Prostate Hypofractionated Radiation Therapy: Injection of Hyaluronic Acid to Better Preserve The Rectal Wall

Chapet, O.; Udrescu, C.; Devonec, M.; Tanguy, R.; Sotton, M.-P.; Enachescu, C.; Colombel, Marc; Azria, D.; Jalade, P.; Ruffion, A.

doi:10.1016/j.ijrobp.2012.11.027

Cited by 23 publications

(15 citation statements)

References 24 publications

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“…The impact of HA thickness on the rectal dose distribution has been the subject of a previous publication and is therefore not discussed in this article (14,15).…”

Section: Discussionmentioning

confidence: 99%

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Prostate Hypofractionated Radiation Therapy With Injection of Hyaluronic Acid: Acute Toxicities in a Phase 2 Study

Chapet

Decullier

Bin

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…The impact of HA thickness on the rectal dose distribution has been the subject of a previous publication and is therefore not discussed in this article (14,15).…”

Section: Discussionmentioning

confidence: 99%

“…Units of measurement for prostate volume are in cubic centimeters literature (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). An injection of 3 to 20 mL gave an average prostate-rectum separation of 8 to 20 mm.…”

Section: Tolerance Of Hyaluronic Acidmentioning

confidence: 99%

Prostate Hypofractionated Radiation Therapy With Injection of Hyaluronic Acid: Acute Toxicities in a Phase 2 Study

Chapet

Decullier

Bin

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…Clinical studies of injectable hyaluronic acid, 109 a polyethylene glycol-based hydrogel,110, 111, 112 human collagen, 113 and an implantable, biodegradable balloon114, 115 to separate the prostate from the rectum during prostate EBRT have been reported. Injection of these spacer materials between the rectum and prostate gland has been shown to be safe and to reduce exposure of the rectum to conventionally fractionated IMRT,111, 112, 113, 115, 116 hypofractionated IMRT, 109 and SBRT 117 . Although some early evidence suggests lower-than-expected rates of acute gastrointestinal side effects with the use of spacer materials during prostate EBRT, 110 further research is needed before this technique can be recommended as a standard component of prostate EBRT, particularly considering potential risks of the implantation.…”

Section: Techniques Of Patient Immobilization and Setupmentioning

confidence: 99%

ACR Appropriateness Criteria ® external beam radiation therapy treatment planning for clinically localized prostate cancer, part I of II

Zaorsky

Showalter

Ezzell

et al. 2017

Advances in Radiation Oncology

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“…There was no major intra-fraction volume variation but for one patient who experienced no toxicity. This was expected since all patients had a hyaluronic acid spacer that prevented the rectal wall to move anteriorly [9] (Fig. 5).…”

Section: Discussionmentioning

confidence: 90%

CBCT evaluation of inter- and intra-fraction motions during prostate stereotactic body radiotherapy: a technical note

et al. 2020

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Background: In most clinical trials, gold fiducial markers are implanted in the prostate to tune the table position before each radiation beam. Yet, it is unclear if a cone-beam computed tomography (CBCT) should be performed before each beam to monitor a possible variation of the organs at risk (OARs) fullness, especially in case of rectoprostatic spacer implantation. The present study aimed at assessing the inter-and intra-fraction movements of prostate, bladder and rectum in patients implanted with a hyaluronic acid spacer and undergoing prostate stereotactic body radiotherapy (SBRT). Methods: Data about consecutive patients undergoing prostate SBRT were prospectively collected between 2015 and 2019. Inter-and intra-fraction prostate displacements and volume variation of organs at risk (OARs) were assessed with CBCTs. Results: Eight patients were included. They underwent prostate SBRT (37.5Gy, 5 fractions of 7.5Gy) guided by prostate gold fiducial markers. Inter-fraction variation of the bladder volume was insignificant. Intra-fraction mean increase of the bladder volume was modest (29 cc) but significant (p < 0.001). Both inter-and intra-fraction variations of the rectum volume were insignificant but for one patient. He had no rectal toxicity. The magnitude of table displacement necessary to match the prostate gold fiducial marker frequently exceeded the CTV/PTV margins (0.4 cm) before the first (35%) and the second arc (15%). Inter-and intra-fraction bladder and rectum volume variations did not correlate with prostate displacement. Conclusion: Major prostate position variations were reported. In-room kV fiducial imaging before each arc seems mandatory. Intra-fraction imaging of the OARs appears unnecessary. We suggest that only one CBCT is needed before the first arc.

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Prostate Hypofractionated Radiation Therapy: Injection of Hyaluronic Acid to Better Preserve The Rectal Wall

Cited by 23 publications

References 24 publications

Prostate Hypofractionated Radiation Therapy With Injection of Hyaluronic Acid: Acute Toxicities in a Phase 2 Study

Prostate Hypofractionated Radiation Therapy With Injection of Hyaluronic Acid: Acute Toxicities in a Phase 2 Study

ACR Appropriateness Criteria ® external beam radiation therapy treatment planning for clinically localized prostate cancer, part I of II

CBCT evaluation of inter- and intra-fraction motions during prostate stereotactic body radiotherapy: a technical note

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