Evidence map›Paper›PMID 40148672›Full record

SynthesisProstate cancer and prostatic diseases2025

Does biodegradable peri-rectal spacer mitigate treatment toxicities in radiation therapy for localised prostate cancer-a systematic review and meta-analysis.

Chris Ho-Ming Wong, Ivan Ching-Ho Ko, David Ka-Wai Leung, Steffi Kar-Kei Yuen, Brian Siu, Cathy Yuan, Jeremy Yuen-Chun Teoh

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Prostate cancer and prostatic diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Chris Ho-Ming WongS.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Ivan Ching-Ho KoS.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
David Ka-Wai LeungS.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Steffi Kar-Kei YuenS.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.ORCID 0000-0002-9956-1558
Brian SiuS.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Cathy YuanDepartment of Medicine, London Health Science Center, London, ON, Canada.
Jeremy Yuen-Chun TeohS.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. jeremyteoh@surgery.cuhk.edu.hk.ORCID 0000-0002-9361-2342

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThere is an increasing use of biodegradable peri-rectal spacer prior to radiation therapy for prostate cancer to reduce treatment-associated rectal toxicity. While data from individual trials and cohorts is maturing, there is a lack of an updated quantitative analysis that includes outcomes following peri-rectal spacer. We aim to delineate the clinical impact of peri-rectal spacer in localised prostate cancer patients treated with radiotherapy.

methodsIn March 2024, a systematic search was performed on MEDLINE, Embase, and Cochrane Central Register of controlled trials for publications since the year 2010. Prospective and retrospective studies reporting comparative outcomes of patients with and without peri-rectal spacer prior to radiotherapy were considered. Outcomes are reported in binary fashion. Random effect meta-analysis with the use of weighted mean difference was adopted. Early (≤3 months) and late rectal toxicity stratified according to the Common Terminology Criteria for Adverse Events (CTCAE) criteria, early and late genitourinary toxicity, quality of life in bowel, sexual and urinary domains (in terms of minimal clinically important difference) were assessed.

resultsThe systematic review included 17 studies. There are 3 RCTs, 3 prospective cohorts, and 11 retrospective cohorts. Three thousand two hundred patients were included, with 1471 patients who received peri-rectal spacer and 1729 without. The use of spacer is associated with lower likelihood of late (1.62% vs. 9.35%, RR = 0.25, 95% CI = 0.15-0.42, P < 0.001) and early grade 2 or above late rectal toxicity (3.07% vs. 6.05%, RR = 0.53, 95% CI = 0.33-0.86, P < 0.001). No difference is observed in significant grade 3 or above GI (acute or late) events. There is no statistical difference in bowel-related bowel QoL (risk difference = -0.16, 95% CI = -0.38-0.06, P = 0.15). The perirectal spacer is not associated with negative impact to urinary or sexual domains of QoL either.

conclusionIn localised prostate cancer patients treated with radiation therapy, the use of peri-rectal spacer is associated with reduced rectal toxicities.

Indexed as

Absorbable ImplantsProstatic NeoplasmsRadiation InjuriesRectumHumansMaleQuality of Life

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.