Ultrasound-Guided Transrectal Implantation of Gold Markers for Prostate Localization During External Beam Radiotherapy: Complication Rate and Risk Factors

Purpose To report the complication rate and risk factors of transrectally implanted gold markers, used for prostate position verification and correction procedures. Methods and Materials In 209 consecutive men with localized prostate cancer, four gold markers (1 × 7 mm) were inserted under ultrasound guidance in an outpatient setting, and the toxicity was analyzed. All patients received a questionnaire regarding complications after marker implantation. The complications and risk factors were further evaluated by reviewing the medical charts. Results Of the 209 men, 13 (6.2%) had a moderate complication, consisting of pain and fever that resolved after treatment with oral medication. In 1.9% of the men, minor voiding complaints were observed. Other minor transient complications, defined as hematuria lasting >3 days, hematospermia, and rectal bleeding, occurred in 3.8%, 18.5%, and 9.1% of the patients, respectively. These complications were seen more often in patients with advanced tumor stage, younger age, and shorter duration of hormonal therapy. Conclusion Transrectal gold marker implantation for high-precision prostate radiotherapy is a safe and well-tolerated procedure.