Newman Neil B, Rajkumar Anne, Cleary Ryan K, Shinohara Eric T, Kirschner Austin N
Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee.
Adv Radiat Oncol. 2021 Jul 15;6(6):100755. doi: 10.1016/j.adro.2021.100755. eCollection 2021 Nov-Dec.
SpaceOAR is a device approved for conventional radiation in prostate cancer. We sought to observe prospectively how SpaceOAR Hydrogel effected quality of life and dosimetry to organs at risk at our institution.
We prospectively enrolled patients with low risk or favorable-intermediate risk localized prostate cancer. Baseline Expanded Prostate Cancer Index Composite (EPIC-26) scores along with baseline American Urology Association Symptom Index (AUA-SI) scores were collected. SpaceOAR was placed for all patients who then received stereotactic body radiation therapy, low dose rate brachytherapy, conventionally fractionated radiation therapy, or moderately hypofractionated radiation therapy. We evaluated postimplant dosimetry to critical structures, and prospectively collected follow-up EPIC-26 and AUA-SI scores. We performed a repeated measures analysis of variance to compare patient-specific responses and correlated survey data with dosimetric metrics by generating linear regression models.
We enrolled 59 patients in this study with a median follow-up of 366 days (interquartile range, 507). At final follow-up, the "?>prostate-specific antigen had a significant decline compared with baseline ( < .0001). There were no grade 3 toxicities on treatment. There were no significant changes in the AUA-SI score ( = .69) at final follow-up compared with baseline, nor was there any change in EPIC-26 domain scores ( = .19) during the course of the study period. There were no significant associations between AUA scores and EPIC-26 scores and the dose to the rectum, bladder, or urethra with the exception being dose to the 2 mL rectum correlated with decline in EPIC-26 rectal score (β, -0.002; = .006). Patient-reported declines in bowel domains were less than previously reported data.
Use of SpaceOAR results in favorable dosimetry to the organs at risk and portends excellent short-term quality of life as measured by the association with the patient reported outcome measures. Longer-term follow-up is ongoing and necessary to assess the long-term effect and association of the hydrogel.
SpaceOAR是一种已被批准用于前列腺癌常规放疗的设备。我们试图前瞻性地观察SpaceOAR水凝胶对我院患者生活质量以及危及器官剂量测定的影响。
我们前瞻性地纳入了低危或预后良好的中危局限性前列腺癌患者。收集基线扩展前列腺癌指数综合评分（EPIC-26）以及基线美国泌尿外科学会症状指数（AUA-SI）评分。为所有接受立体定向体部放疗、低剂量率近距离放疗、常规分割放疗或适度低分割放疗的患者放置SpaceOAR。我们评估植入后关键结构的剂量测定，并前瞻性地收集随访的EPIC-26和AUA-SI评分。我们进行了重复测量方差分析，以比较患者特异性反应，并通过生成线性回归模型将调查数据与剂量学指标相关联。
我们在本研究中纳入了59例患者，中位随访时间为366天（四分位间距，507）。在最终随访时，前列腺特异性抗原与基线相比有显著下降（P <.0001）。治疗期间无3级毒性反应。与基线相比，最终随访时AUA-SI评分无显著变化（P =.69），在研究期间EPIC-26各领域评分也无变化（P =.19）。AUA评分和EPIC-26评分与直肠、膀胱或尿道所受剂量之间无显著关联，唯一例外是2 mL直肠所受剂量与EPIC-26直肠评分下降相关（β，-0.002；P =.006）。患者报告的肠道领域下降情况低于先前报告的数据。
使用SpaceOAR对危及器官的剂量测定有利，并且通过与患者报告的结局指标相关联来衡量，预示着良好的短期生活质量。正在进行长期随访，这对于评估水凝胶的长期效果和相关性是必要的。
