Prostate cancer: Spacer Gel protects against radiation damages
Barcelona, May 13, 12012 – A spacer gel injected between the prostate and rectum (back passage) before prostate cancer radiotherapy, now offers an even safer radiation therapy of prostate cancer. With the gel, an adequate space between these two organs is maintained, and the rectum is well protected from dangerous radiation damage. The West German Prostate Center in Cologne now has successfully treated the first patient with this innovative system. Dr. Gregory Spira, radiation therapist at the West German Prostate Center, presented the results at the at this year's Symposium of the European Society for Therapeutic Radiology and Oncology (ESTRO) in Barcelona1.
Due to advanced medical technology and refined techniques, radiation therapy for prostate cancer becomes increasingly more important. Today, the placement of tiny radiation sources (radioactive seeds) directly into the prostate (brachytherapy), intensity-modulated radiotherapy, and image-guided radiation allow for highly precise irradiation of the prostate without damaging surrounding tissue. Nevertheless, some radiation-induced irritation of the rectum and the consequent higher stool frequency cannot be prevented in all cases, which is especially the case when very high doses of radiation have to be delivered due to an advanced tumor stage.
A solution is the so-called SpaceOAR system an aqueous gel (hydrogel) that is injected between prostate and rectal wall prior to the treatment. It protects the rectal wall by creating a significantly larger distance between the two organs. "This helps to further minimize the radiation dose to the rectum and thus to prevent further radiation-induced irritation of the rectum almost completely”, emphasizes Dr. Gregory Spira, radiation therapist at the West German Prostate Center. A recent study conducted by the West German Prostate Center, clearly evidenced the advantage of this new method. The study was also introduced to a broad audience at the annual meeting of the European Society for Therapeutic Radiology and Oncology (ESTRO) in Barcelona.
Sparing of the rectum
For the study, specialists at the West German Prostate Center examined a total of 12 patients between November 2011 and February 2012, who had received combination therapy with a brachytherapy (HDR-afterloading) and intensity modulated, image guided external radiation. In all patients, hydrogel was applied between prostate and rectum prior to radiation. "With the injection of the gel, we were able to increase the distance between the prostate and rectum up to 13 millimeters”, explains Dr. Spira. As a result, the radiation dose to the rectum was reduced to almost half. "A clear success, which does not affect the patient’s condition during the irradiation", continues Spira. None of the men showed serious side effects, such as inflammation of the bowel, diarrhea, or bloody stool.
“Not only patients with advanced prostate cancer undergoing brachytherapy in addition to an external radiation benefit from Space OAR but also patients whose distance between rectum and prostate is relatively small”, says Dr. Spira. If necessary, it is also possible to increase the applied radiation dose, without causing damage to the surrounding tissue.
1Spira G., Neubauer S., Weise C., Derakhshani P.: More Space more dose: Dose report of the first Patients with intermediate and high risk Prostate Cancer treated in Cologne with SpaceOar Hydrogel before HDR-Brachytherapy Boost and External beam IMRT, Department of Radiooncology, Department of Urology, West German Prostate Center Cologne.
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