Fawaz Z S, Yassa M, Nguyen D H, Vavassis P
Department of Radiation Oncology, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada; Department of Radiation Oncology, McGill University Health Center, Montreal, Canada.
Department of Radiation Oncology, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada.
Cancer Radiother. 2014 Dec;18(8):736-9. doi: 10.1016/j.canrad.2014.07.160. Epub 2014 Oct 16.
This study aims to report the complication rate from the transrectal ultrasound-guided implantation of gold seed markers in prostate radiotherapy, as well as describing the technique used.
Between May 2010 and December 2012, 169 patients with localized prostate cancer had an intraprostatic fiducial marker implantation under transrectal ultrasound guidance. The procedure included prophylactic antibiotic therapy, fleet enema, implantation performed by trained radiation oncologists at our center prior to image-guided radiotherapy. Toxicity occurring between implantation and subsequent radiotherapy start date was assessed. The following parameters were analyzed via medical chart review: antibiotic therapy, anticoagulant interruption, bleeding, pain, prostate volume, number of markers implanted, post-implantation complications and delay before starting radiotherapy.
Of the 169 men, 119 (70.4%) underwent insertion of 4 fiducial markers and the other 50 (29.6%) had 3. The procedure was well-tolerated. There was no interruption of the implantation with regards to pain or hemorrhage. No grade 3 or 4 complications were observed. Seed migration rate was 0.32%, for the migration of 2 markers on 626 implanted. Mean prostate volume was 38 cm(3) (range: 10-150 cm(3)). Two patients (1.18%) developed a urinary tract infection following the procedure: prostate volume of 25 and 65 cm(3), four gold seed markers implanted, urinary tract infection resistant to prophylactic antibiotherapy, and treated with antibiotics specific to their infection as determined on urine culture.
Transrectal fiducial marker implantation for image-guided radiotherapy in prostate cancer is a well-tolerated procedure without major associated complications.
本研究旨在报告经直肠超声引导下前列腺放疗中植入金种子标记物的并发症发生率，并描述所采用的技术。
2010年5月至2012年12月期间，169例局限性前列腺癌患者在经直肠超声引导下进行了前列腺内基准标记物植入。该操作包括预防性抗生素治疗、缓泻灌肠，由我们中心训练有素的放射肿瘤学家在图像引导放疗前进行植入。评估了植入与随后放疗开始日期之间发生的毒性反应。通过病历审查分析了以下参数：抗生素治疗、抗凝剂中断、出血、疼痛、前列腺体积、植入的标记物数量、植入后并发症以及开始放疗前的延迟情况。
169名男性中，119名（70.4%）植入了4个基准标记物，另外50名（29.6%）植入了3个。该操作耐受性良好。在疼痛或出血方面，植入过程未中断。未观察到3级或4级并发症。种子迁移率为0.32%，在626个植入的标记物中有2个发生迁移。平均前列腺体积为38 cm³（范围：10 - 150 cm³）。两名患者（1.18%）在术后发生了尿路感染：前列腺体积分别为25和65 cm³，植入了4个金种子标记物，对预防性抗生素治疗耐药，根据尿液培养结果用针对其感染的抗生素进行治疗。
经直肠基准标记物植入用于前列腺癌图像引导放疗是一种耐受性良好的操作，无重大相关并发症。
