Georg Böning1, Laura Büttner2, Martin Jonczyk2, Willie Magnus Lüdemann2, Timm Denecke2, Dirk Schnapauff2, Gero Wieners2, Peter Wust3, Bernhard Gebauer2. 1. Department of Radiology, Charité - Universitätsmedizin Berlin, Humboldt University and Free University of Berlin Medical School, Charitéplatz 1, 10117, Berlin, Germany. georg.boening@charite.de. 2. Department of Radiology, Charité - Universitätsmedizin Berlin, Humboldt University and Free University of Berlin Medical School, Charitéplatz 1, 10117, Berlin, Germany. 3. Department of Radiation Oncology and Radiotherapy, Charité - Universitätsmedizin Berlin, Humboldt University and Free University of Berlin Medical School, Charitéplatz 1, 10117, Berlin, Germany.
Abstract
PURPOSE: For local ablation of unresectable tumors, computed tomography-guided high-dose-rate brachytherapy (CT-HDRBT) is a minimally invasive therapeutic option involving CT-guided catheter placement and high-dose-rate irradiation with iridium-192. Possible complications are related to transcutaneous puncture, retraction of the applicator, and delivery of brachytherapy. To classify CT-HDRBT in comparison with other minimally invasive therapeutic options, it is essential to know the probability of complications and their risk factors. This study therefore aimed at quantifying the occurrence of complications in CT-HDRBT and identifying potential risk factors. MATERIALS AND METHODS: Over a period of more than 10 years from 2006 to 2017, 1877 consecutive CT-HDRBTs were performed at our center and retrospectively analyzed. In 165 cases, CT-HDRBT was combined with transarterial (chemo-) embolization. Information on complications and potential risk factors was retrospectively retrieved from electronic documentation. Statistical analysis of the data was performed. RESULTS: No complications occurred in 85.6% of the interventions. The most common complications were bleeding (5.6%), infection (2.0%), and prolonged pain (1.5%). Summarized diameter (defined as sum of maximum diameters in axial orientation) of treated tumor lesions (odds ratio 1.008; p < 0.001), target lesion site (odds ratio 1.132; p = 0.033), combined treatment (odds ratio 1.233; p = 0.038), and the presence of biliodigestive anastomosis (BDA) (odds ratio 1.824; p = 0.025) were identified as risk factors. CONCLUSIONS: CT-HDRBT is a safe minimally invasive therapeutic option. Summarized diameter of treated tumor lesions, target lesion site, combined treatment, and presence of BDA are risk factors for complications.
PURPOSE: For local ablation of unresectable tumors, computed tomography-guided high-dose-rate brachytherapy (CT-HDRBT) is a minimally invasive therapeutic option involving CT-guided catheter placement and high-dose-rate irradiation with iridium-192. Possible complications are related to transcutaneous puncture, retraction of the applicator, and delivery of brachytherapy. To classify CT-HDRBT in comparison with other minimally invasive therapeutic options, it is essential to know the probability of complications and their risk factors. This study therefore aimed at quantifying the occurrence of complications in CT-HDRBT and identifying potential risk factors. MATERIALS AND METHODS: Over a period of more than 10 years from 2006 to 2017, 1877 consecutive CT-HDRBTs were performed at our center and retrospectively analyzed. In 165 cases, CT-HDRBT was combined with transarterial (chemo-) embolization. Information on complications and potential risk factors was retrospectively retrieved from electronic documentation. Statistical analysis of the data was performed. RESULTS: No complications occurred in 85.6% of the interventions. The most common complications were bleeding (5.6%), infection (2.0%), and prolonged pain (1.5%). Summarized diameter (defined as sum of maximum diameters in axial orientation) of treated tumor lesions (odds ratio 1.008; p < 0.001), target lesion site (odds ratio 1.132; p = 0.033), combined treatment (odds ratio 1.233; p = 0.038), and the presence of biliodigestive anastomosis (BDA) (odds ratio 1.824; p = 0.025) were identified as risk factors. CONCLUSIONS: CT-HDRBT is a safe minimally invasive therapeutic option. Summarized diameter of treated tumor lesions, target lesion site, combined treatment, and presence of BDA are risk factors for complications.
Authors: Matthias P Fabritius; Najib Ben Khaled; Wolfgang G Kunz; Jens Ricke; Max Seidensticker Journal: J Clin Med Date: 2021-11-26 Impact factor: 4.241
Authors: Han Xu; Robin Schmidt; Charlie Alexander Hamm; Isabel Theresa Schobert; Yubei He; Georg Böning; Martin Jonczyk; Bernd Hamm; Bernhard Gebauer; Lynn Jeanette Savic Journal: Ther Adv Med Oncol Date: 2021-09-08 Impact factor: 8.168