Journal article
Cs-131 Prostate Brachytherapy Boost and Effect of Hydrogel Rectal Spacer on Long-term Patient-Reported Rectal Bleeding and Bowel Quality of Life
Brachytherapy, v 22(6), pp 808-821
01 Nov 2023
PMID: 37648596
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
: This study evaluates long-term patient-reported bowel quality of life (QOL), rectal bleeding, and bleeding bother in patients with prostate cancer treated with external beam radiation therapy (EBRT) and Cesium-131 LDR brachytherapy (LDR-BT) boost with and without hydrogel rectal spacer.
: This is a retrospective analysis of prostate cancer patients treated between 2007-2022 with 45 Gy EBRT followed by 85 Gy Cs-131 LDR-BT boost with or without hydrogel rectal spacer. Expanded Prostate Cancer Index Composite (EPIC) QOL questionnaires pre-treatment and at each follow-up were collected. Patient-reported rectal bleeding occurring more than “rarely” and bother from rectal bleeding occurring more than a “very small problem” were deemed clinically significant. Fisher's exact test was used to test the association of rectal spacer use and the incidence of clinically significant rectal bleeding and bleeding bother. Paired samples t-test was used to analyze mean bowel scores at each time point.
: 341 patients were included in the analysis. Rectal spacer was used in 108 patients. Overall median follow-up was 48 months (IQR, 24-72), with a median follow-up of 24 months (IQR, 12-37.5) for the hydrogel group and 60 months (IQR, 36-84) for the non-hydrogel group. EPIC questionnaire response rates at median follow-up were 33% and 37% for the hydrogel and non-hydrogel group, respectively. Clinically significant decrease in mean bowel domain scores was seen in the bowel bother domain at 6 and 12 months for patients who did not receive rectal spacer. At last follow-up of 60 months, prevalence of clinically significant rectal bleeding and bleeding bother were 2.2% and 2.2%, respectively. Cumulative incidence of clinically significant long-term rectal bleeding was 2.8% and 18.9% in the hydrogel group and non-hydrogel group, respectively (Fisher's exact test, p<0.0001). Cumulative incidence of clinically significant long-term bowel bother was 4.6% and 19.7% in the hydrogel group and non-hydrogel group, respectively (Fisher's exact test, p<0.001).
: Use of hydrogel rectal spacer with EBRT and Cs-131 LDR-BT boost was significantly associated with lower incidence of patient-reported rectal bleeding and bother from rectal bleeding, and better long-term bowel QOL. Cumulative incidence was 2.8% (hydrogel group) versus 18.9% (non-hydrogel group) and 4.6% (hydrogel group) versus 19.7% (non-hydrogel group) for clinically significant long-term rectal bleeding and long-term bleeding bother, respectively.
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Details
- Title
- Cs-131 Prostate Brachytherapy Boost and Effect of Hydrogel Rectal Spacer on Long-term Patient-Reported Rectal Bleeding and Bowel Quality of Life
- Creators
- Mohamed K. Abdelhakiem - UPMC Hillman Cancer CenterAndrew Keller - Florida Hospital Cancer InstituteRajesh R. Bajpai - University of PittsburghRyan P. Smith - UPMC Hillman Cancer CenterSushil Beriwal - Varian Medical SystemsRonald Benoit - University of Pittsburgh School of Medicine
- Publication Details
- Brachytherapy, v 22(6), pp 808-821
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:001112980400001
- Scopus ID
- 2-s2.0-85171388757
- Other Identifier
- 991021897383204721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging