Comparison of marker implantation through trans-perineal or trans-rectal puncture guided by trans-rectal ultrasound and analysis of risks
Objective To compare the methods of the gold fiducial marker(GFM)implanta-tion by the trans-rectal ultrasound-guided perineal puncture(TPUS)and the trans-rectal ultrasound-guided rectal puncture(TRUS),and to analyze the risk factors of the adverse event(AE)in image-guided radiotherapy for prostate cancer(PCa).Methods The collection of 212 PCa patients who were diagnosed and treated in the First Affiliated Hospital of Hebei North University from August 2017 to December 2021 was conducted for the prospective research.The patients were randomly divided into the TPUS group(100 cases)and the TRUS group(112 cases)by using the lot drawing method.The pain,bleeding and infection of the patients from the two groups were compared,and the risk factors of the AE were analyzed by using the logistic regression.Results Compared with TRUS group,the num-ber of patients with Karnofsky score(KPS),androgen deprivation therapy(ADT),anticoagulant drug use and prostate volume＜30 cm3 in TPUS group was lower,and the differences were statistically sig-nificant(all P＜0.05).The number of patients with pain visual analogue score(VAS)≥4 scores and severe bleeding in the TPUS group was significantly higher than that in the TRUS group(P=0.001,0.019).The overall infection rate was lower in the TPUS group(7.00％)than in the TRUS group(9.82％).The univariate analysis of the influencing factors of VAS showed that there were sta-tistically significant differences in age,prostate volume,anticoagulant use,and ADT between the two groups(all P＜0.05).The results of multivariate analysis showed that PCa patients aged ≥ 60 years had a 5.432 fold increased risk of VAS≥4 points(P=0.022).The univariate analysis results of factors affecting severe bleeding showed that there were statistically significant differences in age,pros-tate volume,and anticoagulant use between the two groups(all P＜0.05).The multivariate analysis results showed that the risk of severe bleeding increased by 4.702 times(P=0.015)and 5.836 times(P＜0.001)in patients aged ≥ 60 years and with prostate volume ≥ 30 cm3,respectively.Conclu-sions PUS and TRUS have their own advantages and disadvantages.It is necessary to select the method according to the patients condition and make the nursing preparations.
万方数据
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