(P141) Rectal Spacer Injection in Postprostatectomy Patients Undergoing High-Dose Salvage External Beam Radiation

OncologyOncology Vol 29 No 4_Suppl_1
Volume 29
Issue 4_Suppl_1

Our study shows that rectal spacer placement in patients who have had a prostatectomy is feasible. Despite the high dose of salvage RT, GI toxicity rate was low, and no patient developed grade ≥ 2 GI toxicity with the rectal spacer.

Jekwon Yeh, MD, Kenneth Tokita, MD, Jeffrey Chien, John Ravera, MD; Cancer Center of Irvine

OBJECTIVE/PURPOSE: There is now increasing literature to support the use of a rectal spacer to decrease rectal side effects during radiation therapy (RT) for patients with intact prostate cancer. There have been no reports on its usage in patients who are undergoing salvage RT after a prostatectomy. This study aims to report on the gastrointestinal toxicity of patients who have had a prostatectomy and received high-dose (>72 Gy) salvage RT with the rectal spacer.

MATERIALS AND METHODS: From January 2010 to October 2013, a total of 32 patients had the rectal spacer placed via transperineal injection posterior to the residual Denonvillier’s fascia under ultrasound guidance. All patients were treated to a minimum of 72 Gy to the prostatic fossa with intensity-modulated RT (IMRT) with daily cone-beam computed tomography (CT) to ensure treatment accuracy. All patients had at least 6 months of follow-up. Radiation Therapy Oncology Group (RTOG) scoring for gastrointestinal morbidity was assessed at the end of treatment and 6 months afterward.

RESULTS: At the end of treatment, 23 patients (72%) had no change in rectal symptoms. Nine patients (28%) developed grade 1 gastrointestinal (GI) toxicity. No patients developed grade ≥ 2 GI toxicity. At 6 months after treatment, 29 patients (91%) were back to their baseline GI function, with only 3 patients (9%) with residual grade 1 GI toxicity. No patients developed grade ≥ 2 GI toxicity.

CONCLUSIONS: Our study shows that rectal spacer placement in patients who have had a prostatectomy is feasible. Despite the high dose of salvage RT, GI toxicity rate was low, and no patient developed grade ≥ 2 GI toxicity with the rectal spacer.

Proceedings of the 97th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(P005) Ultrasensitive PSA Identifies Patients With Organ-Confined Prostate Cancer Requiring Postop Radiotherapy
(P001) Disparities in the Local Management of Breast Cancer in the United States According to Health Insurance Status
(P002) Predictors of CNS Disease in Metastatic Melanoma: Desmoplastic Subtype Associated With Higher Risk
(P003) Identification of Somatic Mutations Using Fine Needle Aspiration: Correlation With Clinical Outcomes in Patients With Locally Advanced Pancreatic Cancer
(P004) A Retrospective Study to Assess Disparities in the Utilization of Intensity-Modulated Radiotherapy (IMRT) and Proton Therapy (PT) in the Treatment of Prostate Cancer (PCa)
(S001) Tumor Control and Toxicity Outcomes for Head and Neck Cancer Patients Re-Treated With Intensity-Modulated Radiation Therapy (IMRT)-A Fifteen-Year Experience
(S003) Weekly IGRT Volumetric Response Analysis as a Predictive Tool for Locoregional Control in Head and Neck Cancer Radiotherapy 
(S004) Combination of Radiotherapy and Cetuximab for Aggressive, High-Risk Cutaneous Squamous Cell Cancer of the Head and Neck: A Propensity Score Analysis
(S005) Radiotherapy for Carcinoma of the Hypopharynx Over Five Decades: Experience at a Single Institution
(S002) Prognostic Value of Intraradiation Treatment FDG-PET Parameters in Locally Advanced Oropharyngeal Cancer
(P006) The Role of Sequential Imaging in Cervical Cancer Management
(P008) Pretreatment FDG Uptake of Nontarget Lung Tissue Correlates With Symptomatic Pneumonitis Following Stereotactic Ablative Radiotherapy (SABR)
(P009) Monte Carlo Dosimetry Evaluation of Lung Stereotactic Body Radiosurgery
(P010) Stereotactic Body Radiotherapy for Treatment of Adrenal Gland Metastasis: Toxicity, Outcomes, and Patterns of Failure
(P011) Stereotactic Radiosurgery and BRAF Inhibitor Therapy for Melanoma Brain Metastases Is Associated With Increased Risk for Radiation Necrosis
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