Feasibility and safety of CT guided high dose rate brachytherapy of liver tumors performed under conscious sedation with analgesia

Abstract Purpose The purpose of this study was to evaluate the feasibility and safety for CT-guided High Dose Rate brachytherapy under conscious sedation with analgesia performed by interventional radiologists in patients with liver malignancies. Material and Methods This prospective, observational, and IRB-approved single-center study (EA/122/23) aimed to evaluate patient experiences and outcomes related to the procedure. A total of 74 patients with malignant liver tumors were included in the final analysis. Data were collected using structured questionnaires, with pain assessed via numeric rating scales (NRS). The study also analyzed the following parameters: 1. Age; 2. Sex; 3. Number of lesions, catheters, and pre-treatments; 4. Tumor size (complete tumor volume, CTV); 5. Tumor location and 6. Complications. Results Pain was measured (0: no pain; to 10: maximum pain) 1. at catheter placement; 2. at the time of radiation (catheter removal); 3. After the radiation on the ward. At catheter placement, 74.5% rated the pain as low (0–2), 19.0% as moderate (3–6), and 6.5% as severe (7–10). At the radiation and afterwards, pain levels were rated as low in 84.0% and 79.5%, as moderate in 11.0% and 16.0% and as severe in 5.5% and 4.0%, respectively. At the time of irradiation, women reported increased pain ( p < 0.001), and the number of lesions were associated with higher pain levels ( p < 0.05). Mild to moderate complications were observed in 23.0% including pain and fever. No major complications were observed. Conclusion In conclusion, CT-guided HDR brachytherapy under conscious sedation with analgesia performed by interventional radiologists in patients with liver tumors is safe and feasible and can be integrated into the clinical routine.