate from more common primary neoplasms.A history of nephrectomy is crucial for the diagnosis.CASE SUMMARY We report the case of a 64-year-old Asian man who was diagnosed with a mass in the pancreatic head using computed tomography.He had no related symptoms,and his medical history was unremarkable,except for unilateral nephrectomy performed to remove a“benign”tumor 19 years ago.All preoperative imaging findings suggested a diagnosis of pancreatic neuroendocrine tumor.However,ultrasound-guided biopsy revealed features of clear cell renal cell carcinoma(ccRCC).Re-examination of the specimen resected 19 years ago confirmed that he had a ccRCC.The pancreatic mass was resected and pathological examination confirmed isPM-RCC.CONCLUSION Misdiagnosis of isPM-RCC is common because of its rarity and the long interval from resection of the primary tumor and manifestation of the metastasis.The history of the previous surgery may be the only clue.
