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CASE REPORT article

Front. Oncol.
Sec. Genitourinary Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1494304

Case report of the first use of hydrogel rectal spacer for Prostate Cancer Reirradiation via LDR-Brachytherapy: Applications and Technical Notes

Provisionally accepted
Amina Lazrek Amina Lazrek 1Sebastiano Finocchi Ghersi Sebastiano Finocchi Ghersi 2Adeline Petre Adeline Petre 3Anne-Agathe Serre Anne-Agathe Serre 3Fred Gassa Fred Gassa 3Magali Sandt Magali Sandt 3Cecile Laude Cecile Laude 3Sarah Houabes Sarah Houabes 4Camille Roukoz Camille Roukoz 3*Salvatore Cozzi Salvatore Cozzi 3*
  • 1 Hôpital Cheikh Zayd, Rabat, Morocco
  • 2 Radiation Oncology Unit, Azienda USL-IRCCS, Reggio Emilia, Italy
  • 3 Centre Léon Bérard, Lyon, France
  • 4 Radiation Oncology unit, Portes de Provence Hospital Groupe 26200 Montelimar, Montelimar, France

The final, formatted version of the article will be published soon.

    Introduction: Prostate cancer remains a prevalent malignancy among men, often necessitating innovative therapeutic strategies for effective management of recurrent cases. This article examines the critical role of a biodegradable hydrogel spacer, which creates a temporary interspace between the prostate and the rectum, thus reducing radiation exposure to healthy tissues. Case Description: We present a case of a 73-year-old man with a history of intermediate-risk prostate adenocarcinoma initially treated with external beam radiotherapy in 2015. Despite initial remission, the patient experienced a rise in PSA levels indicative of local recurrence in 2022. Salvage treatment with Iodine-125 brachytherapy, preceded by the placement of a rectal spacer in January 2024, resulted in a significant reduction of PSA levels. The patient remains asymptomatic with no urinary or gastrointestinal complications 6 months after the salvage treatment.Discussion: This case illustrates the complexities in managing recurrent prostate cancer and the evolving role of reirradiation strategies. Salvage Iodine-125 brachytherapy with the placement of a rectal spacer, provided precise radiation delivery while minimizing the rectal toxicities. The significant biochemical response observed underscores the efficacy of this approach in controlling disease progression. The rectal spacer enhances treatment safety by reducing radiation exposure to adjacent tissues highlighting its importance in reirradiation protocols. This case contributes to the growing evidence supporting the rectal spacer's role in enhancing the safety and efficacy of salvage brachytherapy for recurrent prostate cancer.Our experience advocate for the integration of a hydrogel rectal spacer as a valuable tool in prostate cancer reirradiation protocols, offering a strategic approach to optimize treatment safety by minimizing rectal toxicity.

    Keywords: Rectal spacer, hydrogel spacer, prostate reirradiation, prostate cancer, Brachytherapy MANUSCRIPT

    Received: 10 Sep 2024; Accepted: 08 Jan 2025.

    Copyright: © 2025 Lazrek, Finocchi Ghersi, Petre, Serre, Gassa, Sandt, Laude, Houabes, Roukoz and Cozzi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Camille Roukoz, Centre Léon Bérard, Lyon, France
    Salvatore Cozzi, Centre Léon Bérard, Lyon, France

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.