Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, China.
Clin Lung Cancer. 2023 Jul;24(5):e187-e194. doi: 10.1016/j.cllc.2023.04.003. Epub 2023 Apr 8.
The risk factors for operation complications of high-dose-rate dimensional (3D) interstitial brachytherapy for lung malignant tumors are still unclear. We aimed to provide a reliable reference for the preoperative safety assessment of interstitial brachytherapy.
We analyzed the degree and incidence of operational complications in 120 eligible patients with lung carcinoma who underwent computed tomography (CT)-guided HDR interstitial brachytherapy. Univariate and multivariate analyses were used to study the relationships between patient-related factors, tumor-related factors, operation-related factors, and operational complications.
The most frequent complications of CT-guided HDR interstitial brachytherapy were pneumothorax and hemorrhage. In univariate analysis, smoking, emphysema, distance of implanted needles through the normal lung tissue, number of implanted needle adjustments, and distance of the lesion from the pleura were the risk factors for pneumothorax; the tumor size, distance of the tumor from the pleura, number of implanted needle adjustments, and distance of the implanted needle through the normal lung tissue were risk factors for hemorrhage. In multivariate analysis, the depth of the implanted needle through the normal lung tissue and distance of the lesion from the pleura were independent risk factors for pneumothorax. Tumor size, number of implanted needle adjustments, and distance through normal lung tissue were independent risk factors for hemorrhage.
This study provides a reference for the clinical treatment of lung cancer by analyzing the risk factors for complications of interstitial brachytherapy.
高剂量率三维（3D）间质近距离放疗治疗肺部恶性肿瘤的手术并发症的危险因素仍不清楚。我们旨在为间质近距离放疗的术前安全评估提供可靠的参考。
我们分析了 120 例符合条件的肺癌患者接受 CT 引导下 HDR 间质近距离放疗后手术并发症的严重程度和发生率。使用单因素和多因素分析研究了患者相关因素、肿瘤相关因素、手术相关因素与手术并发症之间的关系。
CT 引导下 HDR 间质近距离放疗最常见的并发症是气胸和出血。单因素分析显示，吸烟、肺气肿、植入针穿过正常肺组织的距离、植入针调整次数和病变与胸膜的距离是气胸的危险因素；肿瘤大小、肿瘤与胸膜的距离、植入针调整次数和植入针穿过正常肺组织的距离是出血的危险因素。多因素分析显示，植入针穿过正常肺组织的深度和病变与胸膜的距离是气胸的独立危险因素。肿瘤大小、植入针调整次数和穿过正常肺组织的距离是出血的独立危险因素。
本研究通过分析间质近距离放疗并发症的危险因素，为肺癌的临床治疗提供了参考。
