1. Prospective analysis of hydrogel spacer for patients with prostate cancer undergoing radiotherapy
- Author
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Nathan Lawrentschuk, Alwin Tan, Trung Pham, Damien M Bolton, Michael Chao, Shomik Sengupta, Jason Wasiak, Kevin McMillan, Huong Ho, B. Subramanian, Yee Chan, Daryl Lim Joon, Andrew Troy, Chee Wee Cham, Catherine Temelcos, Wei Ding, Sandra Spencer, and Madalena Liu
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Rectum ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Fiducial Markers ,Prostate ,medicine ,Humans ,General anaesthesia ,Prospective Studies ,Stage (cooking) ,Radiation Injuries ,Radiometry ,Prospective cohort study ,Aged ,Aged, 80 and over ,business.industry ,Radiotherapy Planning, Computer-Assisted ,Prostatic Neoplasms ,Hydrogels ,Radiotherapy Dosage ,Middle Aged ,medicine.disease ,Radiation therapy ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Toxicity ,Radiotherapy, Intensity-Modulated ,business ,Follow-Up Studies - Abstract
Objective To report on the dosimetric benefits and late toxicity outcomes after injection of hydrogel spacer (HS) between the prostate and rectum for patients treated with prostate radiotherapy (RT). Patients and methods In all, 76 patients with a clinical stage of T1-T3a prostate cancer underwent general anaesthesia for fiducial marker insertion plus injection of the HS into the perirectal space before intensity-modulated RT (IMRT) or volumetric-modulated arc RT (VMAT). HS safety, dosimetric benefits, and the immediate- to long-term effects of gastrointestinal (GI) toxicity were assessed. Results There were no postoperative complications reported. The mean (range) prostate size was 66.0 (25.0-187.0) mm. Rectal dose volume parameters were observed and the volume of rectum receiving 70 Gy (rV70 ), 75 Gy (rV75 ) and 78 Gy (rV78 ) was 7.8%, 3.6% and 0.4%, respectively. In all, 21% of patients (16/76) developed acute Grade 1 GI toxicities, but all were resolved completely by 3 months after treatment; whilst, 3% of patients (2/76) developed late Grade 1 GI toxicities. No patients had acute or late Grade ≥2 GI toxicities. Conclusion Injection of HS resulted in a reduction of irradiated rectal dose volumes along with minimal GI toxicities, irrespective of prostate size.
- Published
- 2018