Expanding the Utilization of Rectal Spacer Hydrogel for Larger Prostate Glands (&gt;80 cc): Feasibility and Dosimetric Outcomes

Fagundes, Marcio; Rodrigues, Maria Amélia; Olszewski, Steve; Khan, Fazal Hameed; McKenzie, Craig; Gutierrez, A. Banguero; Chuong, Michael D.; Mehta, Minesh P.

doi:10.1016/j.adro.2021.100651

Cited by 3 publications

(3 citation statements)

References 40 publications

(97 reference statements)

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“…Patients undergoing hypofractionated courses or brachytherapy may also be considered [26]. Typically, trials have limited their use to patients with glands under 80 mL, but several groups have reported safety and efficacy in larger prostate glands [23,27]. Contraindications for hydrogel spacer insertion include locally advanced disease with adjacent organ invasion (T4 disease), bleeding diathesis and coagulopathy [26].…”

Section: Insertion Techniquementioning

confidence: 99%

Comprehensive review of the use of hydrogel spacers prior to radiation therapy for prostate cancer

et al. 2022

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To provide a comprehensive narrative review of the published data on the impact of hydrogel spacers on rectal dosimetry and toxicity and to outline the practicalities of inserting hydrogel spacers. ResultsA growing body of evidence suggests that the administration of hydrogel spacers is safe and is associated with limited perioperative morbidity. The impact on rectal dosimetry has been clearly established and use of hydrogel spacers is associated with reduced rectal morbidity. These results have been corroborated by several Phase II and III clinical trials and subsequent meta-analysis. There are several areas for future research, including the role of hydrogel spacers in prostate stereotactic beam radiotherapy and post-radiotherapy local recurrence. ConclusionsHydrogel spacers provide a low-morbidity method to potential reduce rectal toxicity after radiation therapy in men with prostate cancer. Data outlining sexual function and oncological outcomes are limited to date. Future studies, currently being conducted, may provide further clarification of the role of hydrogel spacers in prostate cancer management.

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Section: Insertion Techniquementioning

confidence: 99%

Comprehensive review of the use of hydrogel spacers prior to radiation therapy for prostate cancer

et al. 2022

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“…The hydrogel is injected through the 18-gauge needle over 10–12 s under ultrasound guidance and withdrawn after completion. Stopping during injection may result in device plugging, requiring the preparation of a replacement system [ 42 ]. The mixture of SpaceOAR Vue TM is more viscous than a traditional hydrogel spacer and is encountered mostly during injection.…”

Section: Placementmentioning

confidence: 99%

Application of Hydrogel Spacer SpaceOAR Vue for Prostate Radiotherapy

Hadigal

Gupta

2022

Tomography

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Damage in the surrounding structures, including the rectum, due to unintended exposure to radiation is a large burden to bear for patients who undergo radiation therapy for prostate cancer. The use of injectable rectal spacers to distance the anterior rectum from the prostate is a potential strategy to reduce the dose of unintended radiation to the rectum. Hydrogel spacers are gaining increasing popularity in the treatment regimen for prostate cancer. After FDA approval of SpaceOAR, specialists are receiving an increasing number of referrals for hydrogel placements. In this paper, we review hydrogel spacers, the supporting clinical data, the best practices for hydrogel placement, and the risk of adverse events.

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“…Other procedures, such as fiducial placement or brachytherapy, should be performed prior to spacer placement as the gel can interfere with visualization of the gland on ultrasound. Placement of the needle in the correct plane and adequate hydrodissection are critical components of the procedure to ensure a high-quality spacer implant for optimal dosimetry ( 55 ). An 18G needle is placed bevel-down in the midline perineum approximately 2 cm above the TRUS probe angled slightly (~15 degrees) posteriorly.…”

Section: Hydrogel Rectal Spacer Placement Proceduresmentioning

confidence: 99%

Rationale for Utilization of Hydrogel Rectal Spacers in Dose Escalated SBRT for the Treatment of Unfavorable Risk Prostate Cancer

et al. 2022

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In this review we outline the current evidence for the use of hydrogel rectal spacers in the treatment paradigm for prostate cancer with external beam radiation therapy. We review their development, summarize clinical evidence, risk of adverse events, best practices for placement, treatment planning considerations and finally we outline a framework and rationale for the utilization of rectal spacers when treating unfavorable risk prostate cancer with dose escalated Stereotactic Body Radiation Therapy (SBRT).

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Expanding the Utilization of Rectal Spacer Hydrogel for Larger Prostate Glands (>80 cc): Feasibility and Dosimetric Outcomes

Cited by 3 publications

References 40 publications

Comprehensive review of the use of hydrogel spacers prior to radiation therapy for prostate cancer

Comprehensive review of the use of hydrogel spacers prior to radiation therapy for prostate cancer

Application of Hydrogel Spacer SpaceOAR Vue for Prostate Radiotherapy

Rationale for Utilization of Hydrogel Rectal Spacers in Dose Escalated SBRT for the Treatment of Unfavorable Risk Prostate Cancer

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