Insertion of Intraprostate Gold Fiducial Markers in Prostate Cancer Treatment

Joaqun Escudero; Jorge Peidro; Macarena de Campos; Jose Torrecilla; Emilio Alcina; Pedro Verdejo; Milagros Deltoro; Emilio Vidal

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Insertion of Intraprostate Gold Fiducial Markers in Prostate Cancer Treatment

Author(s):

Joaqun Ulises Juan Escudero^1,*,

Jorge Pastor Peidro²,

Macarena Ramos de Campos²,

Jose Lopez Torrecilla²,

Emilio Lopez Alcina²,

Pedro Navaln Verdejo²,

Milagros Fabuel Deltoro²,

Emilio Marques Vidal²

1Urology, Consorcio Hospital General de Valencia, chimojuan@hotmail.com, Spain

2Radiotherapic Oncology, ERESA, Spain

Nephro-Urology Monthly:Vol. 2, issue 1; 265-272

Article type:Research Article

Received:Jun 29, 2009

Accepted:Jun 19, 2009

How to Cite:Joaqun Ulises Juan EscuderoJorge Pastor PeidroMacarena Ramos de CamposJose Lopez TorrecillaEmilio Lopez AlcinaPedro Navaln VerdejoMilagros Fabuel DeltoroEmilio Marques Vidalet al.Insertion of Intraprostate Gold Fiducial Markers in Prostate Cancer Treatment.Nephro-Urol Mon.2(1):265-272.

Abstract

Background and Aims: Surgery and radiotherapy continue to be the treatments of choice for localised and locally advanced prostate cancer. In recent years, we have witnessed significant development in radiotherapy techniques in order to increase the dose on the target volume and diminish side effects. In the following work, we describe the technique of insertion of gold fiducial markers (gold seeds) as well as their application and usefulness in the treatment of locallizedand locally advanced prostate adenocarcinoma with image guided radiotherapy (IGRT) by means of the ExacTrac® system.

Methods: We did a prospective descriptive study including consecutive patients undergoing IGRT in our hospital. Patients were reviewed one week after the insertion of the markers and in each radiothrapic session. Between October 2005 and June 2007 we carried out a total of 126 procedures using this technique. Each patient was interviewed in each radiotherapic session. Three or four gold intraprostatic fiducial markers were implanted in each patient by transrectally and ultrasound guided. We reported patients tolerance of this technique by a satisfaction questionaire, as well as the early and late complications derived from the insertion of the markers in the clinical interview. We collected the movements of the gold seeds.

Results: Complications observed were: urinary infection in 4 cases (3.2%), prostatitis in 2 cases (1.6%), slight pelvic pain in 6 patients (4.8%) and self-limited rectal bleeding in 8 patients (6.4%). None of the patients presented haematuria. Loss of 1 marker was registered in 7 patients (5.5%) and loss of 2 markers in 2 patients (1.6%).

Conclusions: Insertion of fiducial markers for prostate cancer treatment is a technique of very simple execution, easy to reproduce almost free of adverse effects, which is able to reduce toxicity derived from radiotherapy and allows dose escalation in radiotherapy.

Keywords

Fiducial Markers

Image-Guided Radiotherapy

Prostate Cancer

Treatment

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