Johns Hopkins Manual for GI Endoscopic Nurses, Third Edition

Mouen Khashab, MD; Toshunia Robinson, MD; Anthony Kalloo, MD

Chapter 24: Eus-Guided Fiducial Placement (continued)

Eun Ji Shin, MD

Pancreatic adenocarcinoma is the fourth-leading cause of cancer deaths in the United States. Although surgical resection offers the best chance for long-term survival, unfortunately most patients present with advanced disease at the time of diagnosis. Chemotherapy and radiation therapy are therapeutic options in these patients. Radiation therapy offers loco-regional control of disease. Fiducials are gold markers that are placed within the tumor to allow a more precise delivery of high-dose radiation to the tumor, while limiting the radiation dose delivered to the nearby normal tissues.