Dosimetry for Organs at Risk With and Without Use of Perirectal Hydrogel Spacer in Prostate Cancer Patients Treated With SBRT

Fried, Daniel B.; Dubose, Rick; Johnson, Kerstie; Cogdell, M.; Gersh, J; Kilburn, J.M.

doi:10.1016/j.ijrobp.2017.06.1161

Cited by 3 publications

(3 citation statements)

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“…As the hydrogel often accumulates more at the base of the prostate relative to apex, it is possible by displacing the prostate further away from the base of the penis and the pudendal neurovascular bundles that the dose to these erectile structures may be spared in an unanticipated manner ( 15 ). A similar reduction in PB dose was noted in a previous study using stereotactic prostate RT with reductions in maximal and mean doses to PB with SpaceOAR (both p < 0.0001) ( 16 ). Furthermore, in the SpaceOAR phase 3 trial for men with erections sufficient for intercourse at baseline increasing mean PB dose directly correlated with worse ED ( p = .03).…”

Section: Introductionsupporting

confidence: 85%

A pooled long-term follow-up after radiotherapy for prostate cancer with and without a rectal hydrogel spacer: impact of hydrogel on decline in sexual quality of life

Seymour,

Pinkawa,

Daignault-Newton

et al. 2023

Front. Oncol.

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PurposeThe purpose of this study was to analyze the impact of prostate rectal spacers on sexual quality of life (QOL) following external beam radiation therapy (RT).Methods and materialsPatient- reported QOL was evaluated using the Expanded Prostate Cancer Index Composite (EPIC). Patients were pooled from two sources: a randomized controlled trial and a non-randomized cohort of patients from a single institution. Both cohorts used the same spacing product and QOL instrument. Analysis was limited to those with good baseline pre-treatment sexual QOL (EPIC >/= 60). Differences in QOL summary score and individual items were assessed compared with baseline and between treatment arms.ResultsA total of 128 men had good baseline sexual function and were evaluated (64% with spacer and 36% without) with QOL data available for median 33 months (range: 2.5–69.4 months). Men without spacer were more likely to have declines in sexual function (p < 0.0001), bother (p = 0.0002), and sexual summary score (p < 0.0001). A minimally important difference of 10 points (1xMID) and 20 point (2xMID) was more likely without rectal spacer [10 points: odds ratio 3.53, (95% confidence interval 1.11–11.2), p = 0.032; 20 points: odds ratio 3.29, (95% confidence interval 1.16–9.33), p = 0.025]. Seven of 13 QOL items were statistically superior with hydrogel (six of nine functional and one of four bother), while no items were statistically superior for control. At baseline, more men treated with hydrogel had erections sufficient for intercourse; however, when analyzed only by the men with best baseline erectile potential and excluding those with worse function, the benefit of rectal spacing was maintained with a higher likelihood of preservation of erections sufficient for intercourse in those treated with hydrogel.ConclusionIn this pooled analysis of QOL after prostate RT, the utilization of a hydrogel spacer was associated with better sexual QOL, less men with measurable declines in sexual QOL, and higher rates of adequate erectile function.

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Section: Introductionsupporting

confidence: 85%

A pooled long-term follow-up after radiotherapy for prostate cancer with and without a rectal hydrogel spacer: impact of hydrogel on decline in sexual quality of life

Seymour,

Pinkawa,

Daignault-Newton

et al. 2023

Front. Oncol.

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“…It can be either applied internally as brachytherapy (BT), which can be high dose rate (HDR) or low dose rate (LDR) or externally delivered as external beam RT (EBRT). 3 EBRT can take a number of forms: intensity-modulated radiation therapy (IMRT) is where each RT beam is divided into many small beamlets that can vary the intensity of radiation, which allows different doses of radiation to be given across the tumour; stereotactic body radiotherapy (SBRT) gives RT from many different angles around the body.…”

Section: Introduction (3150)mentioning

confidence: 99%

SpaceOAR Hydrogel Spacer for Reducing Radiation Toxicity During Radiotherapy for Prostate Cancer. A Systematic Review

Armstrong

Bahl²,

Pinkawa³

et al. 2021

Urology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…В большинстве проанализированных работ (97,3 %) показано, что за счет введения спейсера радиационная нагрузка на прямую кишку снижалась в среднем на 25 % (р <0,0001). Наибольший дозиметрический выигрыш продемонстрирован при использовании современных технологий подведения дозы (брахитерапии и СТЛТ), что объясняется высоким градиентом падения дозы и точным позиционированием мишени, присущим этим методам лучевого лечения [23,47].…”

Section: эффективность спейсеровunclassified

Technologies to reduce radiation toxicity in prostate cancer patients: spacers - a simple and effective solution

Novikov

Новиков

2021

Onkourologiâ

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The basic principles of the treatment of prostate cancer patients have underwent significant revisions in recent years. Modern radiotherapy techniques, which have demonstrated high efficacy and safety in long-term randomized trials, are beginning to take a leading position in the treatment of prostate cancer in an overwhelming number of clinical scenarios (National Comprehensive Cancer Network, 2021). Despite the obvious successes of radiation oncology, a number of important problems remain unresolved, first of all - the need to reduce the rates of radiation complications. The topographical anatomy of the prostate gland determines the main profiles of post-radiation damage: rectal and genitourinary radiation toxicity. The previous five years have been marked by a significant intensification of research work abroad aimed at clinical testing of a number of biopolymer compositions and products for use as spacers between irradiated structures and normal tissues. The experience has made it possible for the first time to consider the possibility of using spacers in radiotherapy treatment of prostate cancer in the modern recommendations of the European Association of Urology (2021). The analysis of the national literature shows a complete lack of publications on the possibilities of optimizing the radiation treatment of prostate cancer through the use of specers. The purpose of this work was the need to highlight this important and perspective clinical problem.

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Dosimetry for Organs at Risk With and Without Use of Perirectal Hydrogel Spacer in Prostate Cancer Patients Treated With SBRT

Cited by 3 publications

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A pooled long-term follow-up after radiotherapy for prostate cancer with and without a rectal hydrogel spacer: impact of hydrogel on decline in sexual quality of life

A pooled long-term follow-up after radiotherapy for prostate cancer with and without a rectal hydrogel spacer: impact of hydrogel on decline in sexual quality of life

SpaceOAR Hydrogel Spacer for Reducing Radiation Toxicity During Radiotherapy for Prostate Cancer. A Systematic Review

Technologies to reduce radiation toxicity in prostate cancer patients: spacers - a simple and effective solution

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