Patient-reported complications from fiducial marker implantation for prostate image-guided radiotherapy - Abstract

Objectives: To report on complications from transrectal ultrasound-guided insertion of fiducial markers for prostate image-guided radiotherapy.

Methods: 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.

Results: 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 that were not 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 >2 weeks. The commonest symptoms that lasted >2 weeks were frequency, dysuria, obstructive symptoms and rectal bleeding. Mean pain score during the procedure was 1.1 (range 0-5).

Conclusion: 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.

Written by:
Gill S, Li J, Thomas J, Bressel M, Thursky K, Styles C, Tai KH, Duchesne GM, Foroudi F.   Are you the author?
Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.

Reference: Br J Radiol. 2012 Jan 17. Epub ahead of print.
doi: 10.1259/bjr/68127917

PubMed Abstract
PMID: 22253345 Prostate Cancer Section