Long-Term Safety and Stability of Gold Coil Fiducial Markers in Non-Small-Cell Lung Cancer Image-Guided Radiotherapy

Abstract

Background: Fiducial markers aid in tumor localization during radiotherapy of lung cancer. We investigated the long-term stability and safety of gold coil fiducial markers in non-small cell lung cancer (NSCLC) patients. Methods: Markers were implanted at our institution in 8 patients included in this analysis who underwent either conventionally fractionated radiochemotherapy or stereotactic body radiotherapy (SBRT, in one patient). Follow up CT scans were used to assess the coil stability. Results: 15 out of 19 fiducials remained in the same anatomical location with an average follow-up of 2.9 years (range 4 months to 6.5 years) after implantation. None of the markers caused any toxicity. Conclusion: These data illustrate that image guidance using fiducial gold coil markers is feasible in NSCLC radiotherapy with excellent long-term marker retention rate and procedural safety.