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American Brachytherapy Society (ABS) rectoprostatic gel spacer consensus statement.
Aurelie Garant1, Craig E Grossman2, Martin T King3
1Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX.
Brachytherapy
|September 21, 2025
Summary
Rectoprostatic gel spacers (RPS) can reduce side effects during prostate cancer radiation therapy (RT). Experts reached consensus on RPS use for most RT types, but not all.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Physics
Background:
- Prostate cancer (PC) radiation therapy (RT) can cause rectal toxicity.
- Rectoprostatic gel spacers (RPS) create a separation between the prostate and rectum to minimize radiation dose to the rectal wall.
Purpose of the Study:
- To provide expert recommendations on the use of RPS in definitive RT for PC.
- To outline the prevention and management of adverse events associated with RPS placement.
Main Methods:
- An expert panel from the American Brachytherapy Society (ABS) used a Delphi consensus method.
- A review of prospective and retrospective studies on RPS in various RT modalities (EBRT, LDR BT, HDR BT) was conducted.
Main Results:
- Consensus was reached on RPS use for external beam RT (photon and proton) and LDR brachytherapy (BT) monotherapy.
- Consensus was not achieved for HDR BT monotherapy or combination BT with EBRT.
- Guidelines were established for RPS contraindications, imaging, informed consent, and rectal wall infiltration management.
Conclusions:
- This consensus statement offers guidance on current RPS indications for PC RT.
- It also addresses the management of potential adverse events, aiding clinicians in patient care.
