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

Abstract

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Injection of hydrogel spacer increased maximal intrafractional prostate motion in anterior and superior directions during volumetric modulated arc therapy-stereotactic body radiation therapy for prostate cancer

“…Because the difference of the MID between the two groups was 0.5-0.7 mm, the dose to the anterior wall of the rectum in the spacer group seems not to have increased due to the recto-prostatic space spread by the spacer. Considering the dosimetric and clinical merit of the hydrogel spacer [24][25][26][27], our results do not support routine avoidance of the hydrogel spacer use. Another limitation of our study was the fact that the quality of our results depends on the accuracy of the Clarity system.…”

“…Nowadays, hydrogel spacer is widely used for the radiotherapy for prostate cancer. It has been shown that the hydrogel spacer improves the dose distribution and reduces gastrointestinal and genitourinary toxicities [24][25][26][27], while some complications related to the injection were observed [27,28]. They included anaphylaxis, colostomy, pulmonary embolism, and prostatic abscess.…”

“…The injection of hydrogel spacer between the prostate and the rectum has been introduced for RT for PCa to separate the prostate from the anterior wall of the rectum, which contributes to reducing the RT dose of the rectum and reduces gastrointestinal and genitourinary toxicities [24][25][26][27]. On the other hand, the complications related to the injection of hydrogel spacer have been reported [27,28].…”

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

“…В 2021 г. опубликованы результаты систематического обзора, включившего 19 исследований различного дизайна (3622 пациента) и посвященного оценке эффективности применения в качестве спейсера ПЭГгидрогеля (SpaceOAR) [45]. 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).…”

“…Схожие результаты продемонстрированы в систематическом анализе N. Armstrong и соавт. : суммарный усредненный показатель поздней постлучевой токсичности со стороны прямой кишки составил 1 % против 6 % (p = 0,01) в случае имплантации БДС, поздних нарушений со стороны нижних отделов мочевыводящих путей -15 % против 32 % (p <0,001) соответственно [45].…”