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Application of a hydrogel spacer for postoperative salvage radiotherapy of prostate cancer

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Application of a hydrogel spacer for postoperative salvage radiotherapy of prostate cancer. / Pinkawa, Michael; Schubert, Carolin; Escobar-Corral, Nuria; Holy, Richard; Eble, Michael J.

In: STRAHLENTHER ONKOL, Vol. 191, No. 4, 04.2015, p. 375-9.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Pinkawa, M, Schubert, C, Escobar-Corral, N, Holy, R & Eble, MJ 2015, 'Application of a hydrogel spacer for postoperative salvage radiotherapy of prostate cancer', STRAHLENTHER ONKOL, vol. 191, no. 4, pp. 375-9. https://doi.org/10.1007/s00066-014-0769-z

APA

Pinkawa, M., Schubert, C., Escobar-Corral, N., Holy, R., & Eble, M. J. (2015). Application of a hydrogel spacer for postoperative salvage radiotherapy of prostate cancer. STRAHLENTHER ONKOL, 191(4), 375-9. https://doi.org/10.1007/s00066-014-0769-z

Vancouver

Pinkawa M, Schubert C, Escobar-Corral N, Holy R, Eble MJ. Application of a hydrogel spacer for postoperative salvage radiotherapy of prostate cancer. STRAHLENTHER ONKOL. 2015 Apr;191(4):375-9. https://doi.org/10.1007/s00066-014-0769-z

Bibtex

@article{48cdd19563cc467e85678a88a0dfd85d,
title = "Application of a hydrogel spacer for postoperative salvage radiotherapy of prostate cancer",
abstract = "BACKGROUND: In contrast to primary radiotherapy, no reports are available for a hydrogel spacer application in postoperative salvage radiotherapy for prostate cancer.CASE REPORT: A 77-year-old patient presented 20 years after radical prostatectomy with a digitally palpable local recurrence at the urethrovesical anastomosis (PSA 5.5 ng/ml). The hydrogel spacer (10 ml, SpaceOAR{\texttrademark}) was injected between the local recurrence and rectal wall under transrectal ultrasound guidance. Treatment planning was performed with an intensity-modulated technique up to a total dose of 76 Gy in 2-Gy fractions. The same planning was performed based on computed tomography before spacer injection for comparison.RESULTS: The local recurrence, initially directly on the rectal wall, could be displaced more than  1 cm from the rectal wall after hydrogel injection. With a mean total dose of 76 Gy to the planning target volume, rectal wall volumes included in the 70 Gy, 60 Gy, 50 Gy isodoses were 0 cm(3), 0 cm(3), and 0.4 cm(3) with a spacer and 2.9 cm(3), 4.5 cm(3), and 6.2 cm(3) without a spacer, respectively. The patient reported rectal urgency during radiotherapy, completely resolving after the end of treatment. The PSA level was 5.4 ng/ml a week before the end of radiotherapy and dropped to 0.9 ng/ml 5 months after radiotherapy.CONCLUSION: A hydrogel spacer was successfully applied for dose-escalated radiotherapy in a patient with macroscopic local prostate cancer recurrence at the urethrovesical anastomosis to decrease the dose at the rectal wall. This option can be considered in specifically selected patients.",
keywords = "Aged, Dose Fractionation, Humans, Hydrogel, Male, Materials Testing, Neoplasm, Residual, Postoperative Care, Prostatic Neoplasms, Prostheses and Implants, Radiation Protection, Radiotherapy, Adjuvant, Radiotherapy, Conformal, Salvage Therapy, Treatment Outcome",
author = "Michael Pinkawa and Carolin Schubert and Nuria Escobar-Corral and Richard Holy and Eble, {Michael J}",
year = "2015",
month = apr,
doi = "10.1007/s00066-014-0769-z",
language = "English",
volume = "191",
pages = "375--9",
journal = "STRAHLENTHER ONKOL",
issn = "0179-7158",
publisher = "Urban und Vogel",
number = "4",

}

RIS

TY - JOUR

T1 - Application of a hydrogel spacer for postoperative salvage radiotherapy of prostate cancer

AU - Pinkawa, Michael

AU - Schubert, Carolin

AU - Escobar-Corral, Nuria

AU - Holy, Richard

AU - Eble, Michael J

PY - 2015/4

Y1 - 2015/4

N2 - BACKGROUND: In contrast to primary radiotherapy, no reports are available for a hydrogel spacer application in postoperative salvage radiotherapy for prostate cancer.CASE REPORT: A 77-year-old patient presented 20 years after radical prostatectomy with a digitally palpable local recurrence at the urethrovesical anastomosis (PSA 5.5 ng/ml). The hydrogel spacer (10 ml, SpaceOAR™) was injected between the local recurrence and rectal wall under transrectal ultrasound guidance. Treatment planning was performed with an intensity-modulated technique up to a total dose of 76 Gy in 2-Gy fractions. The same planning was performed based on computed tomography before spacer injection for comparison.RESULTS: The local recurrence, initially directly on the rectal wall, could be displaced more than  1 cm from the rectal wall after hydrogel injection. With a mean total dose of 76 Gy to the planning target volume, rectal wall volumes included in the 70 Gy, 60 Gy, 50 Gy isodoses were 0 cm(3), 0 cm(3), and 0.4 cm(3) with a spacer and 2.9 cm(3), 4.5 cm(3), and 6.2 cm(3) without a spacer, respectively. The patient reported rectal urgency during radiotherapy, completely resolving after the end of treatment. The PSA level was 5.4 ng/ml a week before the end of radiotherapy and dropped to 0.9 ng/ml 5 months after radiotherapy.CONCLUSION: A hydrogel spacer was successfully applied for dose-escalated radiotherapy in a patient with macroscopic local prostate cancer recurrence at the urethrovesical anastomosis to decrease the dose at the rectal wall. This option can be considered in specifically selected patients.

AB - BACKGROUND: In contrast to primary radiotherapy, no reports are available for a hydrogel spacer application in postoperative salvage radiotherapy for prostate cancer.CASE REPORT: A 77-year-old patient presented 20 years after radical prostatectomy with a digitally palpable local recurrence at the urethrovesical anastomosis (PSA 5.5 ng/ml). The hydrogel spacer (10 ml, SpaceOAR™) was injected between the local recurrence and rectal wall under transrectal ultrasound guidance. Treatment planning was performed with an intensity-modulated technique up to a total dose of 76 Gy in 2-Gy fractions. The same planning was performed based on computed tomography before spacer injection for comparison.RESULTS: The local recurrence, initially directly on the rectal wall, could be displaced more than  1 cm from the rectal wall after hydrogel injection. With a mean total dose of 76 Gy to the planning target volume, rectal wall volumes included in the 70 Gy, 60 Gy, 50 Gy isodoses were 0 cm(3), 0 cm(3), and 0.4 cm(3) with a spacer and 2.9 cm(3), 4.5 cm(3), and 6.2 cm(3) without a spacer, respectively. The patient reported rectal urgency during radiotherapy, completely resolving after the end of treatment. The PSA level was 5.4 ng/ml a week before the end of radiotherapy and dropped to 0.9 ng/ml 5 months after radiotherapy.CONCLUSION: A hydrogel spacer was successfully applied for dose-escalated radiotherapy in a patient with macroscopic local prostate cancer recurrence at the urethrovesical anastomosis to decrease the dose at the rectal wall. This option can be considered in specifically selected patients.

KW - Aged

KW - Dose Fractionation

KW - Humans

KW - Hydrogel

KW - Male

KW - Materials Testing

KW - Neoplasm, Residual

KW - Postoperative Care

KW - Prostatic Neoplasms

KW - Prostheses and Implants

KW - Radiation Protection

KW - Radiotherapy, Adjuvant

KW - Radiotherapy, Conformal

KW - Salvage Therapy

KW - Treatment Outcome

U2 - 10.1007/s00066-014-0769-z

DO - 10.1007/s00066-014-0769-z

M3 - SCORING: Journal article

C2 - 25339311

VL - 191

SP - 375

EP - 379

JO - STRAHLENTHER ONKOL

JF - STRAHLENTHER ONKOL

SN - 0179-7158

IS - 4

ER -