Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, China.
The Institute of Laparoscopic-Endoscopic Minimally Invasive Surgery of Shandong University, Shandong, China.
Int Braz J Urol. 2021 Jan-Feb;47(1):93-99. doi: 10.1590/S1677-5538.IBJU.2019.0713.
Endoclip can be used as fiducial marker in urology.
To assess the feasibility, cost effectiveness and reliability of endoclips as novel fiducial markers in precision radiotherapy, as part of a trimodality bladder-preserving treatment (TBPT) of muscle-invasive bladder carcinoma.
This retrospective study was performed at Weifang People's Hospital (Weifang, China) from January 2015 to June 2018. A total of 15 patients underwent TBPT. Endoclips were applied to healthy edges of the resected bladder wall as novel fiducial markers. Radio-sensitizing chemotherapy and routine precision radiotherapy were given. The number and position of the endoclips during radiotherapy sessions were monitored. Complications and tumor recurrence were analyzed.
The mean age (±standard deviation) of the patients was 67±10 years (range 46-79). There were 3 females and 12 males. Forty-nine endoclips were applied in all patients (3.3±0.8). The tumor was completely visibly resected in all patients. The number of endoclips remained the same through the planned last radiotherapy session (3.3±0.8), i.e., none were lost. All endoclips were removed after the last radiotherapy session. The average number of follow-up months was 38.9±13.2 (range 11-52). There were no procedure-related complications at discharge or follow-up. At one-year, overall recurrence-free survival was 93.3%. Two patients had recurrences at 18 months and 10 months after TBPT, respectively, and salvage radical cystectomy was performed with no further recurrences. Another patient died due to metastasis 9 months after the completion of therapy.
Endoclips are reliable, safe and cost-effective as novel fiducial markers in precision-radiotherapy post-TBPT.
内镜夹可用作泌尿科的基准标记物。
评估内镜夹作为新型基准标记物在精确放射治疗中的可行性、成本效益和可靠性，作为肌层浸润性膀胱癌保膀胱三联疗法（TBPT）的一部分。
本回顾性研究于 2015 年 1 月至 2018 年 6 月在潍坊市人民医院（中国潍坊）进行。共 15 例患者接受了 TBPT。内镜夹被应用于切除的膀胱壁的健康边缘作为新型基准标记物。给予放射增敏化疗和常规精确放疗。在放疗过程中监测内镜夹的数量和位置。分析并发症和肿瘤复发情况。
患者的平均年龄（±标准差）为 67±10 岁（范围 46-79）。其中 3 例为女性，12 例为男性。所有患者共应用 49 个内镜夹（3.3±0.8）。所有患者的肿瘤均完全肉眼可见切除。计划的最后一次放疗疗程中内镜夹的数量保持不变（3.3±0.8），即无一丢失。所有内镜夹均在最后一次放疗后取出。平均随访时间为 38.9±13.2 个月（范围 11-52）。出院或随访时无与操作相关的并发症。一年时，总无复发生存率为 93.3%。2 例患者分别在 TBPT 后 18 个月和 10 个月复发，均行挽救性根治性膀胱切除术，无进一步复发。另 1 例患者在完成治疗 9 个月后因转移死亡。
内镜夹作为 TBPT 后精确放疗的新型基准标记物，具有可靠性、安全性和成本效益。
