Transarterial fiducial marker implantation for CyberKnife radiotherapy to treat pancreatic cancer: an experience with 14 cases

Jpn J Radiol. 2021 Jan;39(1):84-92. doi: 10.1007/s11604-020-01040-1. Epub 2020 Sep 11.

Abstract

Purpose: The purpose of this study was to evaluate the safety and feasibility of transarterial fiducial marker implantation for CyberKnife radiotherapy to treat locally advanced pancreatic cancer.

Materials and methods: Fifteen pancreatic cancer patients were enrolled for transarterial marker implantation. Embolization platinum coils were implanted as a fiducial marker within 20 mm of the cancer edge, and preferably within 3 mm. The technical success of the implantation was defined as implantation of at least one fiducial marker within 20 mm of the target tumor. Irradiation was performed using the CyberKnife system.

Results: For 14 of 15 patients, transarterial implantation was successfully performed, and for 13 of 14 patients, the tracking marker was implanted within 3 mm of the cancer. Tracking instability was observed in two patients, but irradiation was accomplished in all 14 patients. No major complications caused by the implantation procedure were observed. The median overall survival after irradiation was 13.8 months, and the 1- and 2-years survival rates were 62.9% and 32.3%, respectively.

Conclusion: Transarterial fiducial marker implantation for pancreatic cancer can be safely performed for tracking, and it will be a valuable alternative approach to percutaneous fiducial marker implantation.

Keywords: CyberKnife radiotherapy; Pancreatic cancer; Real-time tumor tracking; Transarterial fiducial marker implantation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Feasibility Studies
  • Female
  • Fiducial Markers*
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / radiotherapy*
  • Radiosurgery / methods*
  • Retrospective Studies