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KMID : 0880520090450030182
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Chonnam Medical Journal
2009 Volume.45 No. 3 p.182 ~ p.187
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Application of Image-Guided Radiation Therapy (IGRT) with Gold Markers in Prostate Cancer
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Cho Jin-Kuk
Song Ha-Jong
Song Hyeong-Cheol
Kim Kyoung-Joo
Lee Young-Goo
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Abstract
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For image-guided radiation therapy (IGRT) of prostate cancer, gold markers called fiducials can be inserted into the prostate in advance. Here we examined the short-term results of IGRT for prostate cancer. We obtained the clinical data of 10 patients who underwent IGRT at the Department of Radiation Oncology in Kangnam Sacred Heart Hospital of Hallym University during March 2006 and July 2007. Three gold markers were implanted in the prostate before the radiotherapy. Exact focusing of the image was obtained by 3 gold markers on simple X-ray film or cone beam computed tomography during radiation therapy. The errors induced by setting up the patients during IGRT were examined. The setup errors, averaged over all patients, were -0.88 mm, 1.85 mm, and -0.40 mm in the left-right, cranial-caudal, and anterior-posterior directions, respectively. The motion of the prostate was greatest in the cranial-caudal (6.5 mm) direction. The post-radiation therapy prostate-specific antigen (PSA) level was decreased dramatically in all 10 patients. Two of three patients who had received hormonal therapy with IGRT showed a PSA nadir 12 months later without hormonal therapy. There were no peri-radiotherapy complications. Through the use of IGRT with gold markers, we could correct the setup errors that occur in conventional radiation therapy. Post-IGRT PSA was decreased dramatically. Even though our data are limited, we suggest that IGRT may be an effective radiation therapy modality for decreasing peri-radiotherapy complications and improving radiotherapy results in prostate cancer through exact focusing of the radiation.
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KEYWORD
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Prostatic neoplasms, Gold compounds, Radiotherapy
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