Evidence map›Paper›PMID 40162340›Full record

ArticleClinical and translational radiation oncology2025

Utilization of a stabilized hyaluronic acid spacer in SBRT for retroperitoneal cancers: A case series and dosimetric analysis.

Shing Fung Lee, Nathanial Harris, Pui Lam Yip, Jenna Dean, Brayden Geary, George Koufogiannis, Melanie Bauer, Daryl Lim Joon, Farshad Foroudi, Ee Siang Choong and 1 more

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In one paragraph

Article in Clinical and translational radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Shing Fung LeeDepartment of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore.
Nathanial HarrisOlivia Newton John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Victoria, Australia.
Pui Lam YipDepartment of Radiation Oncology, National University Cancer Institute, National University Hospital, Singapore.
Jenna DeanOlivia Newton John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Victoria, Australia.
Brayden GearyOlivia Newton John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Victoria, Australia.
George KoufogiannisRingwood Private Hospital, Melbourne, Victoria, Australia.
Melanie BauerOlivia Newton John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Victoria, Australia.
Daryl Lim JoonRingwood Private Hospital, Melbourne, Victoria, Australia.
Farshad ForoudiMonash University, Melbourne, Victoria, Australia.
Ee Siang ChoongOlivia Newton John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Victoria, Australia.
Michael ChaoOlivia Newton John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objectives: To evaluate the clinical indications, post-operative complications, and dosimetric impact of stabilized hyaluronic acid (sHA) spacer insertion in the retroperitoneum for stereotactic body radiation therapy (SBRT) of retroperitoneal cancers. Patients and methods: This retrospective study analyzed two cases of SBRT for retroperitoneal lesions: a primary left renal cell carcinoma and an oligometastatic renal cell carcinoma (RCC) lesion in the right adrenal gland. In both cases, a sHA spacer was percutaneously inserted between the bowel and the lesion. The spacer was placed under laparoscopic and ultrasound guidance for the renal tumor, and under CT guidance for the adrenal lesion. The prescribed dose was 42 Gy in three fractions for the primary renal lesion and 40 Gy in five fractions for the adrenal lesion. Dosimetric parameters were evaluated in two planning scenarios: (1) without the spacer, adhering to OAR constraints, and (2) with the spacer. Results: Spacer insertion for the primary left renal cancer significantly improved PTV D95% from 67.9 % to 99.5 % of the prescribed dose, a 46.5 % increase. PTV D99% increased from 54.5 % to 86.7 %, reflecting a 59.1 % improvement. The large bowel's maximum dose was reduced from 28.2 Gy to 24.4 Gy, and the volume receiving 24 Gy was minimal with the spacer (0.06 cc). For the right oligometastatic adrenal lesion, despite a fourfold increase in tumor volume, post-spacer dosimetry showed improved PTV coverage without exceeding OAR constraints. No post-operative complications were observed in either case. Conclusion: This is the first report on sHA spacer use in the retroperitoneum for SBRT. Spacer insertion near the large bowel significantly improves dosimetry, enabling higher doses to targets while keeping OAR doses within safe limits. Further research with a larger patient population is required to assess safety and for optimization of the technique for spacer placement in order to enhance clinical outcomes.

Indexed as

Hyaluronic acidOrgan at riskRenal cell carcinomaRetroperitoneal neoplasmsStereotactic body radiation therapy

Identifiers

PMID40162340
PMCPMC11950742

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