SpaceOAR Hydrogel in Dose-escalated Prostate Cancer Radiotherapy: Rectal Dosimetry and Late Toxicity

Whalley, Deborah; Hruby, George; Alfieri, Florencia; Kneebone, Andrew; Eade, Thomas

doi:10.1016/j.clon.2016.05.005

Cited by 58 publications

(85 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This indicates that the application of HS considerably decreased the amount of the anterior rectal volume being treated, with the mean rV 70 dropping from 12.5% to 7.8% for HS patients. Our present results are in accordance with other published studies and this has further validated our findings. Due to a broad range in prostate size, we also investigated the clinical benefits of HS in larger prostates.…”

Section: Discussionsupporting

confidence: 94%

“…Our present work builds upon published studies examining the use of HS in our region . In particular, our present findings are comparable to three studies that have reported on rectal dose endpoints and toxicities (late Grade 1), and found them to be significantly lower across all patient groups, with the greatest difference observed in the higher rectal dose (rV 65–82 ) range. More recently, a study by Mariados et al , examined 222 patients who were randomised to those with HS ( n = 149) or without HS ( n = 73), whilst undergoing IMRT to a dose of 79.2 Gy in 44 fractions.…”

Section: Discussionsupporting

confidence: 87%

“…No patients had acute or late Grade ≥2 GI toxicities. Uhl et al [20] reported similar low Grade 1 GI toxicities at 12 months and no reported Grade ≥2 GI toxicities, whilst slightly higher acute and late GI toxicity rates were noted by Uhl et al [21] and Whalley et al [12].…”

Section: Discussionmentioning

confidence: 82%

See 2 more Smart Citations

Prospective analysis of hydrogel spacer for patients with prostate cancer undergoing radiotherapy

Chao

Ho²,

Chan

et al. 2018

BJU International

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 87%

See 1 more Smart Citation

Prospective analysis of hydrogel spacer for patients with prostate cancer undergoing radiotherapy

Chao

Ho²,

Chan

et al. 2018

BJU International

View full text Add to dashboard Cite

show abstract

“…A few studies have examined long‐term toxicities in patients treated with IMRT for prostate cancer with and without SpaceOAR. Our report therefore adds to the available information, which is summarised in Table . After a minimum follow‐up of 2 years, Whalley et al reported lower rates of late grade 1 gastrointestinal toxicity in their SpaceOAR group (16.6%) compared to patients treated without a SpaceOAR (41.8%).…”

Section: Discussionmentioning

confidence: 79%

“…Our report therefore adds to the available information, which is summarised in Table 3. [13][14][15][16] After a minimum follow-up of 2 years, Whalley et al 15 reported lower rates of late grade 1 gastrointestinal toxicity in their SpaceOAR group (16.6%) compared to patients treated without a SpaceOAR (41.8%). A single-blind, randomised trial of 222 eligible men from 20 participating institutions 14 reported benefits of the SpaceOAR gel at 15 months for bowel toxicity; quality of life (QOL) was maintained or had increased at 3 years.…”

Section: Discussionmentioning

confidence: 99%

Late toxicities of prostate cancer radiotherapy with and without hydrogel SpaceAOR insertion

et al. 2019

View full text Add to dashboard Cite

Introduction To investigate whether the implantation of a hydrogel spacer (SpaceOAR) reduces long‐term rectal toxicity for prostate cancer patients treated with intensity‐modulated radiotherapy (IMRT). Methods Patients with localised prostate cancer treated with 81 Gy in 45 fx of IMRT over 9 weeks were retrospectively compared: 65 patients with SpaceOAR and 56 patients without SpaceOAR. Planning aims restricted rectal doses to V40 Gy < 35%, V65 Gy < 17%, V75 Gy < 10%. Toxicities were evaluated between 3 months and 3 years after the completion of radiotherapy and were based on the common terminology criteria for adverse events (CTCAE) assessment tool for diarrhoea, haemorrhoids, faecal incontinence and proctitis. Results The cumulative incidence of low‐grade diarrhoea (G1) was significantly higher in the non‐SpaceOAR group (21.4% vs 6.2%; P = 0.016). The cumulative incidence of proctitis (grades G1 and G2) was also higher in the non‐SpaceOAR group (26.7% vs 9.2%; P = 0.015); the cumulative incidence of G2 proctitis was higher in the latter group (P = 0.043). There were no differences between the treatment groups for cumulative incidences of faecal incontinence and/or haemorrhoids. Three years after IMRT, diarrhoea and proctitis were higher in the non‐SpaceOAR group, without reaching statistical significance. This finding was unchanged after correcting for baseline symptoms. Conclusion SpaceOAR is of benefit in reducing the cumulative incidence of low‐grade diarrhoea and proctitis for up to 3 years after intensity‐modulated radiotherapy.

show abstract

Association of the Placement of a Perirectal Hydrogel Spacer With the Clinical Outcomes of Men Receiving Radiotherapy for Prostate Cancer

et al. 2020

View full text Add to dashboard Cite

IMPORTANCE Perirectal spacers are intended to lower the risk of rectal toxic effects associated with prostate radiotherapy. A quantitative synthesis of typical clinical results with specific perirectal spacers is limited. OBJECTIVE To evaluate the association between perirectal hydrogel spacer placement and clinical outcomes of men receiving radiotherapy for prostate cancer. DATA SOURCES A systematic search was performed of the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase for articles published through September 2019.STUDY SELECTION Studies comparing men who received a hydrogel spacer vs men who did not receive a spacer (controls) prior to prostate radiotherapy. DATA EXTRACTION AND SYNTHESISVia random-effects meta-analysis, group comparisons were reported using the weighted mean difference for continuous measures and the risk ratio for binary measures. MAIN OUTCOMES AND MEASURESProcedural results, the percentage volume of rectum receiving at least 70 Gy radiation (v70), early (Յ3 months) and late (>3 months) rectal toxic effects, and early and late changes in bowel-related quality of life on the Expanded Prostate Cancer Index Composite (minimal clinically important difference, 4 points). RESULTSThe review included 7 studies (1 randomized clinical trial and 6 cohort studies) involving 1011 men (486 who received a hydrogel spacer and 525 controls), with a median duration of patient follow-up of 26 months (range, 3-63 months). The success rate of hydrogel spacer placement was 97.0% (95% CI, 94.4%-98.8% [5 studies]), and the weighted mean perirectal separation distance was 11.2 mm (95% CI, 10.1-12.3 mm [5 studies]). Procedural complications were mild and transient, occurring in 0% to 10% of patients within the studies. The hydrogel spacer group received 66% less v70 rectal irradiation compared with controls (3.5% vs 10.4%; mean difference, −6.5%; 95% CI, -10.5% to -2.5%; P = .001 [6 studies]). The risk of grade 2 or higher rectal toxic effects was comparable between groups in early follow-up (4.5% in hydrogel spacer group vs 4.1% in control group; risk ratio, 0.82; 95% CI, 0.52-1.28; P = .38 [6 studies]) but was 77% lower in the hydrogel spacer group in late follow-up (1.5% vs 5.7%; risk ratio, 0.23; 95% CI, 0.06-0.99; P = .05 [4 studies]).Changes in bowel-related quality of life were comparable between groups in early follow-up (mean difference, 0.2; 95% CI, -3.1 to 3.4; P = .92 [2 studies]) but were greater in the hydrogel spacer group in late follow-up (mean difference, 5.4; 95% CI, 2.8-8.0; P < .001 [2 studies]).

show abstract

SpaceOAR Hydrogel in Dose-escalated Prostate Cancer Radiotherapy: Rectal Dosimetry and Late Toxicity

Cited by 58 publications

References 34 publications

Prospective analysis of hydrogel spacer for patients with prostate cancer undergoing radiotherapy

Prospective analysis of hydrogel spacer for patients with prostate cancer undergoing radiotherapy

Late toxicities of prostate cancer radiotherapy with and without hydrogel SpaceAOR insertion

Association of the Placement of a Perirectal Hydrogel Spacer With the Clinical Outcomes of Men Receiving Radiotherapy for Prostate Cancer

Contact Info

Product

Resources

About