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前列腺癌放疗中使用SpaceOAR水凝胶植入后直肠溃疡的自发缓解

Spontaneous remission of rectal ulcer associated with SpaceOAR hydrogel insertion in radiotherapy for prostate cancer.

作者信息

Imai Kazuto, Sakamoto Hiromasa, Akahane Mizuho, Nakashima Masakazu, Fujimoto Takeru, Aoyama Teruyoshi

机构信息

Department of Urology Kansai Electric Power Hospital Osaka Osaka Japan.

出版信息

IJU Case Rep. 2020 Aug 5;3(6):257-260. doi: 10.1002/iju5.12209. eCollection 2020 Nov.

Abstract

INTRODUCTION

The SpaceOAR hydrogel system separates the prostate and rectum to reduce rectal irradiation during prostate radiotherapy. However, it could induce rectal toxicity.

CASE PRESENTATION

A 75-year-old man with localized prostate cancer underwent external beam radiotherapy with the use of SpaceOAR System. However, postimplant magnetic resonance imaging showed hydrogel infiltration to the rectum. Three months after implantation, he complained of bowel symptoms, including bloody stool. Colonofiberscopy and computed tomography revealed a rectal ulcer associated with SpaceOAR hydrogel insertion. He was treated with fasting, fluid replacement, and blood transfusion. One year after implantation, complete healing was confirmed during outpatient follow-up.

CONCLUSION

To our knowledge, this is the first report of a rectal ulcer associated with SpaceOAR hydrogel insertion assessed by magnetic resonance imaging beforehand. Postimplant magnetic resonance imaging evaluation might be a useful follow-up tool in such cases.

摘要

引言

SpaceOAR水凝胶系统可分离前列腺和直肠,以减少前列腺放疗期间的直肠照射。然而,它可能会诱发直肠毒性。

病例报告

一名75岁的局限性前列腺癌男性患者使用SpaceOAR系统进行了外照射放疗。然而,植入后磁共振成像显示水凝胶浸润至直肠。植入后三个月,他出现肠道症状,包括便血。结肠镜检查和计算机断层扫描显示与SpaceOAR水凝胶插入相关的直肠溃疡。他接受了禁食、补液和输血治疗。植入后一年,门诊随访确认完全愈合。

结论

据我们所知,这是第一例通过预先磁共振成像评估与SpaceOAR水凝胶插入相关的直肠溃疡的报告。植入后磁共振成像评估可能是此类病例有用的随访工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a09a/7609181/3202ff504553/IJU5-3-257-g001.jpg

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