Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Br J Radiol. 2012 Jul;85(1015):1011-7. doi: 10.1259/bjr/68127917. Epub 2012 Jan 17.
To report on complications from transrectal ultrasound-guided insertion of fiducial markers for prostate image-guided radiotherapy.
234 patients who underwent transrectal fiducial marker insertion for prostate cancer image-guided radiotherapy were assessed retrospectively by questionnaire with regard to the duration and severity of eight symptoms experienced following the procedure. Pain during the implantation procedure was assessed according to the Wong-Baker faces pain scale.
Of 234 patients, 32% had at least one new symptom after the procedure. The commonest new symptom following the procedure was urinary frequency affecting 16% of patients who had not been troubled by frequency beforehand. Haematuria, rectal bleeding, dysuria and haematospermia affected 9-13% of patients, mostly at Grade 1 or 2. Pain, obstruction, and fever and shivers affected 3-4% of patients. Grade 3 rectal bleeding, haematuria, fever and shivers, and urinary frequency affected 0.5-1.5% of patients. Only one patient had a Grade 4 complication (i.e. fever and shivers). Overall, 9% of patients had symptoms lasting more than 2 weeks. The commonest symptoms that lasted more than 2 weeks were frequency, dysuria, obstructive symptoms and rectal bleeding. Mean pain score during the procedure was 1.1 (range 0-5).
Transrectal ultrasound-guided fiducial marker insertion for image-guided radiotherapy is well tolerated in the majority of prostate cancer patients. Most symptoms were Grade 1 or 2 in severity. Symptoms in the majority of patients last under 2 weeks. The most serious complication was sepsis in our study.
报告经直肠超声引导前列腺图像引导放疗中植入示踪器的并发症。
回顾性评估 234 例接受经直肠 fiducial 标志物植入术的前列腺癌图像引导放疗患者，通过问卷调查评估术后 8 种症状的持续时间和严重程度。根据 Wong-Baker 面部疼痛量表评估植入过程中的疼痛。
234 例患者中，32%在术后至少出现一种新症状。术后最常见的新症状是尿频率增加，影响了 16%术前没有尿频的患者。血尿、直肠出血、排尿困难和血精影响了 9-13%的患者，大多数为 1 级或 2 级。疼痛、梗阻、发热和寒战以及发热影响了 3-4%的患者。3 级直肠出血、血尿、发热和寒战以及尿频率影响了 0.5-1.5%的患者。仅有 1 例患者发生 4 级并发症（即发热和寒战）。总体而言，9%的患者症状持续超过 2 周。持续时间超过 2 周的最常见症状是尿频、排尿困难、梗阻症状和直肠出血。术中平均疼痛评分为 1.1（范围 0-5）。
经直肠超声引导的图像引导放疗中植入示踪器在大多数前列腺癌患者中耐受性良好。大多数症状严重程度为 1 级或 2 级。大多数患者的症状持续时间不到 2 周。在我们的研究中，最严重的并发症是脓毒症。
