Novel Use of Endoscopic Clips as Fiducials for Radiotherapy in Small Bowel Lymphoma

Abstract

A 31-year-old woman was diagnosed with duodenal grade 1 follicular lymphoma. The patient underwent radiotherapy and on surveillance enteroscopy, the lymphoma was persistently identified in the duodenum and jejunum. Endoscopic clips were used as fiducials to better localize the tumor during radiotherapy. Endoscopic clips are increasingly used as tumor localization tools because of their favorable risk-benefit ratio. In our case, endoscopic clipping was necessary to properly localize the tumor after prior treatment failure, and the patient now has no evidence of disease. Larger studies are needed to demonstrate the efficacy of clips in tumor localization and improved disease-related morbidity.

Stereotactic Ablative Radiation Therapy as a Potential Curative Treatment in Duodenal Adenocarcinoma: A Case Report

“…In some cases, locally advanced disease or coexisting comorbidities could compromise the principal treatment. Like in other conditions, i.e., in stage I lung cancer, SABR is becoming a possible treatment option with excellent disease control rate and good tolerance owing to its schedule: high radiotherapy dose on a limited, well-defined area (8,9). Recent studies have examined SBRT in abdominal lesions, as treatment of localized oligometastatic disease, revealing optimal tumor control without severe toxicities (10).…”