Improving rectal dosimetry for patients with intermediate and high-risk prostate cancer undergoing combined high-dose-rate brachytherapy and external beam radiotherapy with hydrogel space.

Chao, Michael; Ow, Darren; Ho, Huong; Chan, Yee; Joon, Daryl Lim; Spencer, Sandra; Lawrentschuk, Nathan; Guerrieri, Mario; Pham, Trung; McMillan, Kevin; Tan, Alwin; Foroudi, Farshad; Tang, Johann; Wasiak, Jason; Liu, Madalena; Koufogiannis, George; Cham, Chee Wee; Bolton, Damien M

doi:10.5114/jcb.2019.82836

Title

Improving rectal dosimetry for patients with intermediate and high-risk prostate cancer undergoing combined high-dose-rate brachytherapy and external beam radiotherapy with hydrogel space.

Publication Date

2019-02

Author(s)

Chao, Michael

Ow, Darren

Ho, Huong

Chan, Yee

Joon, Daryl Lim

Spencer, Sandra

Lawrentschuk, Nathan

Guerrieri, Mario

Pham, Trung

McMillan, Kevin

Tan, Alwin

Foroudi, Farshad

Tang, Johann

Wasiak, Jason

Liu, Madalena

Koufogiannis, George

Cham, Chee Wee

Bolton, Damien M

Subject

brachytherapy

high-dose-rate

hydrogel spacer

Prostate cancer

rectal protection

Type of document

Journal Article

OrcId

0000-0001-8553-5618

0000-0001-8387-0965

0000-0002-5145-6783

0000-0002-9882-1696

#PLACEHOLDER_PARENT_METADATA_VALUE#

DOI

10.5114/jcb.2019.82836

Abstract

To report on rectal dosimetric and toxicity outcomes of intermediate and high-risk prostate cancer patients undergoing combined high-dose-rate (HDR) brachytherapy and external beam radiotherapy (EBRT) with or without hydrogel spacer (HS) insertion. A total of 97 patients were analyzed in this study, with 32 patients (33%) who had HS insertion compared with a preceding group of 65 patients (67%) without HS. HS safety, the dosimetric effects on organs at risk (rectal, urethral, penile bulb, and bladder) as well as gastrointestinal (GI) and genitourinary toxicity were evaluated and compared between the two groups. The median prostate-rectal separation achieved with HS was 10 mm (range, 5-14 mm). There were no post-operative complications following HS insertion. Patients with HS had significantly lower radiation dose to the rectum across all rectal dose volumes from rV30 to rV80, whether in absolute volume (cc) or as percentage of contoured OAR (p < 0.001). There was also significantly less acute > grade 1 GI toxicity (12.5% vs. 30.8%, p = 0.05) and a trend towards less late grade 1 GI toxicity (0% vs. 7.7%; p = 0.11) in the HS group compared to the non-HS group. Insertion of HS in prostate cancer patients receiving combined HDR and EBRT is safe and has resulted in a significant radiation dose reduction to the rectum, resulting in significantly less acute GI toxicity and a trend towards less late GI toxicity.

Link

link

Citation

Journal of contemporary brachytherapy 2019; 11(1): 8-13

Jornal Title

Journal of Contemporary Brachytherapy

ISSN

1689-832X

Austin Health

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