Quality of life after intensity-modulated radiotherapy for prostate cancer with a hydrogel spacer: Matched-pair analysis

• Published in: Strahlentherapie und Onkologie 2012-10, Vol.188 (10), p.917-925
• Main Authors: Pinkawa, M., Piroth, M.D., Holy, R., Escobar-Corral, N., Caffaro, M., Djukic, V., Klotz, J., Eble, M.J.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Erectile Dysfunction - etiology; Erectile Dysfunction - prevention & control; Humans; Hydrogel, Polyethylene Glycol Dimethacrylate; Hydrogels; Male; Matched-Pair Analysis; Medicine; Medicine & Public Health; Middle Aged; Oncology; Original Article; Prostatic Neoplasms - complications; Prostatic Neoplasms - radiotherapy; Prostheses and Implants; Prosthesis Design; Quality of Life; Radiation Protection - instrumentation; Radiation Protection - methods; Radiotherapy; Radiotherapy, Conformal - adverse effects; Radiotherapy, Conformal - instrumentation; Radiotherapy, Conformal - methods; Treatment Outcome; Urinary Incontinence - etiology; Urinary Incontinence - prevention & control
• ISSN: 0179-7158; 1439-099X
• DOI: 10.1007/s00066-012-0172-6

Background Hydrogel spacer is an innovative method to protect the rectal wall during prostate cancer radiotherapy. Clinical effects are not well known. Methods Patients have been surveyed before, at the last day, and 2–3 months after radiotherapy using a validated questionnaire (Expanded Prostate Cancer Index Composite). Median dose to the prostate in the spacer subgroup (SP) was 78 Gy in 2 Gy fractions. The results were independently compared with two matched-pair subgroups (treated conventionally without spacer): 3D conformal 70.2 Gy in 1.8 Gy fractions (3DCRT) and intensity-modulated radiotherapy (IMRT) 76 Gy in 2 Gy fractions. There were 28 patients in each of the three groups. Results Baseline mean bowel bother scores were 96 points in all subgroups. Similar mean changes (SP 16, 3DCRT 14, IMRT 17 points) were observed at the end of radiotherapy. The smallest difference resulted in the spacer subgroup 2–3 months after radiotherapy (SP 2, 3DCRT 8, IMRT 6 points). Bowel bother scores were only significantly different in comparison to baseline levels in the spacer subgroup. The percentage of patients reporting moderate/big bother with specific symptoms did not increase for any item (urgency, frequency, diarrhoea, incontinence, bloody stools, pain). Conclusion Moderate bowel quality-of-life changes can be expected during radiotherapy irrespective of spacer application or total dose. Advantages with a spacer can be expected a few weeks after treatment.