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Implanted spacer approaches for pelvic radiation therapy.
Daniel M Trifiletti1, Allison E Garda1, Timothy N Showalter1
1a Department of Radiation Oncology , University of Virginia School of Medicine , Charlottesville , VA , USA.
Expert Review of Medical Devices
|June 2, 2016
Summary
Rectal spacers significantly reduce radiation dose to the rectum, decreasing toxicity in pelvic radiation therapy for prostate cancer and gynecologic malignancies. This approach enhances treatment safety and efficacy.
Area of Science:
- Radiation Oncology
- Medical Physics
Background:
- Radiation therapy advances aim to improve therapeutic ratio via dose escalation or hypofractionation.
- Gastrointestinal toxicity limits dose escalation in intensity modulated radiation therapy (IMRT).
- Rectal spacers are used to increase prostate-rectal separation, reducing rectal irradiation and toxicity.
Purpose of the Study:
- To review commercially available rectal spacers in pelvic radiation therapy.
- To discuss their application, dosimetric effects, and clinical outcomes in prostate and gynecologic cancers.
Main Methods:
- Literature review of rectal spacer applications in pelvic radiation therapy.
- Analysis of dosimetric data and reported clinical outcomes.
Main Results:
- Rectal spacers have demonstrated significantly reduced rectal doses.
- Decreased rectal toxicity has been reported in multiple studies.
- Evidence supporting the efficacy of rectal spacers is continually emerging.
Conclusions:
- Rectal spacers are a promising approach to mitigate rectal toxicity in pelvic radiation therapy.
- They offer a method to safely escalate doses or enable hypofractionation.
- Further evidence supports their integration into clinical practice for improved patient outcomes.
