BACKGROUND AND PURPOSE: We sought to analyze the effect of polyethylene glycol (PEG) hydrogel on rectal doses in prostate cancer patients undergoing radiotherapy.
MATERIALS AND METHODS: Between July 2009 and April 2013, we treated 200 clinically localized prostate cancer patients with high-dose rate (HDR) brachytherapy±intensity modulated radiation therapy. Half of the patients received a transrectal ultrasound (TRUS)-guided transperineal injection of 10mL PEG hydrogel (DuraSeal™ Spinal Sealant System; Covidien, Mansfield, MA) in their anterior perirectal fat immediately prior to the first HDR brachytherapy treatment and 5mL PEG hydrogel prior to the second HDR brachytherapy treatment. Prostate, rectal, and bladder doses and prostate-rectal distances were calculated based upon treatment planning CT scans.
RESULTS: There was a success rate of 100% (100/100) with PEG hydrogel implantation. PEG hydrogel significantly increased the prostate-rectal separation (mean±SD, 12±4mm with gel vs. 4±2mm without gel, p< 0.001) and significantly decreased the mean rectal D2 mL (47±9% with gel vs. 60±8% without gel, p< 0.001). Gel decreased rectal doses regardless of body mass index (BMI).
CONCLUSIONS: PEG hydrogel temporarily displaced the rectum away from the prostate by an average of 12mm and led to a significant reduction in rectal radiation doses, regardless of BMI.
Strom TJ, Wilder RB, Fernandez DC, Mellon EA, Saini AS, Hunt DC, Pow-Sang JM, Spiess PE, Sexton WJ, Poch MA, Biagioli MC. Are you the author?
Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA; Department of Urology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA.
Reference: Radiother Oncol. 2014 Apr 16. pii: S0167-8140(14)00107-8.