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.

中文翻译：

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计算机断层扫描引导的大剂量近距离放射治疗（CT-HDRBT）的并发症和危险因素：十多年经验的结果。

目的对于无法切除的肿瘤的局部消融，计算机断层扫描引导的高剂量率近距离放射治疗（CT-HDRBT）是一种微创治疗选择，涉及CT引导的导管放置和铱192的高剂量率照射。可能的并发症与经皮穿刺，涂药器缩回和近距离放射治疗有关。为了将CT-HDRBT与其他微创治疗方案进行比较，必须了解并发症的可能性及其危险因素。因此，本研究旨在量化CT-HDRBT中并发症的发生并确定潜在的危险因素。材料与方法从2006年到2017年的10多年中，我们中心连续进行了1877例CT-HDRBT并进行了回顾性分析。在165例中 CT-HDRBT与经动脉（化学）栓塞结合。有关并发症和潜在危险因素的信息可追溯地从电子文档中检索。对数据进行统计分析。结果85.6％的干预措施未发生并发症。最常见的并发症是出血（5.6％），感染（2.0％）和长时间疼痛（1.5％）。治疗肿瘤病变的总直径（定义为轴向最大直径的总和）（奇数比1.008； p <0.001），目标病变部位（奇数比1.132； p = 0.033），联合治疗（奇数比1.233； p = 0.038） ），并且存在胆道消化道吻合术（BDA）（赔率1.824； p = 0.025）被确定为危险因素。结论CT-HDRBT是一种安全的微创治疗选择。