More safety during prostate radiation
Thanks to state-of-the-art medical technology and refined methods, radiation therapy for prostate cancer is becoming increasingly important. Brachytherapy (internal radiation) has proved particularly effective for tumours that are limited to the prostate. By placing the smallest radiation sources directly into the prostate, neighboring organs such as the intestine and bladder can be protected to the maximum by placing them with millimetre accuracy. For even greater safety in irradiation, it is now possible to position a gel-like spacer between the anterior wall of the rectum and the prostate. This provides even better protection of the rectum from radiation damage. The Westdeutsche Prostatazentrum in Cologne has now successfully treated the first patients with this innovative system.
Brachytherapy has a major advantage over external radiation:"We don't have to radiate through the healthy neighbouring organs in order to reach the target organ prostate," explains Dr. Stephan Neubauer, urologist at the West German Prostate Center. Thus, radiation exposure to the mucosa of the rectum, which is located in the immediate vicinity of the prostate gland, is considerably lower than with external radiation. Nevertheless, radiation-related irritations of the rectum and the associated higher stool frequency cannot always be prevented.
The so-called SpaceOAR system now provides a remedy. The principle is relatively simple and yet very effective,"says the Cologne urologist. This is a water-based gel (hydrogel) that is injected between the prostate and rectum before brachytherapy begins. This increases the distance between the two organs by about 1 cm. This is sufficient to further minimize the radiation dose on the rectum and thus almost completely eliminate radiation-related irritations of the rectum,"emphasizes Dr. Neubauer.
Patients with advanced prostate carcinoma, who have to undergo external irradiation in addition to brachytherapy, also benefit from this. Recent studies in patients receiving intensity-modulated radiotherapy have shown that the rate of inflammation of the rectum (proctitis) could be significantly reduced with the introduction of the gel1, while at the same time it is possible to increase the applied radiation dose if necessary without damaging the surrounding tissue.
The gel-like spacer between the prostate and rectum - and thus the protective effect during radiation therapy - remains intact for about six months and then dissolves completely.
- Pinkawa M., Djukic V., Holy R., Piroth M. D., Klotz J., Frank D., Petz D., Eble M. J. University Hospital of the RWTH Aac