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

Accurate radiation treatment delivery in non-small cell lung cancer is technically challenging. While significant improvements in imaging technology lead to improved tumor delineation, other challenges such as respiratory and cardiac-induced motion, setup inconsistencies, and volume changes and deformation result in significant uncertainties when it comes to targeting the tumor and minimizing normal tissue toxicity [1-3]. Both conventional fractionation and SBRT necessitate accurate delivery of radiotherapy [4]. When radiotherapy targeting is suboptimal, there is an increased risk in radiation-induced injury which is directly related to the dose delivered to normal tissue structures [5,6]. Therefore, improving precision by minimizing safety margins without compromising tumor targeting should lead to a decrease in radiation toxicity.