Tissue Spacers Reduce Risk of Rectal Injury

Injecting a tissue spacer in the prostate-rectal inter-space is an effective way to reduce the rectal radiation dose for prostate cancer patients receiving radiation therapy, according to a new study.

Researchers at the Cancer Center of Irvine (CA, USA) conducted a study involving 34 prostate carcinoma patients that were injected with a tissue spacer compound to increase the separation between the prostate and the rectum during the radiation therapy they were receiving. The patients were imaged via magnetic resonance imaging (MRI) preinjection, postinjection, and every two weeks until the end of treatment to monitor any changes.

The researchers found that the spacer generated an additional one centimeter (on average) separation between the prostate and rectum, resulting in a significant reduction in the rectal dose administered and causing very little damage to the rectum. The reductions in severe rectal radiation burns--the most serious risk of injury from the radiation--were essentially eliminated. This enabled the radiation oncologists to increase the dose to the posterior prostate without concern of damaging the rectum. The study was presented at the Cancer Imaging and Radiation Therapy Symposium, held during April 2011 in Atlanta (GA, USA).

"Removing rectal injury from the treatment essentially makes radiation therapy the treatment of choice for prostate cancer," said senior author and study presenter Kenneth Tokita, MD. "The ability to reach almost perfect cure rates and minimal injury is the dream of all cancer specialists. We are now wondering where else this may benefit cancer patients in radiation therapy treatments."

Treatment for prostate cancer may involve active surveillance (monitoring for tumor progress or symptoms), surgery (radical prostatectomy), radiation therapy including brachytherapy and external beam radiation therapy, high-intensity focused ultrasound (HIFU), chemotherapy, cryosurgery, hormonal therapy, or some combination. Which option is best depends on the stage of the disease, the Gleason score, and the prostate-specific antigen (PSA) level. Other important factors are age, general health, and patient views about potential treatments and their possible side effects.

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Cancer Center of Irvine