Endoscopic ultrasound-guided fiducial marker placement in pancreatic cancer:A systematic review and meta-analysis

作     者：Jaymon B Patel Vakya Revanur David G Forcione Matthew L Bechtold Srinivas R Puli 

作者机构：Department of GastroenterologyUniversity of Illinois College of Medicine at PeoriaPeoriaIL 61637United States Department of Internal MedicineUniversity of Illinois College of Medicine at PeoriaPeoriaIL 61637United States Department of GastroenterologyMassachusetts General HospitalBostonMA 02114United States Department of GastroenterologyUniversity of MissouriColumbiaMO 65203United States 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2020年第12卷第8期

页      面：231-240页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Endoscopic ultrasound Pancreatic cancer Fiducial marker Image-guided radiotherapy Systematic review Meta-analysis 

摘      要：BACKGROUND Pancreatic cancer(PC)mortality remains high despite advances in *** chemoradiotherapy offers modest survival benefit over monotherapy with *** markers serve as needed landmarks for imageguided radiotherapy(IGRT).Traditionally,these markers were placed surgically or percutaneously with limitations of *** ultrasound-guided placement overcomes these *** To evaluate the safety,efficacy,and feasibility of endoscopic ultrasound(EUS)-guided fiducial placement for PC undergoing *** Articles were searched in MEDLINE,PubMed,and Ovid *** was conducted by fixed and random effects *** was assessed using Cochran’s Q test based upon inverse variance *** Initial search identified 1024 reference articles for EUS-guided fiducial placement in *** these,261 relevant articles were *** was extracted from 11 studies(n=820)meeting inclusion *** proportion of successful placement was 96.27%(95%CI:95.35-97.81)with fiducial migration rates low at 4.33%(95%CI:2.45-6.71).Adverse event rates remained low,with overall pooled proportion of 4.85%(95%CI:3.04-7.03).CONCLUSION EUS-guided placement of fiducial markers for IGRT of PC is safe,feasible,and *** ability to target deep structures under direct visualization while remaining minimally invasive are added ***,the ability to perform fine needle aspiration or celiac plexus neurolysis add value and increase patient-care *** EUS-guided fiducial placement improves outcomes in IGRT or offers any mortality benefits over traditional placement remains unknown and future studies are needed.