One-year clinical outcomes of MR-guided stereotactic body radiation therapy with rectal spacer for patients with localized prostate cancer

Background and purpose This prospective study aimed to investigate adaptive magnetic resonance (MR)-guided stereotactic body radiation therapy (MRgSBRT) with rectal spacer for localized prostate cancer (PC) and report 1-year clinical outcomes. Materials and methods Thirty-four consecutive patients w...

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Bibliographic Details
Published in:World journal of urology 2024-02, Vol.42 (1), p.97-97, Article 97
Main Authors: Poon, Darren M. C., Yuan, Jing, Wong, Oi Lei, Yang, Bin, Tse, Mei Yan, Lau, Ka Ki, Chiu, Sin Ting, Chiu, Peter Ka-Fung, Ng, Chi Fai, Chui, Ka Lun, Kwong, Yiu Ming, Ma, Wai Kit, Cheung, Kin Yin, Chiu, George, Yu, Siu Ki
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Clinical outcomes
Clinical trials
Dosimetry
Humans
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Male
Medicine
Medicine & Public Health
Middle Aged
Nephrology
Oncology
Patients
Prospective Studies
Prostate cancer
Prostatic Neoplasms - pathology
Prostatic Neoplasms - radiotherapy
Prostatic Neoplasms - surgery
Radiation therapy
Radiotherapy Dosage
Rectum
Topic Paper
Urology
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Summary:Background and purpose This prospective study aimed to investigate adaptive magnetic resonance (MR)-guided stereotactic body radiation therapy (MRgSBRT) with rectal spacer for localized prostate cancer (PC) and report 1-year clinical outcomes. Materials and methods Thirty-four consecutive patients with low- to high-risk localized PC that underwent 5-fraction adaptive MRgSBRT with rectal spacer were enrolled. The dosimetric comparison was performed on a risk- and age-matched cohort treated with MRgSBRT but without a spacer at a similar timepoint. Clinician-reported outcomes were based on Common Terminology Criteria for Adverse Events. Patient-reported outcomes were based on the Expanded Prostate Cancer Index Composite (EPIC) questionnaire at baseline, acute (1–3 months), subacute (4–12 months), and late (> 12 months) phases. Results The median follow-up was 390 days (range 28–823) and the median age was 70 years (range 58–82). One patient experienced rectal bleeding soon after spacer insertion that subsided before MRgSBRT. The median distance between the midline of the prostate midgland and the rectum after spacer insertion measured 7.8 mm (range 2.6–15.3), and the median length of the spacer was 45.9 mm (range 16.8–62.9) based on T2-weighted MR imaging. The use of spacer resulted in significant improvements in target coverage (V100% > 95% = 98.6% [range 93.4–99.8] for spacer vs. 97.8% [range 69.6–99.7] for non-spacer) and rectal sparing (V95% 
ISSN:1433-8726
0724-4983
1433-8726
DOI:10.1007/s00345-024-04784-x