Patients with a Short Distance Between the Prostate and the Rectum Are Appropriate Candidates for Hydrogel Spacer Placement to Prevent Short-Term Rectal Hemorrhage After External-Beam Radiotherapy for Prostate Cancer
Radiation therapy, including external-beam radiation therapy (EBRT) and brachytherapy, is curative for localized prostate cancer. Hydrogel spacer (HS) placement between the rectum and prostate is popular for reducing radiation-related complications. Criteria to identify patients who benefit from HS...
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| Format: | Article |
| Language: | English |
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MDPI AG
2025-07-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/32/7/385 |
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| author | Shunsuke Owa Takeshi Sasaki Akito Taniguchi Kazuki Omori Taketomo Nishikawa Momoko Kato Shinichiro Higashi Yusuke Sugino Yutaka Toyomasu Akinori Takada Kouhei Nishikawa Yoshihito Nomoto Takahiro Inoue |
| author_facet | Shunsuke Owa Takeshi Sasaki Akito Taniguchi Kazuki Omori Taketomo Nishikawa Momoko Kato Shinichiro Higashi Yusuke Sugino Yutaka Toyomasu Akinori Takada Kouhei Nishikawa Yoshihito Nomoto Takahiro Inoue |
| author_sort | Shunsuke Owa |
| collection | DOAJ |
| description | Radiation therapy, including external-beam radiation therapy (EBRT) and brachytherapy, is curative for localized prostate cancer. Hydrogel spacer (HS) placement between the rectum and prostate is popular for reducing radiation-related complications. Criteria to identify patients who benefit from HS placement would be clinically valuable. In a retrospective analysis of 430 patients with localized prostate cancer treated between November 2010 and March 2023 with ≥2 years of follow-up, we evaluated the incidence of rectal hemorrhage and its association with the median distance at the midpoint between the prostate and the rectum (mDPR) on pretreatment MRI. Rectal hemorrhage occurred in 6% of HS cases and 18% of non-HS cases (<i>p</i> < 0.001). Among 268 patients who received EBRT (±brachytherapy), the incidence was 9% with HS and 30% without HS (<i>p</i> < 0.001). In non-HS cases, the rate in patients with mDPR ≤ 1.62 mm was higher than in those with mDPR > 1.62 mm (24% vs. 12%, respectively; <i>p</i> = 0.04). In patients with EBRT and mDPR ≤ 1.62 mm, HS significantly reduced hemorrhage (9% vs. 39%, respectively; <i>p</i> < 0.001). Multivariate analysis identified mDPR and HS as independent predictors of rectal hemorrhage (both <i>p</i> = 0.02). Thus, HS placement may be safely omitted in non-EBRT cases with mDPR ≥ 1.62 mm. |
| format | Article |
| id | doaj-art-632cd44c404b44e2aa988942bbc7c607 |
| institution | Kabale University |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-632cd44c404b44e2aa988942bbc7c6072025-08-20T03:36:18ZengMDPI AGCurrent Oncology1198-00521718-77292025-07-0132738510.3390/curroncol32070385Patients with a Short Distance Between the Prostate and the Rectum Are Appropriate Candidates for Hydrogel Spacer Placement to Prevent Short-Term Rectal Hemorrhage After External-Beam Radiotherapy for Prostate CancerShunsuke Owa0Takeshi Sasaki1Akito Taniguchi2Kazuki Omori3Taketomo Nishikawa4Momoko Kato5Shinichiro Higashi6Yusuke Sugino7Yutaka Toyomasu8Akinori Takada9Kouhei Nishikawa10Yoshihito Nomoto11Takahiro Inoue12Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanDepartment of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Mie, JapanRadiation therapy, including external-beam radiation therapy (EBRT) and brachytherapy, is curative for localized prostate cancer. Hydrogel spacer (HS) placement between the rectum and prostate is popular for reducing radiation-related complications. Criteria to identify patients who benefit from HS placement would be clinically valuable. In a retrospective analysis of 430 patients with localized prostate cancer treated between November 2010 and March 2023 with ≥2 years of follow-up, we evaluated the incidence of rectal hemorrhage and its association with the median distance at the midpoint between the prostate and the rectum (mDPR) on pretreatment MRI. Rectal hemorrhage occurred in 6% of HS cases and 18% of non-HS cases (<i>p</i> < 0.001). Among 268 patients who received EBRT (±brachytherapy), the incidence was 9% with HS and 30% without HS (<i>p</i> < 0.001). In non-HS cases, the rate in patients with mDPR ≤ 1.62 mm was higher than in those with mDPR > 1.62 mm (24% vs. 12%, respectively; <i>p</i> = 0.04). In patients with EBRT and mDPR ≤ 1.62 mm, HS significantly reduced hemorrhage (9% vs. 39%, respectively; <i>p</i> < 0.001). Multivariate analysis identified mDPR and HS as independent predictors of rectal hemorrhage (both <i>p</i> = 0.02). Thus, HS placement may be safely omitted in non-EBRT cases with mDPR ≥ 1.62 mm.https://www.mdpi.com/1718-7729/32/7/385prostate cancerradiation therapyhydrogel spacer |
| spellingShingle | Shunsuke Owa Takeshi Sasaki Akito Taniguchi Kazuki Omori Taketomo Nishikawa Momoko Kato Shinichiro Higashi Yusuke Sugino Yutaka Toyomasu Akinori Takada Kouhei Nishikawa Yoshihito Nomoto Takahiro Inoue Patients with a Short Distance Between the Prostate and the Rectum Are Appropriate Candidates for Hydrogel Spacer Placement to Prevent Short-Term Rectal Hemorrhage After External-Beam Radiotherapy for Prostate Cancer Current Oncology prostate cancer radiation therapy hydrogel spacer |
| title | Patients with a Short Distance Between the Prostate and the Rectum Are Appropriate Candidates for Hydrogel Spacer Placement to Prevent Short-Term Rectal Hemorrhage After External-Beam Radiotherapy for Prostate Cancer |
| title_full | Patients with a Short Distance Between the Prostate and the Rectum Are Appropriate Candidates for Hydrogel Spacer Placement to Prevent Short-Term Rectal Hemorrhage After External-Beam Radiotherapy for Prostate Cancer |
| title_fullStr | Patients with a Short Distance Between the Prostate and the Rectum Are Appropriate Candidates for Hydrogel Spacer Placement to Prevent Short-Term Rectal Hemorrhage After External-Beam Radiotherapy for Prostate Cancer |
| title_full_unstemmed | Patients with a Short Distance Between the Prostate and the Rectum Are Appropriate Candidates for Hydrogel Spacer Placement to Prevent Short-Term Rectal Hemorrhage After External-Beam Radiotherapy for Prostate Cancer |
| title_short | Patients with a Short Distance Between the Prostate and the Rectum Are Appropriate Candidates for Hydrogel Spacer Placement to Prevent Short-Term Rectal Hemorrhage After External-Beam Radiotherapy for Prostate Cancer |
| title_sort | patients with a short distance between the prostate and the rectum are appropriate candidates for hydrogel spacer placement to prevent short term rectal hemorrhage after external beam radiotherapy for prostate cancer |
| topic | prostate cancer radiation therapy hydrogel spacer |
| url | https://www.mdpi.com/1718-7729/32/7/385 |
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