A biodegradable rectal balloon implant to protect the rectum during prostate cancer radiotherapy for a patient with active Crohn's disease. (June 2018)

• Record Type: Journal Article
• Authors: Vanneste, Ben G.L.; Van Limbergen, Evert J.; van de Beek, Kees; van Lin, Emile; Lutgens, Ludy; Lambin, Philippe
• Is Part Of: Technical innovations & patient support in radiation oncology. Volume 6(2018)
• Page Start: 1
• Page End: 4
• Publication Date: 2018-06
• Subjects: Prostate cancer -- Radiotherapy -- Rectal balloon implant -- Inflammatory bowel disease; Radiotherapy -- Periodicals; Cancer -- Radiotherapy -- Periodicals; Cancer -- Patients -- Hospital care -- Periodicals; 615.842
• DOI: 10.1016/j.tipsro.2018.01.004
• Languages: English
• ISSNs: 2405-6324

Abstract

Highlights: Active inflammatory bowel disease is an exclusion criterion for high-dose radiotherapy. A rectum spacer was inserted between the prostate and the rectal wall. The rectum spacer pushes the rectum outside of the high-dose area. No rectal toxicity of the radiotherapy or toxicity flare of the IBD was observed. Abstract: Background: Radiotherapy in patients with active inflammatory bowel disease (IBD) is usually considered an absolute exclusion criterion for prostate cancer radiotherapy treatment. There are no reports available on the use of a biodegradable rectal balloon implantation (RBI) in patients with active IBD for prostate cancer radiotherapy. Case presentation: We report on a patient with high-risk prostate cancer with the comorbidity of an active IBD with pancolitis location. He was treated with neo-adjuvant hormonal therapy and high-dose external beam radiotherapy to the prostate and the seminal vesicles. Before radiotherapy treatment, a biodegradable RBI was implanted between the prostate and the anterior rectal wall to push the rectum outside of the high-dose area. This patient at high-risk for rectal toxicity was successfully irradiated to his prostate with only a grade I urinary toxicity, no acute rectal toxicity or toxicity flare of the IBD. Conclusions: This case describes the use of a RBI implantation in patients with active IBD for prostate cancer radiotherapy. The use of a biodegradable RBI proved to be a promised solution for such patients, and have to be further investigated.