High-Dose-Rate Brachytherapy Boost for Brain Gliomas: Implementation of New Technique in a Single Institution

bile tumor) and another one cholangitis complicated by sepsis (one Klatskin III tumor), so only 20 patients underwent HDR-192Ir-ILBT. One biliary brachytherapy catheter was used in 14 patients, two catheters in 6 patients. The dose delivered was 15 Gy in 3 patients, 20 Gy in 9 patients and 25 Gy in 8 patients with daily 500 cGy per fraction. During the brachytherapy procedure, cholangitis occurred in two patients. The median followup was 42 months (range 6e76 months). Two patients developed late toxicity (1 hemobilia, 1 hepatic abscess). Subsequent bouts of cholangitis occurred in 16 patients (72,7%, median 7 months) while stent occlusion (due to biliary sludge, tumor ingrown and overgrown) was observed in 12 patients (54,5%, median 13 months). Six-month and oneyear overall survival was 77% and 59%, with a median of 13 months; sixmonth and one-year local progression (tumor ingrown and overgrown) was 82% and 72% (median not reached).