The use of hyperbaric oxygen to treat actinic rectal fistula after SpaceOAR use and radiotherapy for prostate cancer: a case report

Bibliographic Details
Title: The use of hyperbaric oxygen to treat actinic rectal fistula after SpaceOAR use and radiotherapy for prostate cancer: a case report
Authors: Tairo Kashihara, Koji Inaba, Motokiyo Komiyama, Hiroki Nakayama, Kotaro Iijima, Shie Nishioka, Hiroyuki Okamoto, Nao Kikkawa, Yuko Kubo, Satoshi Shima, Satoshi Nakamura, Ayaka Takahashi, Kana Takahashi, Kae Okuma, Naoya Murakami, Hiroshi Igaki, Yuko Nakayama, Arinobu Fukunaga, Yoshiyuki Matsui, Hiroyuki Fujimoto, Jun Itami
Source: BMC Urology, Vol 20, Iss 1, Pp 1-5 (2020)
Publisher Information: BMC, 2020.
Publication Year: 2020
Collection: LCC:Diseases of the genitourinary system. Urology
Subject Terms: Radiotherapy, Hydrogel spacer, Side effects, Hyperbaric oxygen therapy, MR-guided radiation therapy, Diseases of the genitourinary system. Urology, RC870-923
More Details: Abstract Background In definitive radiation therapy for prostate cancer, the SpaceOARĀ® System, a hydrogel spacer, is widely used to decrease the irradiated dose and toxicity of rectum. On the other hand, periprostatic abscesses formation and rectal perforation are known as rare adverse effects of SpaceOAR. Nevertheless, there is a lack of reports clarifying the association between aggravation of abscesses and radiation therapy, and hyperbaric oxygen therapy (HBOT) is effective for a peri-SpaceOAR abscess and rectal perforation. Case presentation We report a case of a 78-year-old high-risk prostate cancer patient. After SpaceOAR insertion into the correct space, he started to receive external beam radiation therapy (EBRT). He developed a fever, perineal pain and frequent urination after the completion of EBRT, and the magnetic resonance imaging (MRI) revealed a peri-SpaceOAR abscess. Scheduled brachytherapy was postponed, administration of antibiotics and opioid via intravenous drip was commenced, and transperineal drainage was performed. After the alleviation of the abscess, additional EBRT instead of brachytherapy was performed with MRI-guided radiation therapy (MRgRT). On the last day of the MRgRT, perineal pain reoccurred, and MRI and colonoscopy detected the rectal perforation. He received an intravenous antibiotics drip and HBOT, and fully recovered from the rectal perforation. Conclusions Our report indicates that EBRT can lead to a severe rectum complication by causing inflammation for patients with a peri-SpaceOAR abscess. Furthermore, HBOT was effective for the peri-SpaceOAR abscess and rectal perforation associated with EBRT.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1471-2490
Relation: https://doaj.org/toc/1471-2490
DOI: 10.1186/s12894-020-00767-3
Access URL: https://doaj.org/article/724fa5d937bc43ca900cb4016afb1166
Accession Number: edsdoj.724fa5d937bc43ca900cb4016afb1166
Database: Directory of Open Access Journals
More Details
ISSN:14712490
DOI:10.1186/s12894-020-00767-3
Published in:BMC Urology
Language:English