Hyaluronic acid spacer in prostate cancer radiotherapy: dosimetric effects, spacer stability and long-term toxicity and PRO in a phase II study

Radiation Oncology

Research

Per Fransson¹  Camilla Thellenberg Karlsson²  Anders Widmark²  Kristina Notstam²  Karin Söderkvist²  Lars Beckman²  Tufve Nyholm³  Ulrika Björeland³  Joakim Jonsson³ 

[1]Department of Nursing, Umeå University, 901 87, Umeå, Sweden

[2]Department of Radiation Sciences, Oncology, Umeå University, 901 87, Umeå, Sweden

[3]Department of Radiation Sciences, Radiation Physics, Umeå University, 901 87, Umeå, Sweden

关键词: Prostate cancer;    Radiotherapy;    Rectal toxicity;    Hyaluronic Acid;   

DOI  :  10.1186/s13014-022-02197-x

 received in 2022-11-15, accepted in 2022-12-30,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundPerirectal spacers may be beneficial to reduce rectal side effects from radiotherapy (RT). Here, we present the impact of a hyaluronic acid (HA) perirectal spacer on rectal dose as well as spacer stability, long-term gastrointestinal (GI) and genitourinary (GU) toxicity and patient-reported outcome (PRO).MethodsIn this phase II study 81 patients with low- and intermediate-risk prostate cancer received transrectal injections with HA before external beam RT (78 Gy in 39 fractions). The HA spacer was evaluated with MRI four times; before (MR0) and after HA-injection (MR1), at the middle (MR2) and at the end (MR3) of RT. GI and GU toxicity was assessed by physician for up to five years according to the RTOG scale. PROs were collected using the Swedish National Prostate Cancer Registry and Prostate cancer symptom scale questionnaires.ResultsThere was a significant reduction in rectal V70% (54.6 Gy) and V90% (70.2 Gy) between MR0 and MR1, as well as between MR0 to MR2 and MR3. From MR1 to MR2/MR3, HA thickness decreased with 28%/32% and CTV-rectum space with 19%/17% in the middle level. The cumulative late grade ≥ 2 GI toxicity at 5 years was 5% and the proportion of PRO moderate or severe overall bowel problems at 5 years follow-up was 12%. Cumulative late grade ≥ 2 GU toxicity at 5 years was 12% and moderate or severe overall urinary problems at 5 years were 10%.ConclusionWe show that the HA spacer reduced rectal dose and long-term toxicity.

【 授权许可】

CC BY   
© The Author(s) 2023

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