Distribution analysis of hydrogel spacer and evaluation of rectal dose reduction in Japanese prostate cancer patients undergoing stereotactic body radiation therapy

Kobayashi, Hiroaki; Eriguchi, Takahisa; Tanaka, Tomohiko; Ogata, Takeru; Ishida, Masaru; Nakajima, Yosuke; Kumabe, Atsuhiro; Kosugi, Michio

doi:10.1007/s10147-020-01855-y

Cited by 5 publications

(2 citation statements)

References 16 publications

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“…According to this survey, fewer than 1% of prostate cancer patients undergoing radical radiotherapy receive SBRT. However, a further decreased risk of late gastrointestinal toxicity observed with SBRT may maximise the bowel toxicity reductions observed with rectal spacers, as observed in a number of small studies; [33][34][35][36] more widespread use of SBRT together with rectal spacers could therefore improve outcomes in clinical practice, but further research is warranted.…”

Section: What's Newmentioning

confidence: 99%

Rectal spacers in patients with prostate cancer undergoing radiotherapy: A survey of UK uro‐oncologists

et al. 2021

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Radical radiotherapy and brachytherapy are recommended in guidelines for the management of patients with localised or locally advanced prostate cancer. 1,2 However, the prostate is a mobile structure, 3 which means that movement during focal treatments can increase the field of exposure, including the rectum and bladder, resulting in potentially serious toxicities.Bowel toxicities include urgency, loose stools, increased frequency of bowel movements, rectal bleeding and faecal incontinence, which can all impact patients' lives. 4 According to the 2020 National Prostate Cancer Audit in England and Wales, 11% of men who had received radical radiotherapy experienced severe bowel toxicity within 2 years of treatment. 5 Additionally, published studies have reported rates of late grade 2 or worse bowel toxicity following intensity-modulated radiation therapy (IMRT) or stereotactic body radiation therapy (SBRT), including hypofractionation regimens, of between 1% and 14%. 6-10 Brachytherapy boost with external beam radiation therapy (EBRT) increases the rate of late genitourinary and gastrointestinal adverse effects compared with EBRT alone. 11,12 It has been shown that rectal spacer devices (endorectal balloons, biodegradable balloons or hydrogel spacers) can help stabilise the prostate during local therapy, by increasing the space between Denonvillier's fascia and the rectal wall, thereby decreasing radiation exposure. 13,14 SpaceOAR hydrogel is the most widely studied rectal spacer, which maintains a stable separation between the prostate and rectum for up to 12 weeks, before hydrolysis, absorption and renal excretion. [13][14][15] In the prospective pivotal phase III study, 222 patients with T1-2 prostate cancer were randomised to SpaceOAR or no spacer during treatment with IMRT; there was a 74% reduction in rectal radiation dose. 15 Although acute (3-month) grade 2 or worse rectal toxicity was reported by approximately 4% of patients in both groups, after a median follow-up of 37 months, grade 2 or above rectal toxicity was reported in 6% of patients in the control arm and none in the SpaceOAR arm. 16 However, several retrospective

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Section: What's Newmentioning

confidence: 99%

Rectal spacers in patients with prostate cancer undergoing radiotherapy: A survey of UK uro‐oncologists

et al. 2021

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“…Meanwhile, the current state of UHF radiotherapy in Japan is unclear, although several Japanese institutions are likely to have already started UHF radiotherapy. In addition, treatment results for Japanese patients have not yet been reported except in a few papers 3 – 5 . We therefore conducted a survey of the current status of UHF radiotherapy in Japan and undertook a multi-institutional retrospective analysis of UHF radiotherapy for Japanese prostate cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Multi-institutional retrospective analysis of ultrahypofractionated radiotherapy for Japanese prostate cancer patients

Ishiyama

Tsumura

Nagano³

et al. 2021

Sci Rep

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To report outcomes and risk factors of ultrahypofractionated (UHF) radiotherapy for Japanese prostate cancer patients. This multi-institutional retrospective analysis comprised 259 patients with localized prostate cancer from 6 hospitals. A total dose of 35–36 Gy in 4–5 fractions was prescribed for sequential or alternate-day administration. Biochemical failure was defined according to the Phoenix ASTRO consensus. Toxicities were assessed using National Cancer Institute Common Toxicity Criteria version 4. Tumor control and toxicity rates were analyzed by competing risk frames. Median follow-up duration was 32 months (range 22–97 months). 2- and 3-year biochemical control rates were 97.7% and 96.4%, respectively. Initial prostate-specific antigen (p < 0.01) and neoadjuvant androgen deprivation therapy (p < 0.05) were identified as risk factors for biochemical recurrence. 2- and 3-year cumulative ≥ Grade 2 late genitourinary (GU) toxicities were 5.8% and 7.4%, respectively. Corresponding rates of gastrointestinal (GI) toxicities were 3.9% and 4.5%, respectively. Grade 3 rates were lower than 1% for both GU and GI toxicities. No grade 4 or higher toxicities were encountered. Biologically effective dose was identified as a risk factor for ≥ Grade 2 late GU and GI toxicities (p < 0.05). UHF radiotherapy offered effective, safe treatment for Japanese prostate cancer with short-term follow-up. Our result suggest higher prescribed doses are related to higher toxicity rates.

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An optimal method of hydrogel spacer insertion for stereotactic body radiation therapy of prostate cancer

Kobayashi,

Eriguchi,

Tanaka

et al. 2023

Jpn J Radiol

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Distribution analysis of hydrogel spacer and evaluation of rectal dose reduction in Japanese prostate cancer patients undergoing stereotactic body radiation therapy

Cited by 5 publications

References 16 publications

Rectal spacers in patients with prostate cancer undergoing radiotherapy: A survey of UK uro‐oncologists

Rectal spacers in patients with prostate cancer undergoing radiotherapy: A survey of UK uro‐oncologists

Multi-institutional retrospective analysis of ultrahypofractionated radiotherapy for Japanese prostate cancer patients

An optimal method of hydrogel spacer insertion for stereotactic body radiation therapy of prostate cancer

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