Focal hepatic ablation using interstitial photon radiation energy
Background: Intratumoral ablative therapy is being used increasingly for the treatment of primary and secondary hepatic malignancies. The interstitial point-source photon radiosurgery system (PRS) is a novel ablative technique that uses radiation therapy similar in dosimetry to interstitial brachyth...
Gespeichert in:
| Veröffentlicht in: | Journal of the American College of Surgeons 2000-08, Vol.191 (2), p.164-174 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 174 |
|---|---|
| container_issue | 2 |
| container_start_page | 164 |
| container_title | Journal of the American College of Surgeons |
| container_volume | 191 |
| creator | Koniaris, Leonidas G Chan, David Y Magee, Carolyn Solomon, Stephen B Anderson, James H Smith, Donald O De Weese, Theodore Kavoussi, Louis R Choti, Michael A |
| description | Background: Intratumoral ablative therapy is being used increasingly for the treatment of primary and secondary hepatic malignancies. The interstitial point-source photon radiosurgery system (PRS) is a novel ablative technique that uses radiation therapy similar in dosimetry to interstitial brachytherapy.
Study Design: To determine the feasibility, toxicity, and local tissue destructive capabilities of the PRS in the liver, preliminary studies in a nontumor-bearing canine model were examined. A 6-month survival study was conducted. Each animal received three radiation treatments, in the right, central, and left hepatic regions. Three low-dose treatments were delivered to each of six animals (group A), generating a 2.0-cm-diameter radiated sphere with a dose of 20 Gy at the lesion edge. Three high-dose treatments were delivered to each of six animals (group B), generating a 3.0-cm-diameter radiated sphere with 20 Gy at the lesion edge.
Results: The treatment reproducibly generated sharply demarcated hepatic ablative lesions proportional to the administered dose. Mean lesion diameter at 1 month was 1.6 ± 0.2 cm in group A and 3.4 ± 1.0 cm in group B. Lesion size was independent of intrahepatic location, including near vascular structures. PRS therapy, when applied to portal structures, resulted in hilar damage. Hilar damage appeared to be associated with arteriolar thrombosis and bile duct injury. Treatment of regions adjacent to large hepatic veins and the IVC was not associated with vessel thrombosis or stricture.
Conclusions: PRS ablation is a generally well-tolerated method that results in consistent, well-demarcated, symmetric lesions of complete necrosis with minimal adjacent parenchymal injury. Application of such an approach for the treatment of liver tumors is promising. |
| doi_str_mv | 10.1016/S1072-7515(00)00295-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_journals_211192194</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1072751500002957</els_id><sourcerecordid>59697568</sourcerecordid><originalsourceid>FETCH-LOGICAL-e319t-b65b2b1a2034e23f5d3dcd2d511d9bea877badf6704fa6516019c119a73fcb8c3</originalsourceid><addsrcrecordid>eNpF0V1LwzAUBuAgipvTn6AU8UIvque0TdNcyRhOhYEX6nVIk3TL2NqatML-vdkXXp1AHk548xJyjfCIgPnTJwJLYkaR3gM8ACScxuyEDLFgPEbkcBrORzIgF94vAZABz8_JAIFnNM1hSMbTRslVtDCt7KyKZLkKs6mj3tt6Htm6M853trPBtIumCzdOars3pjZuvrkkZ5VceXN1mCPyPX35mrzFs4_X98l4FpsUeReXOS2TEmUCaWaStKI61UonmiJqXhpZMFZKXeUMskrmFHNArkIOydJKlYVKR-R2v7d1zU9vfCeWTe_q8KRIMMAEeRbQzQH15dpo0Tq7lm4jjoEDuDsA6UPwyslaWf_vsozTAgN73jMTEv1a44RX1tTKaOuM6oRubNgptk2IXRNi-80CQOyaECz9A4_6eU0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211192194</pqid></control><display><type>article</type><title>Focal hepatic ablation using interstitial photon radiation energy</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Koniaris, Leonidas G ; Chan, David Y ; Magee, Carolyn ; Solomon, Stephen B ; Anderson, James H ; Smith, Donald O ; De Weese, Theodore ; Kavoussi, Louis R ; Choti, Michael A</creator><creatorcontrib>Koniaris, Leonidas G ; Chan, David Y ; Magee, Carolyn ; Solomon, Stephen B ; Anderson, James H ; Smith, Donald O ; De Weese, Theodore ; Kavoussi, Louis R ; Choti, Michael A</creatorcontrib><description>Background: Intratumoral ablative therapy is being used increasingly for the treatment of primary and secondary hepatic malignancies. The interstitial point-source photon radiosurgery system (PRS) is a novel ablative technique that uses radiation therapy similar in dosimetry to interstitial brachytherapy.
Study Design: To determine the feasibility, toxicity, and local tissue destructive capabilities of the PRS in the liver, preliminary studies in a nontumor-bearing canine model were examined. A 6-month survival study was conducted. Each animal received three radiation treatments, in the right, central, and left hepatic regions. Three low-dose treatments were delivered to each of six animals (group A), generating a 2.0-cm-diameter radiated sphere with a dose of 20 Gy at the lesion edge. Three high-dose treatments were delivered to each of six animals (group B), generating a 3.0-cm-diameter radiated sphere with 20 Gy at the lesion edge.
Results: The treatment reproducibly generated sharply demarcated hepatic ablative lesions proportional to the administered dose. Mean lesion diameter at 1 month was 1.6 ± 0.2 cm in group A and 3.4 ± 1.0 cm in group B. Lesion size was independent of intrahepatic location, including near vascular structures. PRS therapy, when applied to portal structures, resulted in hilar damage. Hilar damage appeared to be associated with arteriolar thrombosis and bile duct injury. Treatment of regions adjacent to large hepatic veins and the IVC was not associated with vessel thrombosis or stricture.
Conclusions: PRS ablation is a generally well-tolerated method that results in consistent, well-demarcated, symmetric lesions of complete necrosis with minimal adjacent parenchymal injury. Application of such an approach for the treatment of liver tumors is promising.</description><identifier>ISSN: 1072-7515</identifier><identifier>EISSN: 1879-1190</identifier><identifier>DOI: 10.1016/S1072-7515(00)00295-7</identifier><identifier>PMID: 10945360</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Animals ; Arterioles - radiation effects ; Bile Ducts, Intrahepatic - radiation effects ; Biological and medical sciences ; Disease Models, Animal ; Dogs ; Dose-Response Relationship, Radiation ; Equipment Design ; Feasibility Studies ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Hepatic Veins - radiation effects ; Liver - blood supply ; Liver - radiation effects ; Liver - surgery ; Liver Neoplasms - surgery ; Liver, biliary tract, pancreas, portal circulation, spleen ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Medical sciences ; Other diseases. Semiology ; Photons ; Radiation Injuries, Experimental - etiology ; Radiosurgery - adverse effects ; Radiosurgery - instrumentation ; Radiosurgery - methods ; Radiotherapy Dosage ; Reproducibility of Results ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Survival Rate ; Thrombosis - etiology ; Vena Cava, Inferior - radiation effects</subject><ispartof>Journal of the American College of Surgeons, 2000-08, Vol.191 (2), p.164-174</ispartof><rights>2000 American College of Surgeons</rights><rights>2000 INIST-CNRS</rights><rights>Copyright American College of Surgeons Aug 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1072751500002957$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306,69986</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1449581$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10945360$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koniaris, Leonidas G</creatorcontrib><creatorcontrib>Chan, David Y</creatorcontrib><creatorcontrib>Magee, Carolyn</creatorcontrib><creatorcontrib>Solomon, Stephen B</creatorcontrib><creatorcontrib>Anderson, James H</creatorcontrib><creatorcontrib>Smith, Donald O</creatorcontrib><creatorcontrib>De Weese, Theodore</creatorcontrib><creatorcontrib>Kavoussi, Louis R</creatorcontrib><creatorcontrib>Choti, Michael A</creatorcontrib><title>Focal hepatic ablation using interstitial photon radiation energy</title><title>Journal of the American College of Surgeons</title><addtitle>J Am Coll Surg</addtitle><description>Background: Intratumoral ablative therapy is being used increasingly for the treatment of primary and secondary hepatic malignancies. The interstitial point-source photon radiosurgery system (PRS) is a novel ablative technique that uses radiation therapy similar in dosimetry to interstitial brachytherapy.
Study Design: To determine the feasibility, toxicity, and local tissue destructive capabilities of the PRS in the liver, preliminary studies in a nontumor-bearing canine model were examined. A 6-month survival study was conducted. Each animal received three radiation treatments, in the right, central, and left hepatic regions. Three low-dose treatments were delivered to each of six animals (group A), generating a 2.0-cm-diameter radiated sphere with a dose of 20 Gy at the lesion edge. Three high-dose treatments were delivered to each of six animals (group B), generating a 3.0-cm-diameter radiated sphere with 20 Gy at the lesion edge.
Results: The treatment reproducibly generated sharply demarcated hepatic ablative lesions proportional to the administered dose. Mean lesion diameter at 1 month was 1.6 ± 0.2 cm in group A and 3.4 ± 1.0 cm in group B. Lesion size was independent of intrahepatic location, including near vascular structures. PRS therapy, when applied to portal structures, resulted in hilar damage. Hilar damage appeared to be associated with arteriolar thrombosis and bile duct injury. Treatment of regions adjacent to large hepatic veins and the IVC was not associated with vessel thrombosis or stricture.
Conclusions: PRS ablation is a generally well-tolerated method that results in consistent, well-demarcated, symmetric lesions of complete necrosis with minimal adjacent parenchymal injury. Application of such an approach for the treatment of liver tumors is promising.</description><subject>Animals</subject><subject>Arterioles - radiation effects</subject><subject>Bile Ducts, Intrahepatic - radiation effects</subject><subject>Biological and medical sciences</subject><subject>Disease Models, Animal</subject><subject>Dogs</subject><subject>Dose-Response Relationship, Radiation</subject><subject>Equipment Design</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hepatic Veins - radiation effects</subject><subject>Liver - blood supply</subject><subject>Liver - radiation effects</subject><subject>Liver - surgery</subject><subject>Liver Neoplasms - surgery</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Medical sciences</subject><subject>Other diseases. Semiology</subject><subject>Photons</subject><subject>Radiation Injuries, Experimental - etiology</subject><subject>Radiosurgery - adverse effects</subject><subject>Radiosurgery - instrumentation</subject><subject>Radiosurgery - methods</subject><subject>Radiotherapy Dosage</subject><subject>Reproducibility of Results</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Survival Rate</subject><subject>Thrombosis - etiology</subject><subject>Vena Cava, Inferior - radiation effects</subject><issn>1072-7515</issn><issn>1879-1190</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0V1LwzAUBuAgipvTn6AU8UIvque0TdNcyRhOhYEX6nVIk3TL2NqatML-vdkXXp1AHk548xJyjfCIgPnTJwJLYkaR3gM8ACScxuyEDLFgPEbkcBrORzIgF94vAZABz8_JAIFnNM1hSMbTRslVtDCt7KyKZLkKs6mj3tt6Htm6M853trPBtIumCzdOars3pjZuvrkkZ5VceXN1mCPyPX35mrzFs4_X98l4FpsUeReXOS2TEmUCaWaStKI61UonmiJqXhpZMFZKXeUMskrmFHNArkIOydJKlYVKR-R2v7d1zU9vfCeWTe_q8KRIMMAEeRbQzQH15dpo0Tq7lm4jjoEDuDsA6UPwyslaWf_vsozTAgN73jMTEv1a44RX1tTKaOuM6oRubNgptk2IXRNi-80CQOyaECz9A4_6eU0</recordid><startdate>20000801</startdate><enddate>20000801</enddate><creator>Koniaris, Leonidas G</creator><creator>Chan, David Y</creator><creator>Magee, Carolyn</creator><creator>Solomon, Stephen B</creator><creator>Anderson, James H</creator><creator>Smith, Donald O</creator><creator>De Weese, Theodore</creator><creator>Kavoussi, Louis R</creator><creator>Choti, Michael A</creator><general>Elsevier Inc</general><general>Elsevier Science</general><general>American College of Surgeons</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>20000801</creationdate><title>Focal hepatic ablation using interstitial photon radiation energy</title><author>Koniaris, Leonidas G ; Chan, David Y ; Magee, Carolyn ; Solomon, Stephen B ; Anderson, James H ; Smith, Donald O ; De Weese, Theodore ; Kavoussi, Louis R ; Choti, Michael A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-e319t-b65b2b1a2034e23f5d3dcd2d511d9bea877badf6704fa6516019c119a73fcb8c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Animals</topic><topic>Arterioles - radiation effects</topic><topic>Bile Ducts, Intrahepatic - radiation effects</topic><topic>Biological and medical sciences</topic><topic>Disease Models, Animal</topic><topic>Dogs</topic><topic>Dose-Response Relationship, Radiation</topic><topic>Equipment Design</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hepatic Veins - radiation effects</topic><topic>Liver - blood supply</topic><topic>Liver - radiation effects</topic><topic>Liver - surgery</topic><topic>Liver Neoplasms - surgery</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Medical sciences</topic><topic>Other diseases. Semiology</topic><topic>Photons</topic><topic>Radiation Injuries, Experimental - etiology</topic><topic>Radiosurgery - adverse effects</topic><topic>Radiosurgery - instrumentation</topic><topic>Radiosurgery - methods</topic><topic>Radiotherapy Dosage</topic><topic>Reproducibility of Results</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Survival Rate</topic><topic>Thrombosis - etiology</topic><topic>Vena Cava, Inferior - radiation effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koniaris, Leonidas G</creatorcontrib><creatorcontrib>Chan, David Y</creatorcontrib><creatorcontrib>Magee, Carolyn</creatorcontrib><creatorcontrib>Solomon, Stephen B</creatorcontrib><creatorcontrib>Anderson, James H</creatorcontrib><creatorcontrib>Smith, Donald O</creatorcontrib><creatorcontrib>De Weese, Theodore</creatorcontrib><creatorcontrib>Kavoussi, Louis R</creatorcontrib><creatorcontrib>Choti, Michael A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><jtitle>Journal of the American College of Surgeons</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koniaris, Leonidas G</au><au>Chan, David Y</au><au>Magee, Carolyn</au><au>Solomon, Stephen B</au><au>Anderson, James H</au><au>Smith, Donald O</au><au>De Weese, Theodore</au><au>Kavoussi, Louis R</au><au>Choti, Michael A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Focal hepatic ablation using interstitial photon radiation energy</atitle><jtitle>Journal of the American College of Surgeons</jtitle><addtitle>J Am Coll Surg</addtitle><date>2000-08-01</date><risdate>2000</risdate><volume>191</volume><issue>2</issue><spage>164</spage><epage>174</epage><pages>164-174</pages><issn>1072-7515</issn><eissn>1879-1190</eissn><abstract>Background: Intratumoral ablative therapy is being used increasingly for the treatment of primary and secondary hepatic malignancies. The interstitial point-source photon radiosurgery system (PRS) is a novel ablative technique that uses radiation therapy similar in dosimetry to interstitial brachytherapy.
Study Design: To determine the feasibility, toxicity, and local tissue destructive capabilities of the PRS in the liver, preliminary studies in a nontumor-bearing canine model were examined. A 6-month survival study was conducted. Each animal received three radiation treatments, in the right, central, and left hepatic regions. Three low-dose treatments were delivered to each of six animals (group A), generating a 2.0-cm-diameter radiated sphere with a dose of 20 Gy at the lesion edge. Three high-dose treatments were delivered to each of six animals (group B), generating a 3.0-cm-diameter radiated sphere with 20 Gy at the lesion edge.
Results: The treatment reproducibly generated sharply demarcated hepatic ablative lesions proportional to the administered dose. Mean lesion diameter at 1 month was 1.6 ± 0.2 cm in group A and 3.4 ± 1.0 cm in group B. Lesion size was independent of intrahepatic location, including near vascular structures. PRS therapy, when applied to portal structures, resulted in hilar damage. Hilar damage appeared to be associated with arteriolar thrombosis and bile duct injury. Treatment of regions adjacent to large hepatic veins and the IVC was not associated with vessel thrombosis or stricture.
Conclusions: PRS ablation is a generally well-tolerated method that results in consistent, well-demarcated, symmetric lesions of complete necrosis with minimal adjacent parenchymal injury. Application of such an approach for the treatment of liver tumors is promising.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10945360</pmid><doi>10.1016/S1072-7515(00)00295-7</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1072-7515 |
| ispartof | Journal of the American College of Surgeons, 2000-08, Vol.191 (2), p.164-174 |
| issn | 1072-7515 1879-1190 |
| language | eng |
| recordid | cdi_proquest_journals_211192194 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Animals Arterioles - radiation effects Bile Ducts, Intrahepatic - radiation effects Biological and medical sciences Disease Models, Animal Dogs Dose-Response Relationship, Radiation Equipment Design Feasibility Studies Female Gastroenterology. Liver. Pancreas. Abdomen Hepatic Veins - radiation effects Liver - blood supply Liver - radiation effects Liver - surgery Liver Neoplasms - surgery Liver, biliary tract, pancreas, portal circulation, spleen Liver. Biliary tract. Portal circulation. Exocrine pancreas Medical sciences Other diseases. Semiology Photons Radiation Injuries, Experimental - etiology Radiosurgery - adverse effects Radiosurgery - instrumentation Radiosurgery - methods Radiotherapy Dosage Reproducibility of Results Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Survival Rate Thrombosis - etiology Vena Cava, Inferior - radiation effects |
| title | Focal hepatic ablation using interstitial photon radiation energy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T02%3A52%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Focal%20hepatic%20ablation%20using%20interstitial%20photon%20radiation%20energy&rft.jtitle=Journal%20of%20the%20American%20College%20of%20Surgeons&rft.au=Koniaris,%20Leonidas%20G&rft.date=2000-08-01&rft.volume=191&rft.issue=2&rft.spage=164&rft.epage=174&rft.pages=164-174&rft.issn=1072-7515&rft.eissn=1879-1190&rft_id=info:doi/10.1016/S1072-7515(00)00295-7&rft_dat=%3Cproquest_pubme%3E59697568%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=211192194&rft_id=info:pmid/10945360&rft_els_id=S1072751500002957&rfr_iscdi=true |