Nowadays, implanted fiducial gold markers can be regarded as part of standard care for prostate external beam radiotherapy.
Several investigations have shown the efficacy of portal imaging based prostate position verification and correction protocols to reduce the day-to-day prostate.variation. As a consequence, treatment margins can be reduced leading to reduction of irradiation dose on the surrounding normal tissues (e.g. rectal wall, bladder).
A recent study has strongly emphasized the need for regular prostate position verification. Several investigators from different instiitutes observed in patients,irradiated without daily prostate localization, lower biochemical control and lower tumor control*.
Gold markers are also well visible on MR scans and can be used for CT-MR fusion and improved delineation of the prostatic gland, leading to reduced irradiation volumes.
The combination of an endorectal balloon (ERB) and a gold marker based correctionprotocol, may even lead to further reduction of rectal toxicity.
QLRAD gold markers are pure gold cylinders. Standard markers are 3, 5, 7 mm. long and 1 or 1.2 mm. in diameter. Gold markers are available separately or preloaded in sterilized needles
