A dosimetric study of polyethylene glycol hydrogel in 200 prostate cancer patients treated with high-dose rate brachytherapy ± intensity modulated radiation therapy

Tobin J. Strom, Richard B. Wilder, Daniel C. Fernandez, Eric A. Mellon, Amarjit S. Saini, Dylan C. Hunt, Julio M. Pow-Sang, Phillipe E. Spiess, Wade J. Sexton, Michael A. Poch, Matthew C. Biagioli

Research output: Contribution to journalArticlepeer-review

40 Scopus citations

Abstract

Background and purpose We sought to analyze the effect of polyethylene glycol (PEG) hydrogel on rectal doses in prostate cancer patients undergoing radiotherapy. Materials and methods Between July 2009 and April 2013, we treated 200 clinically localized prostate cancer patients with high-dose rate (HDR) brachytherapy ± intensity modulated radiation therapy. Half of the patients received a transrectal ultrasound (TRUS)-guided transperineal injection of 10 mL PEG hydrogel (DuraSeal™ Spinal Sealant System; Covidien, Mansfield, MA) in their anterior perirectal fat immediately prior to the first HDR brachytherapy treatment and 5 mL PEG hydrogel prior to the second HDR brachytherapy treatment. Prostate, rectal, and bladder doses and prostate-rectal distances were calculated based upon treatment planning CT scans. Results There was a success rate of 100% (100/100) with PEG hydrogel implantation. PEG hydrogel significantly increased the prostate-rectal separation (mean ± SD, 12 ± 4 mm with gel vs. 4 ± 2 mm without gel, p < 0.001) and significantly decreased the mean rectal D2 mL (47 ± 9% with gel vs. 60 ± 8% without gel, p < 0.001). Gel decreased rectal doses regardless of body mass index (BMI). Conclusions PEG hydrogel temporarily displaced the rectum away from the prostate by an average of 12 mm and led to a significant reduction in rectal radiation doses, regardless of BMI.

Original languageEnglish (US)
Pages (from-to)126-131
Number of pages6
JournalRadiotherapy and Oncology
Volume111
Issue number1
DOIs
StatePublished - Apr 2014
Externally publishedYes

Keywords

  • Gel
  • HDR
  • High-dose-rate
  • Prostate
  • Radiotherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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