RESUMEN
Eighty percent of hepatocarcinomas are inoperable at the moment of diagnosis. Liver transplantation is the treatment of choice in these cases, but local therapies are another alternative. Among these, Image-Guided BrachyAblation is a safe choice. We report a 76-year-old male with a hepatocarcinoma, who was considered inoperable due to the high surgical risk of the patient. A local treatment with Image-Guided BrachyAblation was decided. A brachytherapy needle was placed in the tumor under computed tomography guidance and a 15 Gy single dose was delivered from an Iridium-192 source. The patient had no immediate complications and at one month of follow up he continued without incidents.
Asunto(s)
Humanos , Masculino , Anciano , Braquiterapia/métodos , Carcinoma Hepatocelular/radioterapia , Técnicas de Ablación/métodos , Radioterapia Guiada por Imagen/métodos , Neoplasias Hepáticas/radioterapia , Dosis de Radiación , Radioisótopos de Iridio , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Carcinoma Hepatocelular/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagenRESUMEN
Introduction: The main indication of modern high dose rate end bronchial brachyherapy (HDR EBBT) is the palliation of symptoms related to the growth of the endobronchial lung cancer. Methods: EBBT was performed to 27 patients who suffered symptomatic tumoral endobronchial or tracheal pathology, due to primary bronchial disease or secondary metastasis cancer, evaluating the rate of clinical benefit. The tumors were located at tracheal, carinal or proximal bronchial level. Fibrobronchoscopy was performed to all the patients to measure the degree of airway obstruction and to install brachytherapy endobronchial catheters. Between 1 to 4 fractions of 7 to 7.5 Gy were administered. Dyspnea, cough and hemoptysis were subjectively registered before and after treatment, according to an international validated scale. Results: After treatment, all symptoms considerably decreased, disappearing all of the severe categories. Hemoptysis and dyspnea resolved in a 100 percent and 40 percent of patients, respectively; and cough disappeared or was reduced to a minimum grade in 90 percent of cases.
Introducción: La indicación principal de la braquiterapia endobronquial moderna (BTEB) de alta tasa de dosis (HDR), es la paliación de síntomas por crecimiento endobronquial de cánceres pulmonares. Métodos: Se realizó BTEB HDR a 27 pacientes sintomáticos de patología tumoral endobronquial o traqueal, debido a patologías primarias bronquiales o secundarias metastásicas. Los tumores se ubicaban en tráquea, carina o a nivel bronquialproximal. Para observar mejorías en la sintomatología clínica, a todos se les realizó una fibrobroncoscopía (FBC) para medir el grado de obstrucción bronquial e instalar catéteres endobronquiales de braquiterapia. Se administraron entre 1 y 4 fracciones de 7 a 7,5 Gy. Se registró subjetivamente la disnea, tos y hemoptisis antes y después del tratamiento, de acuerdo a una escala internacionalmente validada. Resultados: Tras el tratamiento todos los síntomas disminuyeron considerablemente, desapareciendo toda sintomatología severa. La hemoptisis y disnea desaparecieron en el 100 por ciento y 40 por ciento de los pacientes respectivamente, y la tos desapareció o disminuyó a grado leve en el 90 por ciento de los pacientes.