To evaluate the effectiveness of polyethylene glycol (PEG) hydrogel spacers in prostate brachytherapy (PBT) regarding space creation, rectal dosimetry, failure rates, and gastrointestinal toxicity, with a focus on specific metrics of effectiveness.
Key Findings:
671 patients received PEG hydrogel spacers alongside PBT, with 537 controls.
All studies were retrospective case series published within the last 5 years, indicating a need for more robust study designs.
DuraSeal was used in four studies, while SpaceOAR was used in five studies since 2017, highlighting a shift in preferred technology.
Antibiotic prophylaxis was mentioned in two articles, with variations in protocols, which may affect complication rates.
Interpretation:
PEG hydrogel spacers effectively increase the distance between the prostate and rectum, potentially reducing rectal radiation exposure and associated GI toxicity.
Limitations:
Heterogeneity of evidence prevented formal meta-analysis, limiting the strength of conclusions.
Most studies were retrospective and lacked standardized complication grading, which may affect reliability.
Limited data on the long-term clearance and effectiveness of different spacer types necessitates further investigation.
Conclusion:
PEG hydrogel spacers are a promising technique in PBT, enhancing safety by minimizing rectal radiation exposure; however, further studies are needed for a comprehensive evaluation of their long-term effectiveness and safety.
