Can bowel side effects caused by radiotherapy be reduced by a spacer tool in patients with prostate cancer?

This study examined if a hydrogel spacer tool improved long-term quality of life for patients with prostate cancer (PC) who received radiotherapy (RT). The results showed that the spacer significantly reduced bowel side effects and improved patients’ quality of life.

RT is an effective therapy for patients with PC. However, the radiation beams sometimes affect nearby organs, such as the bowel. This can cause long-term side effects, reducing patients’ quality of life. 

Hydrogel spacers act as physical barriers between the prostate and the bowel. They allow RT to treat the prostate while reducing the amount of radiation that reaches the bowel. In the short term, it is clear that spacers significantly improve patients’ quality of life. It is unclear if this effect continues long-term.

Data from 380 men with PC who received RT was evaluated. 245 patients received a spacer (spacer group) and 135 did not (control group). Patients were followed for an average of 39.5 months. Bowel symptoms and how they related to the quality of life were assessed by questionnaire. 

After 1 and 2 years, quality of life declined less in patients who received a spacer compared to those that did not. This difference in quality of life was maintained after 5 years of follow-up.

Patients who did not receive a spacer were 3.5 times more likely to have a reduced quality of life because of bowel symptoms. 36% of the control group and 14% of the spacer group had reduced quality of life scores of 5 points or more. 19% of the control group and 6% of the spacer group had reduced quality of life scores of 10 points or more.

Patients who received a spacer were less likely to experience urgent bowel motions, soft stools, and frequent bowel motions. Patients who received a spacer were also less likely to experience watery stools and incontinence. 

The authors concluded that spacers could protect patients with PC from bowel side effects caused by RT.

There were unequal numbers of patients in each group which may not allow for a fair comparison. This study would benefit from including more patients.