Transperineal injection of hyaluronic acid in the anterior perirectal fat to decrease rectal toxicity from radiation delivered with low-dose-rate brachytherapy for prostate cancer patients

High-Dose-Rate Interstitial Brachytherapy as Monotherapy in One Fraction for the Treatment of Favorable Stage Prostate Cancer

“…We believe that the increase in distance between rectum and posterior prostatic capsule created by the peri-rectal injection of hyaluronic acid is enough to provide a significant radiation dose reduction from HDR brachytherapy and have significantly smaller incidence of mucosal damage [11,12].…”

“…We believe that the increase in distance (mean 2 cm along the length of the prostate) will be enough to provide a significant radiation dose reduction from HDR brachytherapy [11,12].…”

Internal Immobilization: From Rectal Balloon to Hyaluronic Acid

“…Within a multicenter study Melchert et al were able to demonstrate a remarkable reduction of rectal volume exposed to higher radiation dose comparing dose-volume histograms prior and after insertion of the biodegradable balloon in 26 patients (Melchert et al 2013). Already in 2007 (Prada et al 2009) reported on 27 patients receiving external and HDR-brachytherapy boost. Before the second HDR fraction 6 mL of hyaluronic acid (HA) was injected under TRUS guidance in the perirectal fat creating a space between the rectum and prostate of 2.0 cm.…”

Safe and Curative Brachytherapy Reirradiation with Organ-Sparing Hyaluronate Gel Injection

“…However we must be careful to apply some idea of interval repair because an individual tissue tolerance differs not only by the dose and the interval. [Prada, 2007[Prada, , 2009. In response, Vordermark et al proposed that a material with a faster resolution would be suitable for application to HDRIBT [Vordermark, 2008].…”