Opbroek Thirza J S, Willems Yves C P, Verhaegen Frank, de Ridder Rogier, Hoge Chantal, Melenhorst Jarno, Bakers Frans, Grabsch Heike I, Buijsen Jeroen, Van Limbergen Evert J, Canters Richard A M, Berbée Maaike
Department of Radiation Oncology (Maastro), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, the Netherlands.
Department of Gastroenterology, Maastricht University Medical Center+, the Netherlands.
Clin Transl Radiat Oncol. 2022 Nov 4;38:90-95. doi: 10.1016/j.ctro.2022.10.013. eCollection 2023 Jan.
Dose-escalation in rectal cancer (RCa) may result in an increased complete response rate and thereby enable omission of surgery and organ preservation. In order to implement dose-escalation, it is crucial to develop a technique that allows for accurate image-guided radiotherapy. The aim of the current study was to determine the performance of a novel liquid fiducial marker (BioXmark®) in RCa patients during the radiotherapy course by assessing its positional stability on daily cone-beam CT (CBCT), technical feasibility, visibility on different imaging modalities and safety.
Prospective, non-randomized, single-arm feasibility trial with inclusion of twenty patients referred for neoadjuvant chemoradiotherapy for locally advanced RCa. Primary study endpoint was positional stability on CBCT. Furthermore, technical aspects, safety and clinical performance of the marker, such as visibility on different imaging modalities, were evaluated.
Seventy-four markers from twenty patients were available for analysis. The marker was stable in 96% of the cases. One marker showed clinically relevant migration, one marker was lost before start of treatment and one marker was lost during treatment. Marker visibility was good on computed tomography (CT) and CBCT, and moderate on electronic portal imaging (). Marker visibility on magnetic resonance imaging (MRI) was poor during response evaluation.
The novel liquid fiducial marker demonstrated positional stability. We provide evidence of the feasibility of the novel fiducial marker for image-guided radiotherapy on daily cone beam CT for RCa patients.
直肠癌（RCa）剂量递增可能会提高完全缓解率，从而避免手术并实现器官保留。为了实施剂量递增，开发一种能够实现精确图像引导放疗的技术至关重要。本研究的目的是通过评估新型液体基准标记物（BioXmark®）在直肠癌患者放疗过程中的位置稳定性、技术可行性、在不同成像模态下的可视性以及安全性，来确定其性能。
一项前瞻性、非随机、单臂可行性试验，纳入20例因局部晚期直肠癌接受新辅助放化疗的患者。主要研究终点是在锥形束CT（CBCT）上的位置稳定性。此外，还评估了标记物的技术方面、安全性和临床性能，如在不同成像模态下的可视性。
来自20例患者的74个标记物可供分析。96%的病例中标记物位置稳定。1个标记物出现临床相关移位，1个标记物在治疗开始前丢失，1个标记物在治疗期间丢失。标记物在计算机断层扫描（CT）和CBCT上可视性良好，在电子射野影像（EPID）上可视性中等。在反应评估期间，标记物在磁共振成像（MRI）上的可视性较差。
新型液体基准标记物显示出位置稳定性。我们提供了新型基准标记物用于直肠癌患者每日锥形束CT图像引导放疗的可行性证据。
