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Strobl, Frederik F.; Azam, Houman; Schwarz, Jens B.; Paprottka, Philipp M.; Geith, Tobias; Abdel-Rahman, Sultan; Zilles, Benjamin; Lindner, Lars H.; Reiser, Maximilian F.; Trumm, Christoph G. (2016): CT fluoroscopy-guided closed-tip catheter placement before regional hyperthermia treatment of soft tissue sarcomas: 5-Year experience in 35 consecutive patients. In: International Journal of Hyperthermia, Vol. 32, No. 2: pp. 151-158
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Abstract

Purpose: This study was designed to assess technical success and complications in patients with high-risk soft tissue sarcomas undergoing CT fluoroscopy-guided closed-tip catheter placement before treatment with combined chemotherapy and regional hyperthermia. Materials and methods: This retrospective study comprised all patients referred for insertion of closed-tip catheters for the introduction of thermometry probes before regional hyperthermia treatment at a single university centre from 2010 to 2015. Catheter placements were performed under local anaesthesia and intermittent CT fluoroscopy guidance. Technical success, complication rate, duration of catheter insertion and dose-length product (DLP) were analysed. Technical success was defined as intratumoural catheter placement suitable for subsequent thermometry. Results: A total of 35 procedures were performed on 35 patients (22 men, 13 women). In 34 out of 35 interventions catheters were inserted successfully;in one patient catheter placement was not feasible. No intra-interventional complications occurred. In six patients post-interventional complications were observed - two major (one abscess formation and one severe catheter dislocation) and four minor complications. Technical failure was observed in 11.4% of patients, especially catheter kinking. A total of 55 catheters were placed, with a mean number of 1.7 +/- 0.7 per patient. Mean total DLP was 723.2 +/- 355.9 mGy*cm. Conclusion: CT fluoroscopy-guided closed-tip catheter placement into high-risk soft tissue sarcomas was characterised by high technical success and relatively low complication rate. While major complications were rarely observed, catheter-kinking preventing successful thermometry represented the most frequent technical failure.