Proposed Hydrogel-Implant Quality Score and a Matched-Pair Study for Prostate Radiation Therapy

Liu, Han; Borden, Lester S.; Wiant, D; Sintay, B; Hayes, Lane; Manning, Matthew

doi:10.1016/j.prro.2020.02.006

Cited by 8 publications

(10 citation statements)

References 21 publications

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“…22,23 One study was in PBT and one was in high dose rate brachytherapy (HDR-BT) monotherapy. 24,25 The other seven studies included some BT plus EBRT combination, five with BT first (two HDR-BT 26,27 and three LDR-BT [28][29][30] ) and two with BT second (one HDR-BT 31 and one LDR-BT 19 ). Very few studies provided a comprehensive list of baseline characteristics, although there was little difference in age between arms, where reported (Supplementary Table 8).…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

“…25 Finally, SpaceOAR decreased dose in all seven BT plus EBRT studies, including two of the studies using matching. 19,[26][27][28][29][30][31] Variation in outcome hindered any judgment as to the effect of RT type on size of the difference in dosimetry outcome. Indeed, the higher the Vxx the lower the volume or percentage of the organ exposed to that level of radiation.…”

Section: Rectal Dosimetrymentioning

confidence: 99%

See 1 more Smart Citation

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

Armstrong

Bahl²,

Pinkawa³

et al. 2021

Urology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Study and Patient Characteristicsmentioning

confidence: 99%

Section: Rectal Dosimetrymentioning

confidence: 99%

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

Armstrong

Bahl²,

Pinkawa³

et al. 2021

Urology

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“…Further studies by Kahn et al ., Butler et al ., Patel et al ., Taggar et al ., Zhang et al ., and Liu et al . all showed improvements in rectal dosimetry post-HS insertion for patients treated with LDR-BT with or without EBRT [ 13 , 44 - 49 ]. As such, the reduced rectal dosimetry post-RS insertion in the present study were comparable to, and reaffirming findings from, current literature on LDR-BT.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, a systematic review, which included 12 studies of HS insertion in the setting of LDR-BT and HDR-BT with or without EBRT, VMAT, or IMRT demonstrated that rectal doses were reduced across all these different settings [25]. Further studies by Kahn et [13,[44][45][46][47][48][49]. As such, the reduced rectal dosimetry post-RS insertion in the present study were comparable to, and reaffirming findings from, current literature on LDR-BT.…”

Section: Dosimetry Outcomesmentioning

confidence: 99%

Impact of hydrogel and hyaluronic acid rectal spacer on rectal dosimetry and toxicity in low-dose-rate prostate brachytherapy: a multi-institutional analysis of patients’ outcomes

Lin¹,

Loon²,

Tacey³

et al. 2021

jcb

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Purpose: To report on rectal dosimetry and toxicity outcomes in men with prostate cancer (PCa) treated with iodine-125 low-dose-rate brachytherapy (LDR-BT) with or without polyethylene glycol hydrogel (HS) or hyaluronic acid (HA) rectal spacer (RS) insertion.Material and methods: Seventy consecutive men treated with LDR-BT between December 2017 and July 2019 were included in this study, including twenty-eight (40%) men who had RS insertion according to the preference of referring urologist, compared to a group of forty-two men (60%) without RS. Descriptive statistics were used to compare RS safety, dosimetric effects on organs at risk (rectum and urethra), and gastrointestinal (GI) and genitourinary toxicities (GU) (assessed using the CTCAE v.4) between the two groups of patients.Results: The median prostate-rectal separation with RS at mid prostate was 10 mm (IQR, 8-11.5 mm). The median follow-up was 23.5 months. There were no post-operative complications for RS insertion. There was significantly reduced rectal dosimetry in RS-group vs. non-RS group; the median RV 100 was 0.0 cc (IQR, 0.0-0.0 cc) vs. 0.4 cc (IQR, 0.1-1.1 cc) (p < 0.001), respectively. The mean rectal D 1cc and D 2cc were 52.4% vs. 84.2% (p < 0.001) and 45.7% vs. 70.0% (p < 0.001) for RS and non-RS group, respectively. There were no statistically significant differences in the mean urethral D 20 , D 5 , and D 1 . There were significantly less grade 1 acute and late GI toxicities in RS-group when compared to non-RS group (0% vs. 24%, p = 0.004 for acute GI toxicity; 4% vs. 33%, p = 0.003 for late GI toxicity). There were no reported acute or late grade 2 or above GI toxicities.Conclusions: Insertion of RS in men treated with LDR-BT is safe and resulted in a significant reduction in rectal dosimetry. The reduction in rectal dosimetry with RS insertion translates into significantly reduced acute and late GI toxicities.

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“…Liu et al derived the hydrogelimplant quality score (HIQS) related to the rectal dose in low-dose-rate brachytherapy, and the HIQS score could account for various aspects of the hydrogel spacer distribution including hydrogel spacer volume, left-right (LR) symmetry, superior-inferior (SI) symmetry, and midprostate spacing created by hydrogel spacer. 12 Although the method proposed by Liu et al is considered reasonable because it takes into account the shape of the entire hydrogel spacer distribution, there are no studies of its application to linear-accelerator-based SBRT for prostate cancer. In clinical practice, a more simplified method of evaluating hydrogel spacer distribution is required.…”

Section: Introductionmentioning

confidence: 99%

Relationship between hydrogel spacer distribution and dosimetric parameters in linear‐accelerator‐based stereotactic body radiotherapy for prostate cancer

Ohira,

Yamashita,

Minamitani

et al. 2024

J Applied Clin Med Phys

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PurposeTo explore the potential of quantitative parameters of the hydrogel spacer distribution as predictors for separating the rectum from the planning target volume (PTV) in linear‐accelerator‐based stereotactic body radiotherapy (SBRT) for prostate cancer.MethodsFifty‐five patients underwent insertion of a hydrogel spacer and were divided into groups 1 and 2 of the PTV separated from and overlapping with the rectum, respectively. Prescribed doses of 36.25–45 Gy in five fractions were delivered to the PTV. The spacer cover ratio (SCR) and hydrogel–implant quality score (HIQS) were calculated.ResultsDosimetric and quantitative parameters of the hydrogel spacer distribution were compared between the two groups. For PTV, D99% in group 1 (n = 29) was significantly higher than that in group 2 (n = 26), and Dmax, D0.03cc, D1cc, and D10% for the rectum were significantly lower in group 1 than in group 2. The SCR for prostate (89.5 ± 12.2%) in group 1 was significantly higher (p < 0.05) than that in group 2 (74.7 ± 10.3%). In contrast, the HIQS values did not show a significant difference between the groups. An area under the curve of 0.822 (95% confidence interval, 0.708–0.936) for the SCR was obtained with a cutoff of 93.6%, sensitivity of 62.1%, and specificity of 100%.ConclusionsThe SCR seems promising to predict the separation of the rectum from the PTV in linear‐accelerator‐based SBRT for prostate cancer.

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Proposed Hydrogel-Implant Quality Score and a Matched-Pair Study for Prostate Radiation Therapy

Cited by 8 publications

References 21 publications

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

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

Impact of hydrogel and hyaluronic acid rectal spacer on rectal dosimetry and toxicity in low-dose-rate prostate brachytherapy: a multi-institutional analysis of patients’ outcomes

Relationship between hydrogel spacer distribution and dosimetric parameters in linear‐accelerator‐based stereotactic body radiotherapy for prostate cancer

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