Clinical studySafety and Efficacy of Percutaneous Fiducial Marker Implantation for Image-guided Radiation Therapy
Section snippets
Materials and Methods
This retrospective study was granted a waiver by the institutional review board. Data were handled in compliance with the Health Insurance Portability and Accountability Act. From January 2003 to January 2008, 132 patients (mean age, 66.4 years; age range, 23–89 years) underwent 139 procedures (Table 1). Five patients underwent implantations on two separate occasions for anatomically distinct tumors. Seventy-one patients were men and 61 were women. Of these 139 procedures, 44 were lung
Safety and Technical Success
The median number of fiducial markers implanted for each tumor was four (range, 3–7). There were no procedure-related deaths. Major complications occurred in seven of the 139 implantations (5%). Minor complications occurred in 24 patients (17.3%). Of the 139 implantations, 133 were technically successful; in six implantations (4.3%), the fiducial markers migrated and required additional procedures or alternate methods of implantation. The results are summarized in Table 2.
Lung Implantation
A total of 42 patients
Discussion
For more than half a century, principles of stereotaxy have been used in radiation therapy, predominantly for intracranial and spinal applications. Traditional sterotaxy requires rigid immobilization to establish spatial coordinates for precise guidance. This can be achieved for intracranial and spinal targets with rigid frames and skeletal fixation but is limited for extracranial sites. The limitations of applying conventional systems to extracranial targets include respiratory and
References (34)
- et al.
Society of Interventional Radiology clinical practice guidelines
J Vasc Interv Radiol
(2003) - et al.
Irradiation synchronized with respiration gate
Int J Radiat Oncol Biol Phys
(1989) - et al.
Analysis of movement of intrathoracic neoplasms using ultrafast computerized tomography
Int J Radiat Oncol Biol Phys
(1990) - et al.
Dosimetric evaluation of lung tumor immobilization using breath hold at deep inspiration
Int J Radiat Oncol Biol Phys
(2001) - et al.
The use of active breathing control (ABC) to reduce margin for breathing motion
Int J Radiat Oncol Biol Phys
(1999) - et al.
Medically inoperable lung carcinoma: the role of radiation therapy
Semin Radiat Oncol
(1996) - et al.
Radical radiotherapy for early nonsmall cell lung cancer
Int J Radiat Oncol Biol Phys
(1995) - et al.
Computed tomography–guided frameless stereotactic radiotherapy for stage I non-small cell lung cancer: a 5-year experience
Int J Radiat Oncol Biol Phys
(2001) - et al.
Extracranial stereotactic radioablation: results of a phase I study in medically inoperable stage I non-small cell lung cancer
Chest
(2003) - et al.
Stereotactic single-dose radiotherapy of stage I non-small-cell lung cancer (NSCLC)
Int J Radiat Oncol Biol Phys
(2003)
Clinical outcomes of 3D conformal hypofractionated single high-dose radiotherapy for one or two lung tumors using a stereotactic body frame
Int J Radiat Oncol Biol Phys
Phase I study of stereotactic radiosurgery in patients with locally advanced pancreatic cancer
Int J Radiat Oncol Biol Phys
Phase II study to assess the efficacy of conventionally fractionated radiotherapy followed by a stereotactic radiosurgery boost in patients with locally advanced pancreatic cancer
Int J Radiat Oncol Biol Phys
Quality improvement guidelines for image-guided percutaneous biopsy in adults
J Vasc Interv Radiol
Complications of thoracic computed tomography-guided fiducial placement for the purpose of stereotactic body radiation therapy
Clin Lung Cancer
CT-guided core needle biopsy in the diagnosis of pancreatic diseases with an automated biopsy gun
J Vasc Interv Radiol
EUS-guided fiducial placement for CyberKnife radiotherapy of mediastinal and abdominal malignancies
Gastrointest Endosc
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None of the authors have identified a conflict of interest.