Placement of SpaceOAR hydrogel spacer for prostate cancer patients treated with iodine-125 low-dose-rate brachytherapy
Placement of SpaceOAR hydrogel spacer for prostate cancer patients treated with iodine-125 low-dose-rate brachytherapy
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DOI：
10.1111/iju.14123
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发表时间：
2020-01-01
影响因子：
2.6
通讯作者：
Lederer, John L.
中科院分区：
文献类型：
--
作者：
Morita, Masashi;Fukagai, Takashi;Lederer, John L.
目的本研究的目的是报告我们的早期经验与水凝胶间隔器（SpaceOAR）放置结合碘-125低剂量率近距离放射治疗前列腺癌。方法自2018年4月起，在连续100例接受碘-125低剂量率近距离放射治疗的患者中放置SpaceOAR水凝胶间隔器。对并发症和放置状态进行了评价。通过测量前列腺直径和评估术前状态的变化，检查间隔器引起的前列腺变形。通过评估耻骨联合和前列腺之间的距离变化来类似地检查前列腺的位置。将计划后剂量测定数据与200例未使用融合器治疗的患者进行比较。结果术中、围手术期均无并发症发生。平均位移距离为11.64 mm，置入融合器前平均位移距离为0.28 mm（P < 0.0001）。前列腺直径的变化在所有方向上均表现为正向增加，在任何一个方向上均无明显的负向变化。关于耻骨联合与前列腺之间距离的变化，两组之间未观察到显著缩短趋势（P = 0.14）。垫片组中RV 150和RV 100的剂量测定参数平均值分别为0.001和0.026 cc，而非垫片组中分别为0.025和0.318 cc，这两个参数均显着下降（P < 0.001）。结论：水凝胶植入后继发的前列腺变形可能对接受低剂量率近距离放射治疗的患者的剂量学参数产生不利影响。然而，可以采用直肠剂量的显著减少，而不会对与治疗结果相关的其他参数产生不利影响。
Objectives The aim of the present study was to report on our early experience with hydrogel spacer (SpaceOAR) placement in combination with iodine-125 low-dose-rate brachytherapy for prostate cancer. Methods From April 2018, SpaceOAR hydrogel spacer was placed in 100 consecutive patients undergoing iodine-125 low-dose-rate brachytherapy. Complications and the status of the placement were evaluated. Deformation of the prostate by the spacer was examined measuring prostate diameters and evaluating the change from preoperative status. The position of the prostate was similarly examined by evaluating the change in distance between the pubic symphysis and the prostate. Post-plan dosimetric data were compared with 200 patients treated without a spacer. Results No complications were found during either the intraoperative or perioperative periods. The mean displacement distance of 11.64 mm was created, the mean value before spacer placement was 0.28 mm (P < 0.0001). The change of the prostate diameters showed a positive increase in all directions, with no significant negative change in any one direction. Regarding the change in distance between pubic symphysis and the prostate, no significant shortening trend was observed between the two groups (P = 0.14). Whereas the dosimetric parameters showed means of 0.001 and 0.026 cc for RV150 and RV100 in the spacer group, they were 0.025 and 0.318 cc, respectively, in the non-spacer group, showing a significant decrease in both parameters (P < 0.001). Conclusions Prostate deformation secondary to hydrogel placement might adversely affect dosimetric parameters in patients undergoing low-dose-rate brachytherapy. However, a significant reduction in the rectal dose can be adopted without adversely affecting the other parameters related to treatment outcome.