title: [Prostate-rectum spacers: optimization of prostate cancer irradiation].
abstract: In the curative radiotherapy of localized prostate cancer, improvements in biochemical control observed with dose escalation have been counterbalanced by an increase in radiation-induced toxicity. The injection of biodegradable spacers between prostate and rectum represents a new frontier in the optimization of radiotherapy treatments for patients with localized disease. Transperineal injection of different types of spacers under transrectal ultrasound guidance allows creating a 7-to-20 mm additional space between the prostate and the anterior rectal wall lasting 3 to 12 months. Dosimetrically, a relative reduction in the rectal volume receiving at least 70 Gy (V70) in the order of 43% to 84% is observed with all types of spacers, regardless of the radiotherapy technique used. Preliminary clinical results show for all spacers a good tolerance and a possible reduction in the acute side effects rate. The aim of the present systematic review of the literature is to report on indications as well as dosimetric and clinical advantages of the different types of prostate-rectum spacers commercially available (hydrogel, hyaluronic acid, collagen, biodegradable balloon).
authors.affiliation: Service de radio-oncologie, hôpitaux universitaires de Genève, avenue Gabrielle-Perret-Gentil 4, 1205 Genève, Suisse. Electronic address: thomas.zilli@hcuge.ch.
authors.forename: T
authors.initials: T
authors.lastname: Zilli
authors.affiliation: Faculté de médecine, CMU centre médical universitaire, université de Genève, rue Michel-Servet 1, 1211 Genève, Suisse.
authors.forename: E
authors.initials: E
authors.lastname: Benz
authors.affiliation: Service de radio-oncologie, hôpitaux universitaires de Genève, avenue Gabrielle-Perret-Gentil 4, 1205 Genève, Suisse.
authors.forename: R
authors.initials: R
authors.lastname: Miralbell
mesh_terms: D020341:Absorbable Implants; D001918:Brachytherapy; D002986:Clinical Trials as Topic; D003094:Collagen; D006801:Humans; D006820:Hyaluronic Acid; D008297:Male; D058958:Organs at Risk / Q000528:radiation effects*; D011092:Polyethylene Glycols; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection / Q000295:instrumentation*; D011879:Radiotherapy Dosage; D012007:Rectum / Q000528:radiation effects*
chemical_list: D011092:Polyethylene Glycols; D006820:Hyaluronic Acid; D003094:Collagen
keywords: Ballon rectale; Cancer de prostate; Prostate cancer; Radiotherapy; Radiothérapie; Rectal balloon; Rectal toxicity; Spacer; Toxicité rectale