How do you manage rectal wall infiltration during a rectal spacer procedure?   

At ASTRO 2023, PACE-B reported RTOG grade 2+ GI toxicity was exceedingly low at only 1/348 for 78 Gy/39 fx or 62 Gy/20 fx and only 1/363 for 36.25/5 fx. Anyone know what % of patients in PACE-B had SpaceOAR or similar products? This raises the question of whether SpaceOAR or similar products are ne...

Are there updated 2021 recommendations for imaging and management of SpaceOAR hydrogel rectal wall infiltration?We routinely obtain post-SpaceOAR MRI with thin cut T2 axial and sagittal images for fusion with our radiotherapy planning CT. The Fischer-Valuck study (PMID 28089528) categorized rectal w...

I agree, there is no specific intervention to reverse the rectal wall infiltration. Patients often complain of rectal fullness and occasional tenesmus. The spacer will eventually be absorbed. There has not been any case of serious injury with rectal wall infiltration with spacer.

There is no specific intervention needed. Patients do feel the symptoms and it resolves as space OAR gets absorbed.

Recent case report and discussion on management:McLaughlin et al., PMID 34195499.