دورية أكاديمية
Rectal Hydrogel Spacer Improves Late Gastrointestinal Toxicity Compared to Rectal Balloon Immobilization After Proton Beam Radiation Therapy for Localized Prostate Cancer: A Retrospective Observational Study.
| العنوان: | Rectal Hydrogel Spacer Improves Late Gastrointestinal Toxicity Compared to Rectal Balloon Immobilization After Proton Beam Radiation Therapy for Localized Prostate Cancer: A Retrospective Observational Study. |
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| المؤلفون: | Dinh TT; Department of Radiation Oncology, University of Washington, Seattle, Washington. Electronic address: tktdinh@uw.edu., Lee HJ Jr; Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts., Macomber MW; Sutter Health Radiation Oncology, Sacramento, California., Apisarnthanarax S; Department of Radiation Oncology, University of Washington, Seattle, Washington., Zeng J; Department of Radiation Oncology, University of Washington, Seattle, Washington., Laramore GE; Department of Radiation Oncology, University of Washington, Seattle, Washington., Rengan R; Department of Radiation Oncology, University of Washington, Seattle, Washington., Russell KJ; Department of Radiation Oncology, University of Washington, Seattle, Washington., Chen JJ; Department of Radiation Oncology, University of Washington, Seattle, Washington., Ellis WJ; Department of Urology, University of Washington, Seattle, Washington., Schade GR; Department of Urology, University of Washington, Seattle, Washington., Liao JJ; Department of Radiation Oncology, University of Washington, Seattle, Washington. |
| المصدر: | International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2020 Nov 01; Vol. 108 (3), pp. 635-643. Date of Electronic Publication: 2020 Feb 06. |
| نوع المنشور: | Journal Article; Observational Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier, Inc Country of Publication: United States NLM ID: 7603616 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-355X (Electronic) Linking ISSN: 03603016 NLM ISO Abbreviation: Int J Radiat Oncol Biol Phys Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York, NY : Elsevier, Inc Original Publication: Elmsford, N. Y., Pergamon Press. |
| مواضيع طبية MeSH: | Hydrogels*, Adenocarcinoma/*radiotherapy , Immobilization/*methods , Prostatic Neoplasms/*radiotherapy , Proton Therapy/*methods , Radiation Injuries/*prevention & control , Rectum/*radiation effects, Adenocarcinoma/pathology ; Aged ; Dose Fractionation, Radiation ; Fiducial Markers ; Gastrointestinal Hemorrhage/epidemiology ; Hemorrhoids/complications ; Humans ; Immobilization/instrumentation ; Immobilization/statistics & numerical data ; Incidence ; Male ; Multivariate Analysis ; Organs at Risk/diagnostic imaging ; Proportional Hazards Models ; Prostate/diagnostic imaging ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Proton Therapy/adverse effects ; Quality of Life ; Rectum/diagnostic imaging ; Retrospective Studies ; Seminal Vesicles/diagnostic imaging |
| مستخلص: | Purpose: Our purpose was to compare dosimetric parameters and late gastrointestinal outcomes between patients treated with proton beam therapy (PBT) for localized prostate cancer with rectal balloon immobilization versus a hydrogel rectal spacer. Methods and Materials: Patients with localized, clinical stage T1-4 prostate adenocarcinoma were treated at a single institution using conventionally fractionated, dose-escalated PBT from 2013 to 2018. Patient-reported gastrointestinal toxicity was prospectively collected, and the incidence of rectal bleeding was retrospectively reviewed from patient records. Results: One hundred ninety-two patients were treated with rectal balloon immobilization, and 75 were treated with a rectal spacer. Rectal hydrogel spacer significantly improved rectal dosimetry while maintaining excellent target coverage. The 2-year actuarial rate of grade 2+ late rectal bleeding was 19% and 3% in the rectal balloon and hydrogel spacer groups, respectively (P = .003). In univariable analysis, the probability of grade 2+ rectal bleeding was significantly correlated with increasing rectal dose. In multivariable analysis, only receipt of spacer hydrogel (hazard ratio, 0.145; P = .010) and anticoagulation use (hazard ratio, 5.019; P < .001) were significantly associated with grade 2+ bleeding. At 2-year follow-up, patient-reported Expanded Prostate Cancer Index Composite bowel quality of life composite scores were less diminished in the hydrogel spacer group (absolute mean difference, 5.5; P = .030). Conclusions: Use of rectal hydrogel spacer for prostate PBT is associated with a significantly lower incidence of clinically relevant, late rectal bleeding and lower decrement in long-term, patient-reported bowel quality of life compared with rectal balloon immobilization. Our results suggest that hydrogel spacer may improve rectal sparing compared with rectal balloon immobilization during PBT for prostate cancer. (Copyright © 2020 Elsevier Inc. All rights reserved.) |
| التعليقات: | Comment in: Int J Radiat Oncol Biol Phys. 2020 Nov 1;108(3):644-648. (PMID: 32976788) |
| المشرفين على المادة: | 0 (Hydrogels) |
| تواريخ الأحداث: | Date Created: 20200209 Date Completed: 20210409 Latest Revision: 20210409 |
| رمز التحديث: | 20240829 |
| DOI: | 10.1016/j.ijrobp.2020.01.026 |
| PMID: | 32035187 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-355X |
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| DOI: | 10.1016/j.ijrobp.2020.01.026 |