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

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Radiation Oncology · The Oregon Clinic-Radiation Oncology West

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 nee...

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Radiation Oncology · The Oregon Clinic-Radiation Oncology West

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...

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Radiation Oncology · Sunnybrook Health Sciences Centre

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.

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Radiation Oncology · Varian Medical Systems/Allegheny health network

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

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Radiation Oncology · Varian Medical Systems/Allegheny health network

Recent case report and discussion on management:

McLaughlin et al., PMID 34195499.

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