Kawaguchi Gen, Ishida Kyohei, Nishiyama Hiroki, Ikeda Yohei, Hara Noboru, Nishiyama Tsutomu
Department of Radiation Oncology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma, Niigata, Japan.
Department of Urology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minamiuonuma, Niigata, Japan.
SAGE Open Med. 2024 Sep 29;12:20503121241287086. doi: 10.1177/20503121241287086. eCollection 2024.
To evaluate whether hydrogel spacer injection, which increases the distance between the prostate and rectum, prior to local radiation therapy for prostate cancer reduces rectal and bladder toxicity.
With institutional review board approval (05-004), we retrospectively reviewed rectal and bladder toxicity after local radiation therapy in patients with prostate cancer who were followed up for more than 1 year.
We included 156 patients who had received local radiation therapy. Their ages ranged from 63 to 86 years, with an average of 75 years. Most patients were treated only on the prostate and seminal vesicles. All prostate sites were irradiated as follows: whole pelvis with prostate in 10 patients, whole pelvis with prostate and metastatic sites in six, and prostate and metastatic sites in eight. Radiation therapy (70-74 Gy) was performed for the prostate. Irradiation of 45-46.8 Gy was applied to whole pelvic and para-aortic lymph nodes, with 54-60 Gy applied to bone metastatic sites. In one case, stereotactic body radiation therapy (36 Gy) was performed for a sacral bone metastatic site. The hydrogel spacer was injected in 39 patients. Rectal toxicity was reported in 21 patients without (17.9%) and 3 patients with (7.7%) the hydrogel spacer. Bladder toxicity was reported in five patients without and only one patient with the hydrogel spacer.
Hydrogel spacer injection prior to local radiation therapy for prostate cancer reduces rectal radiation exposure, lowers the risk of rectal complications, and may be a promising method for boosting the irradiation dose in the future.
评估在前列腺癌局部放射治疗前注射水凝胶间隔物（其可增加前列腺与直肠之间的距离）是否能降低直肠和膀胱毒性。
经机构审查委员会批准（05 - 004），我们回顾性分析了前列腺癌患者局部放射治疗后随访超过1年的直肠和膀胱毒性情况。
我们纳入了156例接受局部放射治疗的患者。他们的年龄在63至86岁之间，平均年龄为75岁。大多数患者仅接受前列腺和精囊的治疗。所有前列腺部位的照射情况如下：10例患者对包含前列腺的全盆腔进行照射，6例对包含前列腺和转移部位的全盆腔进行照射，8例对前列腺和转移部位进行照射。对前列腺进行放射治疗（70 - 74 Gy）。对全盆腔和腹主动脉旁淋巴结照射45 - 46.8 Gy，对骨转移部位照射54 - 60 Gy。1例患者对骶骨转移部位进行了立体定向体部放射治疗（36 Gy）。39例患者注射了水凝胶间隔物。未注射水凝胶间隔物的患者中有21例（17.9%）报告有直肠毒性，注射了水凝胶间隔物的患者中有3例（7.7%）报告有直肠毒性。未注射水凝胶间隔物的患者中有5例报告有膀胱毒性，注射了水凝胶间隔物的患者中仅有1例报告有膀胱毒性。
前列腺癌局部放射治疗前注射水凝胶间隔物可减少直肠辐射暴露，降低直肠并发症风险，且可能是未来提高照射剂量的一种有前景的方法。
