We have done this in a few patients with high risk of complications ( history of IBD) with LDR brachytherapy. The procedure as suggested is done at the end of brachytherapy to avoid interference with ultrasound imaging. The spacer increased the distance and helped decrease the dose to rectum signifi...

I have been using hydrogel spacer in patients receiving external beam radiation therapy. This includes IMRT and proton therapy for now but I see no reason not to use it in patients also getting SBRT. The phase III trial selected patients with low and low-intermediate risk disease specifically to av...