Purpose (extract from abstract): This study aimed to evaluate the feasibility and safety of percutaneous fiducial marker placement using a 25G needle compared with transarterial placement before proton therapy for pancreatic cancer.
Materials and methods (extract from abstract): Patients who underwent fiducial marker placement from 2013 to 2023 were retrospectively reviewed. For percutaneous placement, a 25G needle [Gold Anchor GA150-10] was used to place markers in or around the tumor under computed tomography (CT) guidance.
For transarterial placement, a metal coil was placed as a fiducial marker in a blood vessel near the tumor using a microcatheter. Technical success was defined as the reliable use of the placed fiducial marker throughout the entire proton therapy course.
Results (extract from abstract): Forty-nine and 60 patients underwent percutaneous and transarterial fiducial marker placement, respectively. The technical success rates were 89.8 and 90.0% for percutaneous and transarterial placement, respectively, with no statistically significant difference between them (P > 0.99). There were no major complications in either case.
The median procedure time for percutaneous placement was significantly shorter than that for transarterial placement (3.3 vs 40.0 min; P < 0.001). The median distance between the marker and the tumor was shorter with percutaneous placement than with transarterial placement (0.0 vs 10.0mm; P = 0.005).
Conclusion (extract from abstract): Percutaneous placement of fiducial markers for pancreatic cancer proton therapy using a 25G needle could be performed faster than transarterial placement with a high success rate.