Utilization, Acute Complications, and Delays in Treatment Associated With Rectal Spacers for Prostate Cancer...

Area of Science:

• Oncology
• Radiation Oncology
• Medical Devices

Background:

• Rectal hydrogel spacers are used to reduce radiation dose to the rectum during prostate cancer treatment.
• Understanding spacer placement complications and their impact on treatment is crucial for patient management.

Purpose of the Study:

• To investigate the utilization, complications, and radiation treatment delays associated with rectal hydrogel spacers in the United States.
• To analyze the impact of spacer placement complications on the timing of radiation therapy initiation.

Main Methods:

• Retrospective analysis of the Merative MarketScan Database (2016-2021) for prostate cancer patients.
• Identification of spacer placement, radiation, genitourinary/gastrointestinal complications, and interventions.
• Use of Cox proportional hazards model to assess the effect of complications on time-to-radiation.

Main Results:

• Spacer use increased from 0.5% to 25.7% among prostate cancer radiation patients (2016-2021), reaching 50% in SBRT patients in 2021.
• Complications occurred in 6.4% of patients before radiation, primarily genitourinary (5.2%) and gastrointestinal (1.2%).
• Complications significantly reduced the risk of starting radiation (HR 0.75, P < .001).

Conclusions:

• Rectal hydrogel spacer use is becoming common, particularly for SBRT in prostate cancer.
• Although infrequent, complications associated with spacer placement can lead to delays in initiating radiation therapy.