title: Prostatic fiducial markers implantation by transrectal ultrasound for adaptive image guided radiotherapy in localized cancer: 7-years experience.
abstract: OBJECTIVE
  we present our 7-years' experience with fiducial gold markers inserted before Image-Guided Radiotherapy (IGRT) focusing on our echo-guided technique reporting early and late complications.
  
  
  METHODS
  78 prostate cancer (PCA) patients who underwent fiducial markers placement for adaptive IGRT (period 2007-2014) were selected. Mean patient age was 75 years (range 60-81), mean PSA 7.8 ng/ml (range 3.1-10), clinical stage &lt; T3, mean Gleason Score 6.4 (range 6-7). We recorded early and late complications. Maximum distance between the Clinical Target Volume (CTV) and Planning Target Volume (PTV) was assessed for each direction and the mean PTV reduction was estimated.
  
  
  RESULTS
  we describe in details our echo-guided technique of intraprostatic gold fiducial markers insertion prior to adaptative IGRT. We report rare early toxicity (5-7% grade 1-2), a mean PTV reduction of 37% and a very low late toxicity (only 3.4% bladder G3 and 8% rectal G2 side effects).
  
  
  CONCLUSIONS
  Our technique of fiducial gold markers implantation for adaptative IGRT is safe and well-tolerated and it resulted helpful to reduce CTV-PTV margin in all cases; the effects on clinical practice seem significant in terms of late toxicity but further investigations are needed with longer follow-up.
authors: Clinica Urologica, Azienda Ospedaliero-Universitaria Ospedali Riuniti, Università Politecnica delle Marche, Ancona. vlacetera@gmail.com.
authors: Vito
authors: V
authors: Lacetera
authors: Massimo
authors: M
authors: Cardinali
authors: Giovanna
authors: G
authors: Mantello
authors: Francesco
authors: F
authors: Fenu
authors: Giulia
authors: G
authors: Sbrollini
authors: Flavia
authors: F
authors: Tombolini
authors: Alessandro
authors: A
authors: Conti
authors: Stefania
authors: S
authors: Maggi
authors: Giovanni
authors: G
authors: Muzzonigro
authors: Andrea Benedetto
authors: AB
authors: Galosi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D057918:Fiducial Markers; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D061089:Radiotherapy, Image-Guided; D012007:Rectum; D013997:Time Factors; D018084:Ultrasonography, Interventional