What factors do you take into account when deciding to offer SpaceOAR to patients with prostate cancer planning to undergo radiation therapy?
For example: radiation fractionation schedule, modality (proton, MRI linac, cyberknife, etc), risk categorization, prostate size, history of IBS, history of prostatitis, etc.
Answer from: Radiation Oncologist at Academic Institution
A shared decision-making opportunity.
It has been interesting to see the pendulum of physician opinion swing back and forth a bit on this issue. [For those unfamiliar with the topic, in addition to reading the initial RCT results, it is worthwhile to read the later Lancet commentary: Hall et ...
Comments
Radiation Oncologist at Tennessee Oncology I offer a rectal hydrogel spacer to most patients ...
Radiation Oncologist at Community Health Network Many of the prostate cancer patients I treat get c...
Radiation Oncologist at The Oregon Clinic-Radiation Oncology West Totally agree on shared decision-making with the p...
Answer from: Radiation Oncologist at Academic Institution
Very important question, as it is my belief that this is a great example of overuse of a medical device. There is evidence to suggest that in some individuals the use of a rectal spacing gel is beneficial and the risks vs the benefit balances more towards the benefits, such as those undergoing SBRT,...
Answer from: Radiation Oncologist at Academic Institution
Everyone has varying levels of enthusiasm about a hydrogel (not differentiating between SpaceOAR vs Barrigel). My personal practice is as follows:Conventional Fx/Mod Hypo Fx - I do not recommend it as the margins used in the trial 'proving' SpaceOARs use were much larger than what I currently u...
Answer from: Radiation Oncologist at Academic Institution
I would offer to patients that would benefit the most: recurrence after previous radiation (yes, it is possible), history of inflammatory bowel disease, and those requiring high dose (high risk patients). I would not offer in patients T3 or T4, history fistula, or previous surgery in the anal/...
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Radiation Oncologist at Kansas City VA Medical Center At our institution, we do not use fiducials nor Hy...
Radiation Oncologist at University of Kansas Health System We use spacers for nearly all of our SBRT and brac...
Answer from: Radiation Oncologist at Community Practice
If a patient asks about it or has read on it and wants it, I won't object. Otherwise, it's my call. And there haven't been many times I've needed to pick up.
Comments
Radiation Oncologist at Lafayette Radiation Center I use Barrigel now. More sculptable. I offer to pr...
I offer a rectal hydrogel spacer to most patients ...
Many of the prostate cancer patients I treat get c...
Totally agree on shared decision-making with the p...