Validation of a Quality Metric Score to Assess the Placement of Hydrogel Rectal Spacer in Patients Treated With Prostate Stereotactic Radiation Therapy.

Autor:	Giacometti V; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom., McLaughlin O; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom., Comiskey P; Department of Radiotherapy Physics, Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom., Marshall H; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom., Houlihan OA; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom.; Department of Clinical Oncology, Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom., Whitten G; Department of Radiotherapy Physics, Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom., Prise KM; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom., Hounsell AR; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom.; Department of Radiotherapy Physics, Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom., Jain S; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom.; Department of Clinical Oncology, Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom., McGarry CK; Patrick G. Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, United Kingdom.; Department of Radiotherapy Physics, Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, United Kingdom.
Jazyk:	angličtina
Zdroj:	Advances in radiation oncology [Adv Radiat Oncol] 2024 Jan 19; Vol. 9 (3), pp. 101396. Date of Electronic Publication: 2024 Jan 19 (Print Publication: 2024).
DOI:	10.1016/j.adro.2023.101396
Abstrakt:	Purpose: To evaluate the quality of the interspace between the prostate and rectum and assess the effect on the dose to the rectum by measuring the spacer quality score (SQS) before and after implanting a hydrogel rectal spacer. Methods and Materials: Thirty patients with prostate cancer were treated with stereotactic ablative body radiation therapy as part of the SPORT clinical trial. Each patient had a 10 mL polyethylene glycol hydrogel spacer inserted transperineally. Computed tomography scans were acquired before and after spacer insertion, 10MV flattening filter free (FFF) stereotactic ablative body radiation therapy (SABR) treatment plans were generated using each image set. To calculate the SQS, the prostate-rectal interspace (PRI) was measured in the anterior-posterior orientation, parallel to the anatomic midline at the prostate base, apex, and midgland on the prespacer and postspacer computed tomography. Measurements were taken in 3 transverse positions between the prostate and the rectum, and PRI scores of 0, 1, and 2 were assigned if the interspace between prostate and rectum was <0.3, 0.3 to 0.9, or ≥1 cm, respectively. The overall SQS was the lowest of the PRI scores. Differences between prespacer and postspacer PRIs and SQS were investigated by performing Fisher's exact test and differences between doses to the rectum were investigated by performing the paired samples Wilcoxon rank-sum test and Student t test. Results: Statistically significant differences between prespacer versus postspacer patients were found when grouping patients according to their overall SQS. The PRI summary score did not reach statistical significance between prespacer and postspacer at the base but was significantly higher for the prostate midline and apex. Statistically significant differences in some rectum dose-volume metrics were found when grouping patients according to their PRIs and SQS. Conclusions: SQS before and after the spacer insertion was evaluated and was found to be correlated with pre- and postspacer rectal dosimetry. Sources of improvement of the SQS scoring metric and limitations are discussed. Competing Interests: Suneil Jain reports consulting fees from Boston Scientific, honoraria from Janssen, Astellas, Bayer, Astra Zeneca, Pfizer, and Accord; support for attending meetings from Janssen and Bayer; and research support from Boston Scientific. (© 2023 The Authors.)
Databáze:	MEDLINE
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