BACKGROUND: CT-guided high-dose-rate brachytherapy(CT-HDRBT) is an interventional radiologic technique for local ablation of primary and secondary malignomas applying a radiation source through a brachycatheter percutaneously into the targeted lesion. The aim of this study was to assess local tumor control, safety and efficacy of CT-HDRBT in the treatment of liver metastases of pancreatic cancer. METHODS: Twenty consecutive patients with 49 unresectable liver metastases of pancreatic cancer were included in this retrospective trial and treated with CT-HDRBT, applied as a single fraction high-dose irradiation(15-20 Gy) using a 192 Irsource. Primary endpoint was local tumor control and secondary endpoints were complications, progression-free survival and overall survival.RESULTS: The mean tumor diameter was 29 mm(range 10-73). The mean irradiation time was 20 minutes(range 7-42). The mean coverage of the clinical target volume was 98%(range 88%-100%). The mean D100 was 18.1 Gy and the median D100 was 19.78 Gy. Three major complications occurred with post-interventional abscesses, three of which were seen in 15 patients with biliodigestive anastomosis(20%)and overall 15%. The mean follow-up time was 13.7 months(range 1.4-55.0). The median progression-free survival was 4.9 months(range 1.4-42.9, mean 9.4). Local recurrence occurred in 5(10%) of 49 metastases treated. The median overall survival after CT-HDRBT was 8.6 months(range 1.5-55.3). Eleven patients received chemotherapy after ablation with a median progression-free survival of 4.9 months(mean 12.9). Nine patients did not receive chemotherapy after intervention with a median progression-free survival of 3.2 months(mean 5.0). The rate of local tumor control was 91% in both groups after 12 months.CONCLUSION: CT-HDRBT was safe and effective for the treatment of liver metastases of pancreatic cancer.