Department of Radiation Oncology, Saku Central Hospital Advanced Care Center, 3400-28 Nakagomi, Saku-shi, Nagano 385-0051, Japan.
Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma 371-8511, Japan.
J Radiat Res. 2024 May 23;65(3):387-392. doi: 10.1093/jrr/rrae018.
The purpose of this study is to evaluate the need for prophylactic antibiotic treatment prior to combined intracavitary and interstitial (hybrid) brachytherapy for gynecologic cancer. A total of 105 gynecologic cancer patients received 405 brachytherapy sessions, including 302 sessions of intracavitary brachytherapy and 103 sessions of hybrid brachytherapy. Prophylactic antibiotics were administered before 35% of the hybrid brachytherapy sessions. The incidence of postbrachytherapy fever and the frequency of subsequent antibiotic use for infection were compared between treatment groups. Among patients treated with hybrid brachytherapy, fever ≥37.5°C occurred in 16.4% of those not receiving prophylactic antibiotics and 16.7% of those receiving prophylactic antibiotics (P > 0.05). Similarly, fever ≥38.0°C occurred in 4.9% of patients not receiving prophylactic antibiotics and 2.4% of those receiving prophylactic antibiotics (P > 0.05). Additional antibiotics were used to treat postbrachytherapy infections in 4.8% of the group receiving prophylactic antibiotics and 0% of those not receiving prophylactic antibiotics, again without statistically significant difference. There were also no significant differences in posttreatment fever incidence and antibiotics use for infection between intracavitary brachytherapy and hybrid brachytherapy sessions. In conclusion, the incidences of infection and fever are low following hybrid brachytherapy, so prophylactic antibiotics are generally unnecessary.
本研究旨在评估妇科癌症患者接受腔内和间质（混合）近距离放疗前预防性使用抗生素的必要性。共有 105 例妇科癌症患者接受了 405 次近距离放疗，其中腔内近距离放疗 302 次，混合近距离放疗 103 次。35%的混合近距离放疗前给予预防性抗生素。比较了两组治疗后发热和随后因感染而使用抗生素的频率。在接受混合近距离放疗的患者中，未使用预防性抗生素的患者中发热≥37.5°C 的发生率为 16.4%，使用预防性抗生素的患者中为 16.7%（P>0.05）。同样，未使用预防性抗生素的患者中发热≥38.0°C 的发生率为 4.9%，使用预防性抗生素的患者中为 2.4%（P>0.05）。使用预防性抗生素的患者中有 4.8%因治疗后感染而额外使用抗生素，而未使用预防性抗生素的患者中无 0%因感染而使用抗生素，差异无统计学意义。腔内近距离放疗和混合近距离放疗后发热和感染使用抗生素的发生率也无显著差异。总之，混合近距离放疗后感染和发热的发生率较低，因此通常不需要预防性使用抗生素。
