SpaceOAR Hydrogel Spacer for Reducing Radiation Toxicity During Radiotherapy for Prostate Cancer. A Systematic Review
| Autor: | Samir Bhattacharyya, Heather Payne, Suzanne Battaglia, Emily Woodward, Janine Ross, Amit Bahl, Charlotte Ahmadu, Jean Binns, Nigel Armstrong, Steve Ryder, Michael Pinkawa |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment Brachytherapy 030232 urology & nephrology law.invention 03 medical and health sciences Prostate cancer 0302 clinical medicine Randomized controlled trial law medicine Humans Dosing Radiation Injuries Radiotherapy Genitourinary system business.industry Prostatic Neoplasms Hydrogels Radiotherapy Dosage medicine.disease Radiation therapy 030220 oncology & carcinogenesis Toxicity Observational study business |
| Zdroj: | Urology. 156 |
| ISSN: | 1527-9995 |
| Popis: | OBJECTIVE To evaluate the association between SpaceOAR and radiation dosing, toxicity and quality-of-life vs no spacer across all radiotherapy modalities for prostate cancer. METHODS A systematic search of the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase was performed from database inception through May 2020. Two reviewers independently screened titles/abstracts and full papers. Data extraction was performed, and quality assessed by 1 reviewer and checked by a second, using a third reviewer as required. The synthesis was narrative. RESULTS 19 studies (3,622 patients) were included (only 1 randomized controlled trial, in image-guided intensity-modulated radiotherapy (IG-IMRT), 18 comparatives non-randomized controlled trials in external-beam radiotherapy (EBRT), brachytherapy, and combinations thereof). No hypofractionation studies were found. Regardless of radiotherapy type, SpaceOAR significantly reduced rectal radiation dose (eg, V40 average difference -6.1% in high dose-rate brachytherapy plus IG-IMRT to -9.1% in IG-IMRT) and reduced gastrointestinal and genitourinary toxicities (eg, late gastrointestinal toxicity 1% vs 6% (P = .01), late genitourinary toxicity of 15% vs 32% (P < .001) in stereotactic body radiotherapy). Improvements were observed in most Expanded Prostate Cancer Index Composite quality-of-life domains (eg, bowel function score decrease at 3 and 6 months: Average change of zero vs -6.25 and -3.57 respectively in low dose-rate brachytherapy plus EBRT). CONCLUSION The randomized controlled trial in IG-IMRT demonstrated that SpaceOAR reduces rectal radiation dose and late gastrointestinal and genitourinary toxicities, with urinary, bowel, and sexual quality-of-life improvement. These advantages were verified in observational studies in various radiotherapy types. Further research is required in hypofractionation. |
| Databáze: | OpenAIRE |
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