Prospective observational study on the safety of an original fiducial marker insertion for radiotherapy in gynecological cancer by a simple method

Sekii, Shuhei; Tsujino, Kayoko; Kubota, Hirokazu; Yamaguchi, Satoshi; Kosaka, Kengo; Miyazaki, S.; Sulaiman, Nor Shazrina; Matsumoto, Yōko; Ota, Yosuke; Soejima, Toshinori; Sasaki, Ryohei

doi:10.1093/jrr/rrz070

Cited by 3 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Discussionmentioning

confidence: 99%

“…It is well known that intermediate-high-and high-risk EC often require adjuvant treatments such as RT or BT to reduce the risk of local relapse (3)(4)(5)(6)(7)(8). With the routine implementation of advanced RT techniques, image guidance is increasingly important.…”

Section: Discussionmentioning

confidence: 99%

“…The implantation of FM in the vaginal cuff of patients receiving EBRT or BT could help the daily patient setup, image guidance, and intra-fraction detection of the radiation targets. Within the field of radiotherapy for gynecological cancer, there are some studies in literature assessing the role of fiducial markers on helping to outline the target tissues (7)(8)(9)(10)(11). FM implantation has been used by Jhingran et al to estimate variations in vaginal apex position according to changes in rectal and bladder filling reporting significant shifts in all directions, especially in the anteriorposterior direction (9).…”

Section: Discussionmentioning

confidence: 99%

“…When delivering post-operative EBRT as adjuvant treatment for EC patients, vaginal cuff motion represents a critical issue for radiation oncologists. Indeed the position of the vaginal vault is reported to vary (up to 14.6 mm) due to a difference in daily intra/inter-fraction bladder and rectal fillings; using IGRT with implanted fiducial markers (FMs) as surrogates for the position of the vaginal–parametrial clinical target volume (CTV) ( 5 , 7 , 8 ) could avoid this issue.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Fiducial markers in adjuvant setting for a patient affected by endometrial cancer: a case report

Titone,

Restaino,

Moretti

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

IntroductionIntermediate-high and high-risk endometrial cancer often require adjuvant treatments such as radiotherapy (RT) or brachitherapy (BT) to reduce the risk of loco-regional relapse. Inter- and intra-fraction variability of internal pelvic anatomy are possibly the largest source of error affecting pelvic RT. The implantation of Fiducial Makers (FMs) in the vaginal cuff of patients receiving RT or BT could help patient daily setup, image guidance and intra-fraction detection of the radiation targets.Clinical caseWe have evaluated the case of an 80-year-old woman treated with surgery for endometrioid adenocarcinoma G2 (stage pT1b Nx LVSI+) who underwent adjuvant pelvic IMRT after the implantation of vaginal cuff FMs.CT-simulation, Treatment Planning and IGRT strategyPatient underwent planning CT scan 10 days after FMs implantation. RT consisted of 45Gy in 25 daily fractions to pelvic lymph nodes and surgical bed with simultaneous integrated boost up to 52.5Gy to the vaginal cuff and the upper two-thirds of the vagina. Cone beam Computed Tomography (CBCT) was acquired prior to every RT fraction for IGRT. Bladder and rectum were re-contoured on every CBCTs. Bladder and rectal volumes and median shifts were reported on a prospective database to quantify the impact of the pelvic organ variations.ResultsThe patient reported no discomfort during the FMs implantation, and no complications were seen. No evidence of FMs migration was reported. Bladder and rectal volumes planned contours were 245 and 55.3cc. Median bladder volumes for approved and “not acceptable” CBCTs were 222cc (range: 130-398) and 131cc (range: 65-326), respectively. Median rectal volumes for approved and “not acceptable” CBCTs were 75cc (range: 58-117) and 90cc (range: 54-189), respectively. The median values of the anterior-posterior, superior-inferior, lateral direction shifts were 3.4, 1.8 and 2.11 mm, respectively.ConclusionIn our clinical case, the implantation of FMs in the vaginal cuff of a patient who underwent pelvic adjuvant RT was well tolerated and reported no complications. The use of IGRT procedures based on FMs surrogating the vaginal vault may reduce inter-observer variability and pave the way for adaptive strategies or stereotactic treatments as external beam pelvic boost in gynecological field.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Fiducial markers in adjuvant setting for a patient affected by endometrial cancer: a case report

Titone,

Restaino,

Moretti

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…In patients undergoing IMRT, titanium surgical clips were placed in the vaginal stump during surgery or before CT simulation. 12 With the patient lying on a customized immobilization cushion, a full-bladder CT scan of 2-mm thickness was obtained following intravenous contrast administration. Subsequently, an empty bladder scan was performed to account for potential vaginal motion.…”

Section: Radiation Therapymentioning

confidence: 99%

Reduced Risk of Lymphedema With Intensity-modulated Radiation Therapy Compared With 3-dimensional Conformal Radiation Therapy in Patients With Cervical Cancer Who Received Postoperative Pelvic Radiation Therapy

Uezono¹,

Tsujino²,

Miyazaki³

et al. 2023

American Journal of Clinical Oncology

Self Cite

View full text Add to dashboard Cite

Objectives: To compare the long-term adverse events of intensity-modulated radiation therapy (IMRT) with those of 3-dimensional conformal radiation therapy (3D-CRT) in patients with intermediate-risk and high-risk uterine cervical cancer who underwent postoperative pelvic radiation therapy (PORT). Methods: We reviewed the medical records of 177 patients with cervical cancer who underwent radical surgery and PORT. IMRT and 3D-CRT were administered to 93 and 84 patients, respectively. Follow-up and toxicity assessments were then carried out. Results: The median follow-up period was 63 months (range: 3 to 177). There was a significant difference in the follow-up period between the IMRT and 3D-CRT cohorts (median: 59 vs. 112 mo, P<0.0001). The crude incidences of acute grade 2+ and grade 3+ gastrointestinal toxicities were significantly lower with IMRT than with 3D-CRT (22.6% vs. 48.1%, P=0.002, and 3.2% vs. 11.1%, P=0.04, respectively). The Kaplan-Meier estimates of late toxicities revealed that IMRT significantly reduced grade 2+ genitourinary (GU) toxicity and lower-extremity lymphedema ([LEL] requiring intervention) compared with 3D-CRT ([6.8% vs. 15.2% at 5-year, P=0.048] and [3.1% vs. 14.6% at 5-year, P=0.0029], respectively). IMRT was the only significant predictor of reducing LEL risk. Conclusions: The risks of acute gastrointestinal toxicity, late GU toxicity, and LEL from PORT for cervical cancer were reduced by IMRT. Lower inguinal doses may have contributed to a lower risk of developing LEL, which should be validated in future studies.

show abstract

9 Fiducial markers in adjuvant setting for patient affected by endometrial cancer: a case report

Titone,

Restaino,

Poli

et al. 2024

Poster and E-Posters

View full text Add to dashboard Cite

Introduction: Intermediate-high and high-risk endometrial cancer often require adjuvant treatments such as radiotherapy (RT) or brachitherapy (BT) to reduce the risk of loco-regional relapse. Inter-and intra-fraction variability of internal pelvic anatomy are possibly the largest source of error affecting pelvic RT. The implantation of Fiducial Makers (FMs) in the vaginal cuff of patients receiving RT or BT could help patient daily setup, image guidance and intra-fraction detection of the radiation targets. Clinical case:We have evaluated the case of an 80-year-old woman treated with surgery for endometrioid adenocarcinoma G2 (stage pT1b Nx LVSI+) who underwent adjuvant pelvic IMRT after the implantation of vaginal cuff FMs.CT-simulation, Treatment Planning and IGRT strategy: Patient underwent planning CT scan 10 days after FMs implantation. RT consisted of 45Gy in 25 daily fractions to pelvic lymph nodes and surgical bed with simultaneous integrated boost up to 52.5Gy to the vaginal cuff and the upper two-thirds of the vagina. Cone beam Computed Tomography (CBCT) was acquired prior to every RT fraction for IGRT. Bladder and rectum were re-contoured on every CBCTs. Bladder and rectal volumes and median shifts were reported on a prospective database to quantify the impact of the pelvic organ variations. Results:The patient reported no discomfort during the FMs implantation, and no complications were seen. No evidence of FMs migration was reported. Bladder and rectal volumes planned contours were 245 and 55.3cc. Median bladder volumes for approved and "not acceptable" CBCTs were 222cc (range: 130-398) and 131cc (range: 65-326), respectively. Median rectal volumes for approved and Frontiers in Oncology frontiersin.org 01

show abstract

Prospective observational study on the safety of an original fiducial marker insertion for radiotherapy in gynecological cancer by a simple method

Cited by 3 publications

References 16 publications

Fiducial markers in adjuvant setting for a patient affected by endometrial cancer: a case report

Fiducial markers in adjuvant setting for a patient affected by endometrial cancer: a case report

Reduced Risk of Lymphedema With Intensity-modulated Radiation Therapy Compared With 3-dimensional Conformal Radiation Therapy in Patients With Cervical Cancer Who Received Postoperative Pelvic Radiation Therapy

9 Fiducial markers in adjuvant setting for patient affected by endometrial cancer: a case report

Contact Info

Product

Resources

About