Is there any threshold regarding extraprostatic extension to contraindicate a rectal spacer?

Topics: Radiation Oncology • Genitourinary Cancers

The original study used 50% of positive cores, but the MSKCC nomogram can give a high risk of EPE with just 4-5 positive cores out of 12

Answer from: Radiation Oncologist at Academic Institution

This is an important question, and as far as I know there are no data to guide a response. I personally believe that EPE (within reason) is not a contraindication to hydrogel. One would expect the extension, capsule and prostate to lift in unison, depending on where the extension is.&nbs...

Comments

Radiation Oncologist at University of Virginia School of Medicine
I agree with @Jonathan D. Tward. I have not yet en...

Answer from: Radiation Oncologist at Community Practice

Fascinating question: And as several prior good answers have noted, ECE happens routinely, no matter how tightly we screen the patients. So certainly, from time to time, there will be at least a scattering of bad cells on the "wrong side of SpaceBlob." My indication for no spacer to date has been r...

Answer from: Radiation Oncologist at Community Practice

Let's clearly state the concern here: are there circumstances in which our attempt to lower rectal dose and complications may lead to a higher risk of disease recurrence? And if the chronic bowel toxicity rate is lowered by an absolute value of 5%, but the recurrence rate is raised by 1%, is t...

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