Interdisciplinary consensus statement on indication and application of a hydrogel spacer for prostate radiotherapy based on experience in more than 250 patients

<section class="abstract"><h2 class="abstractTitle text-title my-1" id="d692e2">Abstract</h2><div id="" class="section"><h3 class="abstractTitle text-title my-1" id="d692e5">Background</h3><p...

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Hauptverfasser: Müller, Arndt-Christian (VerfasserIn) , Mischinger, Johannes (VerfasserIn) , Klotz, Theodor (VerfasserIn) , Gagel, Bernd (VerfasserIn) , Habl, Gregor (VerfasserIn) , Hatiboglu, Gencay (VerfasserIn) , Pinkawa, Michael (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 19.07.2016
In: Radiology and oncology
Year: 2016, Jahrgang: 50, Heft: 3, Pages: 329-336
ISSN:1581-3207
DOI:10.1515/raon-2016-0036
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1515/raon-2016-0036
Verlag, lizenzpflichtig, Volltext: https://content.sciendo.com/view/journals/raon/50/3/article-p329.xml
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Verfasserangaben:Arndt-Christian Müller, Johannes Mischinger, Theodor Klotz, Bernd Gagel, Gregor Habl, Gencay Hatiboglu, Michael Pinkawa

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520 |a <section class="abstract"><h2 class="abstractTitle text-title my-1" id="d692e2">Abstract</h2><div id="" class="section"><h3 class="abstractTitle text-title my-1" id="d692e5">Background</h3><p>The aim of the study was to reach a consensus on indication and application of a hydrogel spacer based on multicentre experience and give new users important information to shorten the learning curve for this innovative technique.</p></div><div id="" class="section"><h3 class="abstractTitle text-title my-1" id="d692e8">Methods</h3><p>The interdisciplinary meeting was attended by radiation oncologists and urologists, each with experience of 23 - 138 hydrogel injections (SpaceOAR®) in prostate cancer patients before dose-escalated radiotherapy. User experience was discussed and questions were defined to comprise practical information relevant for successful hydrogel injection and treatment. Answers to the defined key questions were generated. Hydrogel-associated side effects were collected to estimate the percentage, treatment and prognosis of potential risks.</p></div><div id="" class="section"><h3 class="abstractTitle text-title my-1" id="d692e11">Results</h3><p>The main indication for hydrogel application was dose-escalated radiotherapy for histologically confirmed low or intermediate risk prostate cancer. It was not recommended in locally advanced prostate cancer. The injection or implantation was performed under transrectal ultrasound guidance <em>via</em> the transperineal approach after prior hydrodissection. The rate of injection-related G2-toxicity was 2% (n = 5) in a total of 258 hydrogel applications. The most frequent complication (n = 4) was rectal wall penetration, diagnosed at different intervals after hydrogel injection and treated conservatively.</p></div><div id="" class="section"><h3 class="abstractTitle text-title my-1" id="d692e18">Conclusions</h3><p>A consensus was reached on the application of a hydrogel spacer. Current experience demonstrated feasibility, which could promote initiation of this method in more centres to reduce radiation-related gastrointestinal toxicity of dose-escalated IGRT. However, a very low rate of a potential serious adverse event could not be excluded. Therefore, the application should carefully be discussed with the patient and be balanced against potential benefits.</p></div></section> 
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