水凝胶间隔器在妇科恶性肿瘤近距离治疗中的应用进展

doi:10.3760/cma.j.cn113030-20220413-00138

Abstract
Figure/Table
References()
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Radiotherapy is an important treatment of gynecological tumors. Although novel techniques or measures in recemy years have improved the tumor control rate and reduced radiation toxicity, radiation toxicity remains a major problem due to the location of some key organs adjacent to the tumor. A new material-hydrogel, as an organ spacer, provides a new method to reduce the radiotherapy toxicity. In this article, the application of hydrogel as an organ spacer in brachytherapy for gynecological tumors was reviewed from the aspects of hydrogel characteristics, suitable population, mode of injection, interval distance and dose effect, clinical benefits and cost effectiveness, etc.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Luo Huanli
	Jin Fu
	Peng Haiyan
	Yang Xin
	Li Chao
	Wang Ying
	Xie Yue

Key words： Hydrogel spacer Genital Neoplasms Female Brachytherapy Organ spacing Dose effect

Received: 13 April 2022

Fund:National Natural Science Foundation of China (11805025); Chongqing Science and Health Joint Major Project (2022DBXM005); General Project of Chongqing Natural Science Foundation (cstc2021jcyj-msxmX0441)

Corresponding Authors: Jin Fu, Email: jfazj@126.com; Xie Yue, Email: linmn9@gmail.com

Cite this article:

Luo Huanli,Jin Fu,Peng Haiyan et al. Research progress on the application of hydrogel spacer in brachytherapy for gynecological tumors[J]. Chinese Journal of Radiation Oncology, 2023, 32(6): 567-571.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20220413-00138 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2023/V32/I6/567

[1] Luo HL, Jin F, Yang DY, et al.Interfractional variation in bladder volume and its impact on cervical cancer radiotherapy: clinical significance of portable bladder scanner[J]. Med Phys, 2016,43(7):4412. DOI: 10.1118/1.4954206.
[2] Jin F, Luo HL, Zhou J, et al.A parameterized model for mean urinary inflow rate and its preliminary application in radiotherapy for cervical cancer[J]. Sci Rep, 2017,7(1):280. DOI: 10.1038/s41598-017-00356-9.
[3] Jin F, Liu Q, Luo H, et al.Dynamic changes in bladder morphology over time in cervical cancer patients[J]. Cancer Control, 2021,28:10732748211021082. DOI: 10.1177/10732748211021082.
[4] National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. cancerProstate. Version 2.2021[EB/OL]. (2021-02-17)[2022-03-20]. http://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf.
[5] 杨烨, 侯彦杰, 薛少军, 等. 前列腺癌放疗患者植入水凝胶后对直肠保护作用的Meta分析[J].中华放射医学与防护杂志,2021,41(6):436-443. DOI: 10.3760/cma.j.issn.0254-5098.2021.06.007.
Yang Y, Hou YJ, Xue SJ, et al.The protective effects of hydrogel implantation in prostate cancer patients for radiotherapy: a meta-analysis[J].Chin J Radiol Med Prot,2021,41(6):436-443. DOI: 10.3760/cma.j.issn.0254-5098.2021.06.007.
[6] 何尧林, 贺秋冬. 水凝胶在局限期前列腺癌放疗中的研究进展[J].中华放射肿瘤学杂志,2018,27(8):789-792. DOI: 10.3760/cma.j.issn.1004-4221.2018.08.016.
He YL, He QD.Research progress in hydrogel in radiotherapy of localized prostate cancer[J].Chin J Radiat Oncol,2018,27(8):789-792. DOI: 10.3760/cma.j.issn.1004-4221.2018.08.016.
[7] 刘志杰, 邓烨, 杨海明, 等. 水凝胶在前列腺癌放疗中对直肠的保护作用分析[J].世界最新医学信息文摘(连续型电子期刊),2015,(95):283-283. DOI: 10.3969/j.issn.1671-3141.2015.95.217.
Liu ZJ, Deng Y, Yang HM, et al.Analysis of the protective effect of hydrogel on rectum during radiotherapy for prostate cancer[J]. World Latest Medical Information Abstracts (continuous electronic journal),2015,(95):283-283. DOI: 10.3969/j.issn.1671-3141.2015.95.217.
[8] Armstrong N, Bahl A, Pinkawa M, et al.SpaceOAR hydrogel spacer for reducing radiation toxicity during radiotherapy for prostate cancer. A systematic review[J]. Urology, 2021,156:e74-e85. DOI: 10.1016/j.urology.2021.05.013.
[9] Sanei M, Ghaffari H, Ardekani MA, et al.Effectiveness of rectal displacement devices during prostate external-beam radiation therapy: a review[J]. J Cancer Res Ther, 2021,17(2):303-310. DOI: 10.4103/jcrt.JCRT_841_19.
[10] Miller LE, Efstathiou JA, Bhattacharyya SK, et al.Association of the placement of a perirectal hydrogel spacer with the clinical outcomes of men receiving radiotherapy for prostate cancer: a systematic review and meta-analysis[J]. JAMA Netw Open, 2020,3(6):e208221. DOI: 10.1001/jamanetworkopen.2020.8221.
[11] Leiker AJ, Desai NB, Folkert MR.Rectal radiation dose-reduction techniques in prostate cancer: a focus on the rectal spacer[J]. Future Oncol, 2018,14(26):2773-2788. DOI: 10.2217/fon-2018-0286.
[12] 杨烨, 侯彦杰, 李险峰. 水凝胶在前列腺癌和宫颈癌放疗中对直肠的保护[J].中华放射医学与防护杂志,2020,40(9):728-732. DOI: 10.3760/cma.j.issn.0254-5098.2020.09.014.
Yang Y, Hou YJ, Li XF.Protection of hydrogel for rectum in radiotherapy of prostate cancer and cervical cancer[J].Chin J Radiol Med Prot,2020,40(9):728-732. DOI: 10.3760/cma.j.issn.0254-5098.2020.09.014.
[13] Tang QY, Zhao F, Yu XK, et al.The role of radioprotective spacers in clinical practice: a review[J]. Quant Imaging Med Surg, 2018,8(5):514-524. DOI: 10.21037/qims.2018.06.06.
[14] Prada PJ, Gonzalez H, Menéndez C, et al.Transperineal injection of hyaluronic acid in the anterior perirectal fat to decrease rectal toxicity from radiation delivered with low-dose-rate brachytherapy for prostate cancer patients[J]. Brachytherapy, 2009,8(2):210-217. DOI: 10.1016/j.brachy.2008.11.010.
[15] Peach MS, Moore J, Giles W, et al.Development and preclinical testing of a novel biodegradable hydrogel vaginal packing technology for gynecologic high-dose-rate brachytherapy[J]. J Contemp Brachytherapy, 2018,10(4):306-314. DOI: 10.5114/jcb.2018.77952.
[16] Elledge CR, LaVigne AW, Bhatia RK, et al. Aiming for 100% local control in locally advanced cervical cancer: the role of complex brachytherapy applicators and intraprocedural imaging[J]. Semin Radiat Oncol, 2020,30(4):300-310. DOI: 10.1016/j.semradonc.2020.05.002.
[17] Wolf F, Gaisberger C, Ziegler I, et al.Comparison of two different rectal spacers in prostate cancer external beam radiotherapy in terms of rectal sparing and volume consistency[J]. Radiother Oncol, 2015,116(2):221-225. DOI: 10.1016/j.radonc.2015.07.027.
[18] Jones RT, Hassan Rezaeian N, Desai NB, et al.Dosimetric comparison of rectal-sparing capabilities of rectal balloon vs injectable spacer gel in stereotactic body radiation therapy for prostate cancer: lessons learned from prospective trials[J]. Med Dosim, 2017,42(4):341-347. DOI: 10.1016/j.meddos.2017.07.002.
[19] Kashihara T, Murakami N, Tselis N, et al.Hyaluronate gel injection for rectum dose reduction in gynecologic high-dose-rate brachytherapy: initial Japanese experience[J]. J Radiat Res, 2019,60(4):501-508. DOI: 10.1093/jrr/rrz016.
[20] Murakami N, Nakamura S, Kashihara T, et al.Hyaluronic acid gel injection in rectovaginal septum reduced incidence of rectal bleeding in brachytherapy for gynecological malignancies[J]. Brachytherapy, 2020,19(2):154-161. DOI: 10.1016/j.brachy.2019.11.004.
[21] Paetkau O, Gagne IM, Alexander A.SpaceOAR© hydrogel rectal dose reduction prediction model: a decision support tool[J]. J Appl Clin Med Phys, 2020,21(6):15-25. DOI: 10.1002/acm2.12860.
[22] van Wijk Y, Vanneste B, Walsh S, et al. Development of a virtual spacer to support the decision for the placement of an implantable rectum spacer for prostate cancer radiotherapy: Comparison of dose, toxicity and cost-effectiveness[J]. Radiother Oncol, 2017,125(1):107-112. DOI: 10.1016/j.radonc.2017.07.026.
[23] Basu S, Manir KS, Basu A, et al.Rectal separation using hydroxypropyl methylcellulose in intracavitary brachytherapy of cervical cancer: an innovative approach[J]. J Contemp Brachytherapy, 2016,8(5):399-403. DOI: 10.5114/jcb.2016.62951.
[24] Jamal DN, Gutierrez C, Marti L, et al.EP-2127 hydrogel bladder and rectal spacer (TraceIT) for brachytherapy in locally advanced cervical cancer[J]. Radiother Oncol, 2019, 133(1):S1177. DOI: 10.1016/S0167-8140(19)32547-2.
[25] Kishi K, Mabuchi Y, Sonomura T, et al.Eradicative brachytherapy with hyaluronate gel injection into pararectal space in treatment of bulky vaginal stump recurrence of uterine cancer[J]. J Radiat Res, 2012,53(4):601-607. DOI: 10.1093/jrr/rrs015.
[26] Barry PN, Ahmed O, Liao YX, et al.Toxicity reduction with radiopaque hydrogel spacer for salvage treatment of recurrent endometrial cancer: a case report[J]. Brachytherapy, 2018, 17(4):S124. DOI: 10.1016/j.brachy.2018.04.229.
[27] Kishi K, Iida T, Ojima T, et al.Esophageal gel-shifting technique facilitating eradicative boost or reirradiation to upper mediastinal targets of recurrent nerve lymph node without damaging esophagus[J]. J Radiat Res, 2013,54(4):748-754. DOI: 10.1093/jrr/rrs137.
[28] Mariados N, Sylvester J, Shah D, et al.Hydrogel spacer prospective multicenter randomized controlled pivotal trial: dosimetric and clinical effects of perirectal spacer application in men undergoing prostate image guided intensity modulated radiation therapy[J]. Int J Radiat Oncol Biol Phys, 2015,92(5):971-977. DOI: 10.1016/j.ijrobp.2015.04.030.
[29] Fischer-Valuck BW, Chundury A, Gay H, et al.Hydrogel spacer distribution within the perirectal space in patients undergoing radiotherapy for prostate cancer: Impact of spacer symmetry on rectal dose reduction and the clinical consequences of hydrogel infiltration into the rectal wall[J]. Pract Radiat Oncol, 2017,7(3):195-202. DOI: 10.1016/j.prro.2016.10.004.
[30] Morcos M, Bhatia R, Li K, et al. Prospective trial of hydrogel visualization and dosimetric effects on rectum and tumor dose in gynecologic brachytherapy[J]. Int J Radiat Oncol Biol Phys, 2021, 111(3S):e610-e611. DOI: 10.1016/j.ijrobp.2021.07.1627.
[31] Damato AL, Kassick M, Viswanathan AN.Rectum and bladder spacing in cervical cancer brachytherapy using a novel injectable hydrogel compound[J]. Brachytherapy, 2017,16(5):949-955. DOI: 10.1016/j.brachy.2017.04.236.
[32] Hwang ME, Black PJ, Elliston CD, et al.A novel model to correlate hydrogel spacer placement, perirectal space creation, and rectum dosimetry in prostate stereotactic body radiotherapy[J]. Radiat Oncol, 2018,13(1):192. DOI: 10.1186/s13014-018-1135-6.
[33] Murakami N, Shima S, Kashihara T, et al.Hyaluronic gel injection into the vesicovaginal septum for high-dose-rate brachytherapy of uterine cervical cancer: an effective approach for bladder dose reduction[J]. J Contemp Brachytherapy, 2019,11(1):1-7. DOI: 10.5114/jcb.2019.82612.
[34] Marnitz S, Budach V, Weisser F, et al.Rectum separation in patients with cervical cancer for treatment planning in primary chemo-radiation[J]. Radiat Oncol, 2012,7:109. DOI: 10.1186/1748-717X-7-109.
[35] Ahmed O, Nguyen VD, Ginsburg M, et al.CT-guided placement of a polyethylene glycol hydrogel in brachytherapy for gynecologic malignancy to limit nontarget organ toxicity[J]. J Vasc Interv Radiol, 2019,30(3):469-471. DOI: 10.1016/j.jvir.2018.12.002.
[36] Viswanathan AN, Damato AL, Nguyen PL.Novel use of a hydrogel spacer permits reirradiation in otherwise incurable recurrent gynecologic cancers[J]. J Clin Oncol, 2013,31(34):e446-447. DOI: 10.1200/JCO.2012.47.9931.
[37] Susil RC, McNutt TR, DeWeese TL, et al. Effects of prostate-rectum separation on rectal dose from external beam radiotherapy[J]. Int J Radiat Oncol Biol Phys, 2010,76(4):1251-1258. DOI: 10.1016/j.ijrobp.2009.07.1679.
[38] Temming S, Haddad H, Schmitt V, et al. Rectal and bladder protection by hydrogel spacer (TraceIT) during external beam radiotherapy and brachytherapy of cervical cancer[C/OL]. (2019-06-29)[2022-03-15]. http://www.research gate.net/publication/333648086.
[39] Delia P, Sansotta G, Pontoriero A, et al.Clinical evaluation of low-molecular-weight hyaluronic acid-based treatment on onset of acute side effects in women receiving adjuvant radiotherapy after cervical surgery: a randomized clinical trial[J]. Oncol Res Treat, 2019,42(4):217-223. DOI: 10.1159/000496036.
[40] Boyko AV, Dunaeva E, Demidova L, et al.Prevention and treatment of early radiation complications induced by a hydrogel material with derinat in patients with malignant neoplasms of female genital organs[J]. Oncology, 2016,6:1-7.DOI:10.17116/onkolog2016565-11.