A Urologist’s Perspective: Initial Experiences With SpaceOAR Hydrogel Insertion for Prostate Cancer Patients

Purpose To evaluate the placement accuracy and learning curve of SpaceOAR hydrogel and gold fiducial marker insertion in Korean prostate cancer patients undergoing carbon ion radiotherapy (CIRT), performed by a single urologist without prior experience. Materials and Methods In this retrospective ob...

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Main Authors: Hyunho Han, Ik Jae Lee, Woong Sub Koom, Chan Woo Wee, Woong Kyu Han
Format: Article
Language:English
Published: Korean Urological Oncology Society 2025-03-01
Series:Journal of Urologic Oncology
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Online Access:http://www.e-juo.org/upload/pdf/juo-244800760038.pdf
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author Hyunho Han
Ik Jae Lee
Woong Sub Koom
Chan Woo Wee
Woong Kyu Han
author_facet Hyunho Han
Ik Jae Lee
Woong Sub Koom
Chan Woo Wee
Woong Kyu Han
author_sort Hyunho Han
collection DOAJ
description Purpose To evaluate the placement accuracy and learning curve of SpaceOAR hydrogel and gold fiducial marker insertion in Korean prostate cancer patients undergoing carbon ion radiotherapy (CIRT), performed by a single urologist without prior experience. Materials and Methods In this retrospective observational study, 104 prostate cancer patients scheduled for CIRT at Severance Hospital between November 2022 and October 2023 underwent simultaneous SpaceOAR hydrogel insertion and 2 gold fiducial markers placement under transrectal ultrasound guidance. Postprocedural magnetic resonance imaging scans assessed spacer placement accuracy using the SpaceOAR Symmetry Score. Complications were documented and graded according to the Common Terminology Criteria for Adverse Events v5.0. Statistical analyses evaluated the impact of age, prostate volume, and operative time on complication rates and procedural efficiency. Results Spacer placement was successful in all cases, achieving SpaceOAR Symmetry Score of 2.0 or less in 85.58% of the cases. The average operative time for the first 50 cases was 12.70±3.40 minutes, while for the latter 54 cases was 12.50±5.35 minutes, which suggests no significant learnig curve exist. Complications occurred in 25 of patients (24.0%), with constipation (9.6%), weak urinary stream (4.8%) and perianal pain (3.8%) being the most common. Acute urinary retention (grade 2) occurred in 3 patients and was not related to patient age or the presence of benign prostatic hyperplasia. Other complications were rare and mostly mild (grade 1). Conclusions SpaceOAR hydrogel insertion with gold fiducial marker placement is a reliable and efficient procedure that can be effectively performed by urologists without prior experience in patients undergoing CIRT. The procedure demonstrates a significant learning curve, with operative efficiency improving over time, supporting its feasibility and potential for widespread adoption.
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spelling doaj-art-b895affb37df4ab4a30992f7faf328e62025-08-20T02:32:18ZengKorean Urological Oncology SocietyJournal of Urologic Oncology2951-603X2982-70432025-03-01231202910.22465/juo.244800760038611A Urologist’s Perspective: Initial Experiences With SpaceOAR Hydrogel Insertion for Prostate Cancer PatientsHyunho Han0Ik Jae Lee1Woong Sub Koom2Chan Woo Wee3Woong Kyu Han4 Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, KoreaPurpose To evaluate the placement accuracy and learning curve of SpaceOAR hydrogel and gold fiducial marker insertion in Korean prostate cancer patients undergoing carbon ion radiotherapy (CIRT), performed by a single urologist without prior experience. Materials and Methods In this retrospective observational study, 104 prostate cancer patients scheduled for CIRT at Severance Hospital between November 2022 and October 2023 underwent simultaneous SpaceOAR hydrogel insertion and 2 gold fiducial markers placement under transrectal ultrasound guidance. Postprocedural magnetic resonance imaging scans assessed spacer placement accuracy using the SpaceOAR Symmetry Score. Complications were documented and graded according to the Common Terminology Criteria for Adverse Events v5.0. Statistical analyses evaluated the impact of age, prostate volume, and operative time on complication rates and procedural efficiency. Results Spacer placement was successful in all cases, achieving SpaceOAR Symmetry Score of 2.0 or less in 85.58% of the cases. The average operative time for the first 50 cases was 12.70±3.40 minutes, while for the latter 54 cases was 12.50±5.35 minutes, which suggests no significant learnig curve exist. Complications occurred in 25 of patients (24.0%), with constipation (9.6%), weak urinary stream (4.8%) and perianal pain (3.8%) being the most common. Acute urinary retention (grade 2) occurred in 3 patients and was not related to patient age or the presence of benign prostatic hyperplasia. Other complications were rare and mostly mild (grade 1). Conclusions SpaceOAR hydrogel insertion with gold fiducial marker placement is a reliable and efficient procedure that can be effectively performed by urologists without prior experience in patients undergoing CIRT. The procedure demonstrates a significant learning curve, with operative efficiency improving over time, supporting its feasibility and potential for widespread adoption.http://www.e-juo.org/upload/pdf/juo-244800760038.pdfspaceoarprostatic neoplasmscarbon-ion radiotherapygold radioisotopesadverse effects
spellingShingle Hyunho Han
Ik Jae Lee
Woong Sub Koom
Chan Woo Wee
Woong Kyu Han
A Urologist’s Perspective: Initial Experiences With SpaceOAR Hydrogel Insertion for Prostate Cancer Patients
Journal of Urologic Oncology
spaceoar
prostatic neoplasms
carbon-ion radiotherapy
gold radioisotopes
adverse effects
title A Urologist’s Perspective: Initial Experiences With SpaceOAR Hydrogel Insertion for Prostate Cancer Patients
title_full A Urologist’s Perspective: Initial Experiences With SpaceOAR Hydrogel Insertion for Prostate Cancer Patients
title_fullStr A Urologist’s Perspective: Initial Experiences With SpaceOAR Hydrogel Insertion for Prostate Cancer Patients
title_full_unstemmed A Urologist’s Perspective: Initial Experiences With SpaceOAR Hydrogel Insertion for Prostate Cancer Patients
title_short A Urologist’s Perspective: Initial Experiences With SpaceOAR Hydrogel Insertion for Prostate Cancer Patients
title_sort urologist s perspective initial experiences with spaceoar hydrogel insertion for prostate cancer patients
topic spaceoar
prostatic neoplasms
carbon-ion radiotherapy
gold radioisotopes
adverse effects
url http://www.e-juo.org/upload/pdf/juo-244800760038.pdf
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