Association Between Perirectal Spacer Use and Short-Term Complications After Prostate Radiation Therapy in a National...

Area of Science:

• Oncology
• Radiation Oncology
• Medical Devices

Background:

• Perirectal spacers are designed to minimize radiation exposure to the rectum during prostate radiotherapy.
• Limited large-scale data exist on clinical outcomes of spacer use outside clinical trials.

Purpose of the Study:

• To evaluate the real-world effectiveness of perirectal spacers in reducing genitourinary and rectal toxicities.
• To assess the impact of perirectal spacers on healthcare costs following prostate radiotherapy.

Main Methods:

• A retrospective analysis of 32,319 patients undergoing prostate radiotherapy from 2016-2022 using claims databases.
• Comparison of genitourinary and rectal toxicities within 12 months between patients with and without perirectal spacers.
• Multivariable Cox models and cost analysis were employed.

Main Results:

• Perirectal spacer use (18% of patients) was linked to lower rates of urinary toxicity, including incontinence and UTIs (HR 0.88-0.86).
• No significant difference in all-cause rectal toxicity was observed (HR 0.94, p=0.09).
• Total 12-month healthcare costs were significantly lower in the spacer group ($35,417 vs $43,514).

Conclusions:

• Perirectal spacers are associated with reduced short-term urinary toxicities and lower healthcare costs in prostate radiotherapy.
• The study did not demonstrate a statistically significant benefit in rectal toxicity, the primary indication for spacer use.