Prospective evaluation of a hydrogel spacer for rectal separation in dose-escalated intensity-modulated radiotherapy for clinically localized prostate cancer
<p>Abstract</p> <p>Background</p> <p>As dose-escalation in prostate cancer radiotherapy improves cure rates, a major concern is rectal toxicity. We prospectively assessed an innovative approach of hydrogel injection between prostate and rectum to reduce the radiation do...
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| Format: | Article |
| Language: | English |
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BMC
2013-01-01
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| Series: | BMC Cancer |
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| Online Access: | http://www.biomedcentral.com/1471-2407/13/27 |
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| author | Eckert Franziska Alloussi Saladin Paulsen Frank Bamberg Michael Zips Daniel Spillner Patrick Gani Cihan Kramer Ulrich Thorwarth Daniela Schilling David Müller Arndt-Christian |
| author_facet | Eckert Franziska Alloussi Saladin Paulsen Frank Bamberg Michael Zips Daniel Spillner Patrick Gani Cihan Kramer Ulrich Thorwarth Daniela Schilling David Müller Arndt-Christian |
| author_sort | Eckert Franziska |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>As dose-escalation in prostate cancer radiotherapy improves cure rates, a major concern is rectal toxicity. We prospectively assessed an innovative approach of hydrogel injection between prostate and rectum to reduce the radiation dose to the rectum and thus side effects in dose-escalated prostate radiotherapy.</p> <p>Methods</p> <p>Acute toxicity and planning parameters were prospectively evaluated in patients with T1-2 N0 M0 prostate cancer receiving dose-escalated radiotherapy after injection of a hydrogel spacer. Before and after hydrogel injection, we performed MRI scans for anatomical assessment of rectal separation. Radiotherapy was planned and administered to 78 Gy in 39 fractions.</p> <p>Results</p> <p>From eleven patients scheduled for spacer injection the procedure could be performed in ten. In one patient hydrodissection of the Denonvillier space was not possible. Radiation treatment planning showed low rectal doses despite dose-escalation to the target. In accordance with this, acute rectal toxicity was mild without grade 2 events and there was complete resolution within four to twelve weeks.</p> <p>Conclusions</p> <p>This prospective study suggests that hydrogel injection is feasible and may prevent rectal toxicity in dose-escalated radiotherapy of prostate cancer. Further evaluation is necessary including the definition of patients who might benefit from this approach. Trial registration: German Clinical Trials Register DRKS00003273.</p> |
| first_indexed | 2024-12-17T15:25:47Z |
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| id | doaj.art-e685c0c2b40a430491119fa520f2dfad |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-17T15:25:47Z |
| publishDate | 2013-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-e685c0c2b40a430491119fa520f2dfad2022-12-21T21:43:17ZengBMCBMC Cancer1471-24072013-01-011312710.1186/1471-2407-13-27Prospective evaluation of a hydrogel spacer for rectal separation in dose-escalated intensity-modulated radiotherapy for clinically localized prostate cancerEckert FranziskaAlloussi SaladinPaulsen FrankBamberg MichaelZips DanielSpillner PatrickGani CihanKramer UlrichThorwarth DanielaSchilling DavidMüller Arndt-Christian<p>Abstract</p> <p>Background</p> <p>As dose-escalation in prostate cancer radiotherapy improves cure rates, a major concern is rectal toxicity. We prospectively assessed an innovative approach of hydrogel injection between prostate and rectum to reduce the radiation dose to the rectum and thus side effects in dose-escalated prostate radiotherapy.</p> <p>Methods</p> <p>Acute toxicity and planning parameters were prospectively evaluated in patients with T1-2 N0 M0 prostate cancer receiving dose-escalated radiotherapy after injection of a hydrogel spacer. Before and after hydrogel injection, we performed MRI scans for anatomical assessment of rectal separation. Radiotherapy was planned and administered to 78 Gy in 39 fractions.</p> <p>Results</p> <p>From eleven patients scheduled for spacer injection the procedure could be performed in ten. In one patient hydrodissection of the Denonvillier space was not possible. Radiation treatment planning showed low rectal doses despite dose-escalation to the target. In accordance with this, acute rectal toxicity was mild without grade 2 events and there was complete resolution within four to twelve weeks.</p> <p>Conclusions</p> <p>This prospective study suggests that hydrogel injection is feasible and may prevent rectal toxicity in dose-escalated radiotherapy of prostate cancer. Further evaluation is necessary including the definition of patients who might benefit from this approach. Trial registration: German Clinical Trials Register DRKS00003273.</p>http://www.biomedcentral.com/1471-2407/13/27Prostate cancerIntensity-modulated radiotherapyHydrogel spacerRectal toxicityDose-escalation |
| spellingShingle | Eckert Franziska Alloussi Saladin Paulsen Frank Bamberg Michael Zips Daniel Spillner Patrick Gani Cihan Kramer Ulrich Thorwarth Daniela Schilling David Müller Arndt-Christian Prospective evaluation of a hydrogel spacer for rectal separation in dose-escalated intensity-modulated radiotherapy for clinically localized prostate cancer BMC Cancer Prostate cancer Intensity-modulated radiotherapy Hydrogel spacer Rectal toxicity Dose-escalation |
| title | Prospective evaluation of a hydrogel spacer for rectal separation in dose-escalated intensity-modulated radiotherapy for clinically localized prostate cancer |
| title_full | Prospective evaluation of a hydrogel spacer for rectal separation in dose-escalated intensity-modulated radiotherapy for clinically localized prostate cancer |
| title_fullStr | Prospective evaluation of a hydrogel spacer for rectal separation in dose-escalated intensity-modulated radiotherapy for clinically localized prostate cancer |
| title_full_unstemmed | Prospective evaluation of a hydrogel spacer for rectal separation in dose-escalated intensity-modulated radiotherapy for clinically localized prostate cancer |
| title_short | Prospective evaluation of a hydrogel spacer for rectal separation in dose-escalated intensity-modulated radiotherapy for clinically localized prostate cancer |
| title_sort | prospective evaluation of a hydrogel spacer for rectal separation in dose escalated intensity modulated radiotherapy for clinically localized prostate cancer |
| topic | Prostate cancer Intensity-modulated radiotherapy Hydrogel spacer Rectal toxicity Dose-escalation |
| url | http://www.biomedcentral.com/1471-2407/13/27 |
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