Abstract
Objectives:
The objective of this study was to evaluate the effectiveness of a hydrogel spacer in reducing acute and delayed rectal toxicities.
Materials and Methods:
Patients undergoing definitive radiotherapy between January 2015 and March 2018 were retrospectively identified from our institutional cancer registry. Planning data were collected on dose-volume histograms (DVH) for V65, V70 and V75 Gy. All patients underwent definitive volumetric modulated arc therapy (VMAT) of 78 Gy over 39 fractions in a single centre. Toxicity reporting and definitions were in accordance with Common Terminology Criteria for Adverse Events (CTCAE) guidelines.
Results:
A total of 162 patients received radiotherapy during the study period (spacer n = 80; no spacer n = 82). Baseline characteristics between groups were comparable. Acute rectal toxicity was documented in 19 men (24%) with spacer versus 36 men (44%) without spacer devices (p = 0.007). Over a median post-treatment follow-up period of 17 months (range = 3–38 months), there was a significant reduction in delayed toxicity in men with spacers compared to men without (17 men 21% vs. 31 men 39%, p = 0.021).
Conclusion:
Hydrogel spacer devices reduce rectal radiation exposure in prostate cancer patients undergoing radiotherapy. This translates into a clinical benefit in terms of acute and delayed rectal toxicities.
Level of evidence:
cohort study
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