Dr. Henderson on Anticipated Developments With Radiotherapy in Prostate Cancer

Randal H. Henderson, MD, MBA, professor, Department of Radiation Oncology, associate medical director, University of Florida Health Proton Therapy Institute, discusses anticipated developments with radiotherapy in prostate cancer.

There is a lot of interest in shortening the duration of radiotherapy, says Henderson. Investigators are actively looking at 4 weeks of treatment versus the traditional 8 weeks. The use of proton therapy would allow patients to undergo shorter schedules and spare the normal tissues better than intensity modulated radiation therapy (IMRT) could.

SpaceOAR hydrogel has also emerged as a way to help protect the rectum from high-dose injury that can occur with protons or IMRT. Instead of having the rectum right behind the prostate and having the anterior rectal wall being exposed to the high-dose area, a needle could be placed between the anterior rectal wall and the prostate. By opening that area up with some saline and placing the hydrogel into that space, it helps hold the anterior rectal wall further from the prostate.

Then, protons or IMRT could be used to get the anterior rectal wall out of the exposure field, explains Henderson; that has essentially eliminated any resulting rectal bleeding and ulceration. Although SpaceOAR is not yet widely available, it could become an effective way to improve the results of existing technology, he concludes.