Prospective analysis of hydrogel spacer for patients with prostate cancer undergoing radiotherapy Academic Article uri icon


  • OBJECTIVE:To report on the dosimetric benefits and late toxicity outcomes after injection of hydrogel spacer (HS) between the prostate and rectum for patients treated with prostate radiotherapy (RT). PATIENTS AND METHODS:In all, 76 patients with a clinical stage of T1-T3a prostate cancer underwent general anaesthesia for fiducial marker insertion plus injection of the HS into the perirectal space before intensity-modulated RT (IMRT) or volumetric-modulated arc RT (VMAT). HS safety, dosimetric benefits, and the immediate- to long-term effects of gastrointestinal (GI) toxicity were assessed. RESULTS:There were no postoperative complications reported. The mean (range) prostate size was 66.0 (25.0-187.0) mm. Rectal dose volume parameters were observed and the volume of rectum receiving 70 Gy (rV70 ), 75 Gy (rV75 ) and 78 Gy (rV78 ) was 7.8%, 3.6% and 0.4%, respectively. In all, 21% of patients (16/76) developed acute Grade 1 GI toxicities, but all were resolved completely by 3 months after treatment; whilst, 3% of patients (2/76) developed late Grade 1 GI toxicities. No patients had acute or late Grade ≥2 GI toxicities. CONCLUSION:Injection of HS resulted in a reduction of irradiated rectal dose volumes along with minimal GI toxicities, irrespective of prostate size.


  • Chao, Michael
  • Ho, Huong
  • Chan, Yee
  • Tan, Alwin
  • Pham, Trung
  • Bolton, Damien
  • Troy, Andrew
  • Temelcos, Catherine
  • Sengupta, Shomik
  • McMillan, Kevin
  • Cham, Chee Wee
  • Liu, Madalena
  • Ding, Wei
  • Subramanian, Brindha
  • Wasiak, Jason
  • Lim Joon, Daryl
  • Spencer, Sandra
  • Lawrentschuk, Nathan

publication date

  • 2018