TY - JOUR
T1 - A novel liquid fiducial marker for imageguided adaptive radiotherapy in bladder cancer.
AU - de Ridder, Mischa
AU - Gerbrandy, Lara C.
AU - De Reijke, Theo M
AU - Hinnen, K.A.
AU - Hulshof, M.C.
PY - 2020/11
Y1 - 2020/11
N2 - Purpose or Objective To optimize Image Guided Adaptive RadioTherapy (IGART) for bladder preservation in bladder cancer, fiducial markers at the margins of the bladder tumor are needed to improve the precision of planning and delivery. All currently available fiducial markers have disadvantages like migration (titanium and gold fiducials), fading during treatment (hydrogel) or blurring (lipiodol, see fig 1). So, there is a need for a safe, feasible, visible and positionally stable marker. BioXmark® is a novel liquid injectable and adherent fiducial marker. This study evaluated the clinical performance of BioXmark for IGRT of bladder cancer. Material and Methods Prospective, single center phase I-II trial, including 20 patients with muscle-invasive bladder cancer treated with chemo-radiotherapy (55 Gy/20 fractions). BioXmark® liquid markers were injected in an outpatient setting using a flexible cystoscope. Visibility and stability of BioXmark® liquid markers on CT and cone-beam CT (CBCT) were evaluated. Results In total 77 markers were implanted in 20 patients; 60 markers (78%) in 19 patients (95%) were visible on treatment planning CT-scan. Invisible markers at the CT scan were mainly encountered during the first 4 patients, suggesting a learning curve for the application of markers. All visible markers after CT-acquisition were still visible at the last CBCT at the same position, without any signs of migration or fading. In 15/20 (75%) of the patients, 3 or more markers were visible on CT and thereby applicable for an daily automatic matching procedure. No BioXmark® related adverse-events were reported.
AB - Purpose or Objective To optimize Image Guided Adaptive RadioTherapy (IGART) for bladder preservation in bladder cancer, fiducial markers at the margins of the bladder tumor are needed to improve the precision of planning and delivery. All currently available fiducial markers have disadvantages like migration (titanium and gold fiducials), fading during treatment (hydrogel) or blurring (lipiodol, see fig 1). So, there is a need for a safe, feasible, visible and positionally stable marker. BioXmark® is a novel liquid injectable and adherent fiducial marker. This study evaluated the clinical performance of BioXmark for IGRT of bladder cancer. Material and Methods Prospective, single center phase I-II trial, including 20 patients with muscle-invasive bladder cancer treated with chemo-radiotherapy (55 Gy/20 fractions). BioXmark® liquid markers were injected in an outpatient setting using a flexible cystoscope. Visibility and stability of BioXmark® liquid markers on CT and cone-beam CT (CBCT) were evaluated. Results In total 77 markers were implanted in 20 patients; 60 markers (78%) in 19 patients (95%) were visible on treatment planning CT-scan. Invisible markers at the CT scan were mainly encountered during the first 4 patients, suggesting a learning curve for the application of markers. All visible markers after CT-acquisition were still visible at the last CBCT at the same position, without any signs of migration or fading. In 15/20 (75%) of the patients, 3 or more markers were visible on CT and thereby applicable for an daily automatic matching procedure. No BioXmark® related adverse-events were reported.
U2 - 10.1016/S0167-8140(21)01227-5
DO - 10.1016/S0167-8140(21)01227-5
M3 - Meeting Abstract
SN - 0167-8140
VL - 152
SP - S637
JO - Radiotherapy & Oncology
JF - Radiotherapy & Oncology
IS - S1
ER -