Clinical impact of spacer placement surgery with expanded polytetrafluoroethylene sheet for particle therapy

Radiation Oncology

Research

Tomoaki Okimoto¹  Sunao Tokumaru¹  Kazuki Terashima¹  Yusuke Demizu²  Shohei Komatsu³  Masahiro Kido³  Hirochika Toyama³  Ryosuke Fujinaka³  Satoshi Omiya³  Takumi Fukumoto³ 

[1] Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Kouto, Shingu-cho, 679-5165, Tatsuno, Hyogo, Japan;Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Kouto, Shingu-cho, 679-5165, Tatsuno, Hyogo, Japan;Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, 1-6-8 Minatojimaminami-machi, Chuo-ku, 650-0047, Kobe, Hyogo, Japan;Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, 650-0017, Kobe, Hyogo, Japan;

关键词: Spacer placement surgery;    Expanded polytetrafluoroethylene;    Particle therapy;    Spacer-related complication;   

DOI  :  10.1186/s13014-023-02359-5

 received in 2023-09-03, accepted in 2023-10-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSpacer placement surgery is useful in particle therapy (PT) for patients with abdominopelvic malignant tumors located adjacent to the gastrointestinal tract. This study aimed to assess the safety, efficacy, and long-term outcomes of spacer placement surgery using an expanded polytetrafluoroethylene (ePTFE) spacer.MethodsThis study included 131 patients who underwent ePTFE spacer placement surgery and subsequent PT between September 2006 and June 2019. The overall survival (OS) and local control (LC) rates were calculated using Kaplan-Meier method. Spacer-related complications were classified according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0).ResultsThe median follow-up period after spacer placement surgery was 36.8 months. The 3-year estimated OS and LC rates were 60.5% and 76.5%, respectively. A total of 130 patients (99.2%) were able to complete PT. Spacer-related complications of ≥ grade 3 were observed in four patients (3.1%) in the acute phase and 13 patients (9.9%) in the late phase. Ten patients (7.6%) required removal of the ePTFE spacer.ConclusionsSpacer placement surgery using an ePTFE spacer for abdominopelvic malignant tumors is technically feasible and acceptable for subsequent PT. However, severe spacer-related late complications were observed in some patients. Since long-term placement of a non-absorbable ePTFE spacer is associated with risks for morbidity and infection, careful long-term follow-up and prompt therapeutic intervention are essential when complications associated with the ePTFE spacer occur.Trial registrationretrospectively registered.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

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Fig. 2