Long-term clinical outcomes of lipiodol marking using standard gastroscopy for image-guided radiotherapy of upper gastrointestinal cancers  

作　　者：Kim Hay Be Richard Khor Daryl Lim Joon Ben Starvaggi Michael Chao Sweet Ping Ng Michael Ng Leonardo Zorron Cheng Tao Pu Marios Efthymiou Rhys Vaughan Sujievvan Chandran 

机构地区：[1]Department of Gastroenterology and Hepatology,Austin Health,Heidelberg 3084,Victoria,Australia [2]Department of Radiation Oncology,Austin Health,Heidelberg 3084,Victoria,Australia [3]School of Cancer Medicine,La Trobe University,Melbourne 3086,Victoria,Australia [4]Medicine,Dentistry and Health Sciences,University of Melbourne,Parkville 3010,Victoria,Australia [5]Genesis Care,East Melbourne 3002,Victoria,Australia

出　　处：《World Journal of Gastroenterology》2021年第42期7387-7401,共15页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Image-guided radiotherapy(IGRT)has significantly improved the precision in which radiotherapy is delivered in cancer treatment.Typically,IGRT uses bony landmarks and key anatomical structures to locate the tumor.Recent studies have demonstrated the feasibility of peri-tumor fiducials in enabling even more accurate delineation of target and normal tissue.The use of gold coils as fiducials in gastrointestinal tumors has been extensively studied.However,placement requires expertise and specialized endoscopic ultrasound equipment.This article reports the long-term outcomes of using a standard gastroscopy to inject liquid fiducials for the treatment of oesophageal and gastric tumors with IGRT.AIM To assess the long-term outcomes of liquid fiducial-guided IGRT in a cohort of oesophageal and gastric cancer patients.METHODS A retrospective cohort study of consecutive adults with Oesophagogastric cancers referred for liquid fiducial placement before definitive/neo-adjuvant or palliative IGRT between 2013 and 2021 at a tertiary hospital in Melbourne,Australia was conducted.Up to four liquid fiducials were inserted per patient,each injection consisting of 0.2-0.5mL of a 1:1 mixture of iodized oil(Lipiodol;Aspen Pharmacare)and n-butyl 2-cyanoacrylate(Histoacryl®;B.Braun).A 23-gauge injector(Cook Medical)was used for the injection.All procedures were performed by or under the supervision of a gastroenterologist.Liquid fiducial-based IGRT(LF-IGRT)consisted of computer-assisted direct matching of the fiducial region on cone-beam computerised tomography at the time of radiotherapy.Patients received standard-IGRT(S-IGRT)if fiducial visibility was insufficient,consisting of bone match as a surrogate for tumor position.Radiotherapy was delivered to 54Gy in 30 fractions for curative patients and up to 45Gy in 15 fractions for palliative treatments.RESULTS 52 patients were referred for liquid fiducial placement within the study period.A total of 51 patients underwent liquid fiducial implantation.Of these a total of 31 pat

关 键 词：Image-guided radiotherapy LIPIODOL GASTROSCOPY Gastric cancer Oesophageal cancer Fiducial 

分 类 号：R735[医药卫生—肿瘤]