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Gel-like spacer between rectum and prostate reduces radiation-related side effects / WPZ is one of the first centers in Germany to use the innovative SpaceOAR system.
Thanks to state-of-the-art medical technology and refined methods, radiation therapy of prostate carcinoma is becoming increasingly important. For tumors that remain confined to the prostate, brachytherapy (internal radiation) has proven particularly effective. By placing tiny radiation sources directly into the prostate with millimeter precision, neighboring organs such as the intestine and bladder can be spared to the maximum. For even more safety in radiation, it has recently become possible to position a gel-like spacer, a so-called spacer, between the front wall of the rectum and the prostate. This protects the rectum even better from radiation damage. The West German Prostate Center in Cologne has now successfully treated the first patients with the innovative system.
Brachytherapy has a significant advantage over external radiation: "We do not have to radiate through the healthy neighboring organs to reach the target organ, the prostate," explains Dr. Stephan Neubauer, urologist at the West German Prostate Center. Thus, radiation exposure to the mucosa of the rectum, which is in the immediate vicinity of the prostate, is also much lower than with external radiation. Nevertheless, radiation-induced irritation of the rectum and the associated higher stool frequency cannot always be prevented.
The remedy is now the so-called SpaceOAR system. "The principle is relatively simple and yet very effective," says the Cologne urologist. It 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 minimize the radiation dose to the rectum even further and thus almost completely prevent radiation-induced irritation of the rectum," emphasizes Dr. Neubauer.
Patients with advanced prostate carcinoma who have to undergo external radiation in addition to brachytherapy also benefit from this. Recent studies in patients receiving intensity-modulated radiotherapy show that the application of the gel significantly reduces the rate of inflammation of the rectum (proctitis)1. At the same time, it is possible to increase the applied radiation dose if necessary without affecting the surrounding tissue.
The gel-like spacer between the prostate and rectum - and thus the protective effect during radiation therapy - is retained for about six months. then dissolves completely.