Brachytherapy Technique for Abdominal Wall Metastases of Colorectal Cancer: Ultrasound-Guided Insertion of Applicator Needle and A Skin Preservation Method

Purpose: To report a technique of interstitial brachytherapy for the treatment of subcutaneous metastatic abdominal wall tumors.Material and Methods: We developed a brachytherapy technique consisting of ultrasound-guided insertion of applicator needles to avoid the organs at risk, such as intestines, and saline injection into the subcutaneous tissue between the tumor and the skin to decrease the skin dose. We encountered three patients with painful metastases from rectal carcinoma in the abdominal wall refractory to external radiotherapy. They were Subjected to this brachytherapy with a single dose of 20 Gy.Results: The procedure was safely achieved in all three patients. Long-lasting pain reduction and tumor shrinkage was obtained without early or late complications.Conclusion: This interstitial brachytherapy technique seems to be feasible in the treatment of metastatic abdominal wall tumors.