Vanneste Ben G L, Van Limbergen Evert J, van de Beek Kees, van Lin Emile, Lutgens Ludy, Lambin Philippe
Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands.
Department of Urology, Maastricht University Medical Center+, Maastricht, The Netherlands.
Tech Innov Patient Support Radiat Oncol. 2018 Mar 20;6:1-4. doi: 10.1016/j.tipsro.2018.01.004. eCollection 2018 Jun.
Radiotherapy in patients with active inflammatory bowel disease (IBD) is usually considered an absolute exclusion criterion for prostate cancer radiotherapy treatment.There are no reports available on the use of a biodegradable rectal balloon implantation (RBI) in patients with active IBD for prostate cancer radiotherapy.
We report on a patient with high-risk prostate cancer with the comorbidity of an active IBD with pancolitis location. He was treated with neo-adjuvant hormonal therapy and high-dose external beam radiotherapy to the prostate and the seminal vesicles. Before radiotherapy treatment, a biodegradable RBI was implanted between the prostate and the anterior rectal wall to push the rectum outside of the high-dose area. This patient at high-risk for rectal toxicity was successfully irradiated to his prostate with only a grade I urinary toxicity, no acute rectal toxicity or toxicity flare of the IBD.
This case describes the use of a RBI implantation in patients with active IBD for prostate cancer radiotherapy. The use of a biodegradable RBI proved to be a promised solution for such patients, and have to be further investigated.
活动性炎症性肠病（IBD）患者的放疗通常被视为前列腺癌放疗治疗的绝对排除标准。目前尚无关于在活动性IBD患者中使用可生物降解直肠球囊植入术（RBI）进行前列腺癌放疗的报道。
我们报告了一名患有高危前列腺癌且合并活动性全结肠炎型IBD的患者。他接受了新辅助激素治疗以及对前列腺和精囊的高剂量外照射放疗。在放疗前，在前列腺和直肠前壁之间植入了可生物降解的RBI，以将直肠推至高剂量区域之外。该具有直肠毒性高风险的患者成功接受了前列腺放疗，仅出现I级泌尿毒性，无急性直肠毒性或IBD毒性发作。
本病例描述了在活动性IBD患者中使用RBI植入术进行前列腺癌放疗。事实证明，可生物降解RBI的使用对这类患者是一种有前景的解决方案，有待进一步研究。
