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• W3168348566 abstract "Purpose: External beam radiation for prostate cancer is associated with a risk of rectal toxicity. Recent research has supported the use of biodegradable rectal spacers for radiation therapy in patients with localized prostate cancer. This hydrogel is inserted between the prostate and the rectum, increasing the space between these two organs. This results in decreased radiation dose to the rectum, as the radiation dose falls off in the hydrogel, instead of the rectum. This is specifically important in the use of the hypofractionated stereotactic body radiation therapy (SBRT) to the prostate. Hypofractionation has shown many advantages with increased dose per fraction, while minimizing the hospital visits for the patients. In 2018, the R.S. McLaughlin Durham Regional Cancer Centre (DRCC) implemented the use of the hydrogel tissue spacers in patients receiving SBRT for prostate cancer. The aim of this initiative was to quantify and analyze the use of the hydrogel spacer on this subgroup of patients, with respect to the dosimetric, toxicity or symptom burden and patient quality of life outcomes. Methods: This chart review was submitted and approved by the local research ethics boards prior to commencing. Prostate cancer patients that were treated at DRCC with the SBRT protocol and hydrogel spacer between June 2018 and June 2020 were included, totalling 25 patients. These patients were all prescribed 3625cGy in 5 fractions. Treatment plans were assessed both with the hydrogel, and with a simulated non-hydrogel scenario. Three rectal dose constraints were reviewed. The volume of rectum spared by the use of hydrogel was quantified. Clinician-reported late rectal toxicity scores (CTCAE V4) and patient reported bowel symptom scores (EPIC system) were reviewed for patients post-treatment (minimum of 3 months). Results: When evaluating the rectal dose constraints, 24 patients (96%) with the hydrogel met all three criteria with one patient not meeting one of three constraints. In comparison, in the simulated non-hydrogel scenario, only one patient (4%) met all three criteria, with 24 patients (96%) failing at least one rectal criteria. Follow-up data was available for 12 patients. Of these patients, there was no reported late rectal toxicity with a CTCAE of 0. Only four out of twelve patients choose to complete the EPIC scoring tool. Within these four patients, only one patient scored a symptom above one. Conclusions: The use of hydrogel tissue spacers allows for the safe delivery of hypofractionated SBRT courses of radiation therapy to the prostate, as based on dose distributions, clinician reported late rectal toxicity and patient reported symptoms. Interestingly, the use of SBRT with hydrogel for prostate cancer has dramatically increased by a factor of 2.5 since the onset of the COVID-19 pandemic. This has allowed us to minimize hospital visits while delivering safe and effective treatments." @default.
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• W3168348566 date "2021-06-01" @default.
• W3168348566 modified "2023-09-27" @default.
• W3168348566 title "A Single Institutional Experience of the Utilization of Hydrogel Spacer for Prostate SBRT" @default.
• W3168348566 doi "https://doi.org/10.1016/j.jmir.2021.03.022" @default.
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