CT-Guided Brachytherapy (CTGB) versus Interstitial Laser Ablation (ILT) of Colorectal Liver Metastases

PURPOSE: To compare local tumor control after percutaneous tumor ablation by interstitial laser therapy (ILT) or CT-guided brachytherapy (CTGB). PATIENTS AND METHODS: In a matched pair analysis including 18 patients with 36 liver metastases of colorectal primary, both ILT and CTGB were performed in different lesions. The following matching factors were considered: (i) tumor size < or = 5 cm, and (ii) execution of chemotherapy after tumor ablation. Primary endpoint was local tumor control. RESULTS: Treated lesions were identical in terms of tumor size and all matching criteria were fulfilled in all patients except for the performance of adjuvant chemotherapy. Median follow-up was 14 months (3-24 months) for both groups. Only five of 18 patients (28%) demonstrated local tumor progression after CTGB, whereas in ten of 18 patients (56%) tumor progression was found after ILT. Differences encountered were significant for all patients (p = 0.04), whereas in those who fulfilled all matching criteria (n = 14) the level of statistical significance was not reached (p = 0.23). CONCLUSION: CTGB demonstrated superior local tumor control compared to ILT in long-term follow-up.