Cross-linked hyaluronan gel improves the quality of life of prostate cancer patients undergoing radiotherapy••
Received 29 September 2009; received in revised form 6 November 2009; accepted 31 December 2009. published online 01 July 2010. Corrected Proof
Abstract
Purpose
To test the hypothesis that cross-linked hyaluronan gel (Hylaform) does not affect the quality of life (QOL) of prostate cancer patients undergoing radiotherapy.
Methods and Materials
Thirty-five patients with early stage prostate cancer underwent high-dose-rate brachytherapy to 2200cGy and intensity modulated radiation therapy to 5040cGy on a prospective study. Thirty patients received a single transperineal injection of 9-mL Hylaform between the prostate and rectum under transrectal ultrasound guidance immediately before the start of radiotherapy. Hylaform increased the separation between the prostate and rectum by 6–19mm (median, 13mm) at the start of radiotherapy. Five patients did not receive Hylaform and served as controls. We assessed gastrointestinal-related QOL using Expanded Prostate Cancer Index Composite Bowel Bother scores immediately before the start of and during the last week of radiotherapy.
Results
At the beginning of intensity modulated radiation therapy, daily mean rectal doses were 74±8cGy (mean±standard deviation) and 105±25cGy (mean±standard deviation) with vs. without Hylaform, respectively (p=0.01). Expanded Prostate Cancer Index Composite Bowel Bother scores decreased by 0±3 (mean±standard deviation) and 11±14 (mean±standard deviation) in patients who did and did not receive Hylaform, respectively (p=0.03).
Conclusions
Hylaform increased the separation between the prostate and rectum and decreased the mean rectal dose, thereby improving the gastrointestinal-related acute QOL of prostate cancer patients undergoing radiotherapy. Patients will be followed up long term to determine if the improvement in acute QOL also translates into an improvement in late QOL.
Corresponding author. Department of Radiation Oncology, Moffitt Cancer Center, 12902 Magnolia Dr, Tampa, FL 33612-9416. Tel.: +1-81-745-4142; fax: +1-813-745-7231.
• Reprint requests to: Diane Oshiro, Cancer Center of Irvine, 16100 Sand Canyon Avenue, Suite 130, Irvine, CA 92618. Tel.: +1-949-417-1100; fax: +1-949-417-1165. E-mail: doshiro@ccoi.org.
• Conflicts of interest notification: The Cancer Center of Irvine received a $55,000 research grant from Genzyme Corporation to study Hylaform as a tissue spacer in patients undergoing radiotherapy for localized prostate cancer.
ABSTRACT
cGy and intensity modulated radiation therapy to 5040