Quality of Life After Radiation Therapy for Prostate Cancer With a Hydrogel Spacer: 5-Year Results

Int J Radiat Oncol Biol Phys. 2017 Oct 1;99(2):374-377. doi: 10.1016/j.ijrobp.2017.05.035. Epub 2017 May 31.

Abstract

Purpose: To evaluate quality of life changes up to 5 years after prostate cancer radiation therapy (RT) with a hydrogel spacer.

Methods and materials: In the years 2010 to 2011, 114 patients received external beam radiation therapy to the prostate; 54 patients were selected for a hydrogel injection before the beginning of RT. Treatment was performed applying fractions of 2 Gy up to a total dose of 76 Gy (n=96) or 78 Gy (n=18, all with hydrogel). Patients were surveyed before RT; at the last day of RT; and a median time of 2 months, 17 months, and 63 months after RT using a validated questionnaire (Expanded Prostate Cancer Index Composite). A mean score change of >5 points was defined as clinically relevant.

Results: For patients treated with a hydrogel spacer, mean bowel function and bother score changes of >5 points in comparison with baseline levels were found only at the end of RT (10-15 points; P<.01). No spacer patient reported moderate or big problems with his bowel habits overall. Mean bother score changes of 21 points at the end of RT, 8 points at 2 months, 7 points at 17 months, and 6 points at 63 months after RT were found for patients treated without a spacer. A bowel bother score change >10 points was found in 6% versus 32% (P<.01) at 17 months and in 5% versus 14% (P=.2) at 63 months with versus without a spacer.

Conclusions: The first 5-year quality of life results in a group of prostate cancer patients treated with a hydrogel spacer demonstrate excellent treatment tolerability, in particular regarding bowel problems. Further studies with dose-escalated or re-irradiation concepts can be encouraged.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dose Fractionation, Radiation
  • Humans
  • Hydrogel, Polyethylene Glycol Dimethacrylate / administration & dosage*
  • Male
  • Middle Aged
  • Organ Sparing Treatments / methods*
  • Prostate*
  • Prostatic Neoplasms / radiotherapy*
  • Quality of Life*
  • Radiation Injuries / prevention & control*
  • Rectum*
  • Time Factors
  • Treatment Outcome

Substances

  • Hydrogel, Polyethylene Glycol Dimethacrylate