How do you fractionate prostate cancer where there was rectal wall infiltration by hydrogel after healing?   

For superficial infiltration, I do not change approach. For deeper infiltration with delamination of muscle layers, especially muscularis propia, I typically switch to moderate hypofractionation (60Gy/20 regimen) and treat whole spacer gel area as part of rectum OAR. We have done this systematically...

I’m not quite sure what you mean by “after healing”. Do you mean complete dissolution of the gel? If you are confident that the gel has completely resolved and there’s no additional rectal wall infiltration, theoretically, you should be at the same place before gel insertion ...

It would not impact my choice of fractionation.