INTRODUCTION: The aim of this study was to investigate the feasibility of injecting a temporary spacer between the rectum and the prostate and to quantify the degree of rectal dosimetric improvement that might result. METHODS: Ten patients underwent CT and MRI before and after injection of 10 cc of hydrogel and at completion of radiotherapy. Hydrogel was injected under general anaesthetic using a transperineal approach. The primary endpoints were perioperative toxicity and rectal dosimetry (V80, V75, V70, V65, V40 and V30). Secondary endpoints were acute gastrointestinal toxicity during and 3 months following radiotherapy and the stability of the hydrogel. Treatment for all patients was planned incorporating volumetric modulated arc therapy with a D95 of 80 Gy in 40 fractions to the prostate and proximal seminal vesicles on both the pre- and post-hydrogel scans. Toxicity was scored with the Common Terminology Criteria, v. 3.0. RESULTS: In the first 24 h, two patients described an increase in bowel movement frequency. The comparison plans had identical prescription doses. Rectal doses were significantly lower for all hydrogel patients for all dose endpoints (V80 = 7% vs. 0.1%, V75 = 10.3% vs. 1.1%, V70 = 13.2% vs. 2.7%, V65 = 15.8% vs. 4.6%, V40 = 35.2% vs. 23.3%, V30 = 52.6% vs. 38.5%; P < 0.001). Post-treatment MRI showed gel stability. Grade 1 bowel toxicity was reported in six patients during radiotherapy and two patients at 3 months' follow-up. No Grade 2 or Grade 3 acute bowel toxicity was reported. CONCLUSION: SpaceOAR hydrogel was successfully injected in 10 patients with minimal side effects. Rectal dosimetry was significantly improved in all patients. This study has been extended to 30 patients with longer follow-up planned.
INTRODUCTION: The aim of this study was to investigate the feasibility of injecting a temporary spacer between the rectum and the prostate and to quantify the degree of rectal dosimetric improvement that might result. METHODS: Ten patients underwent CT and MRI before and after injection of 10 cc of hydrogel and at completion of radiotherapy. Hydrogel was injected under general anaesthetic using a transperineal approach. The primary endpoints were perioperative toxicity and rectal dosimetry (V80, V75, V70, V65, V40 and V30). Secondary endpoints were acute gastrointestinal toxicity during and 3 months following radiotherapy and the stability of the hydrogel. Treatment for all patients was planned incorporating volumetric modulated arc therapy with a D95 of 80 Gy in 40 fractions to the prostate and proximal seminal vesicles on both the pre- and post-hydrogel scans. Toxicity was scored with the Common Terminology Criteria, v. 3.0. RESULTS: In the first 24 h, two patients described an increase in bowel movement frequency. The comparison plans had identical prescription doses. Rectal doses were significantly lower for all hydrogel patients for all dose endpoints (V80 = 7% vs. 0.1%, V75 = 10.3% vs. 1.1%, V70 = 13.2% vs. 2.7%, V65 = 15.8% vs. 4.6%, V40 = 35.2% vs. 23.3%, V30 = 52.6% vs. 38.5%; P < 0.001). Post-treatment MRI showed gel stability. Grade 1 bowel toxicity was reported in six patients during radiotherapy and two patients at 3 months' follow-up. No Grade 2 or Grade 3 acute bowel toxicity was reported. CONCLUSION: SpaceOAR hydrogel was successfully injected in 10 patients with minimal side effects. Rectal dosimetry was significantly improved in all patients. This study has been extended to 30 patients with longer follow-up planned.
Authors: Antoni Rucinski; Stephan Brons; Daniel Richter; Gregor Habl; Jürgen Debus; Christoph Bert; Thomas Haberer; Oliver Jäkel Journal: Radiat Oncol Date: 2015-02-27 Impact factor: 3.481
Authors: Samantha G Hedrick; Marcio Fagundes; Ben Robison; Marc Blakey; Jackson Renegar; Mark Artz; Niek Schreuder Journal: J Appl Clin Med Phys Date: 2017-02-25 Impact factor: 2.102
Authors: Samantha G Hedrick; Marcio Fagundes; Sara Case; Jackson Renegar; Marc Blakey; Mark Artz; Hao Chen; Ben Robison; Niek Schreuder Journal: J Appl Clin Med Phys Date: 2016-11-30 Impact factor: 2.102
Authors: Justin L Cantley; Chee-Wai Cheng; Fredrick B Jesseph; Tarun K Podder; Valdir C Colussi; Bryan J Traughber; Lee E Ponsky; Rodney J Ellis Journal: J Appl Clin Med Phys Date: 2016-11-08 Impact factor: 2.102
Authors: Prabhjot Juneja; Andrew Kneebone; Jeremy T Booth; David I Thwaites; Ramandeep Kaur; Emma Colvill; Jin A Ng; Paul J Keall; Thomas Eade Journal: Radiat Oncol Date: 2015-10-24 Impact factor: 3.481