Authors’ response

Abstract

We appreciate Ghaffari et al. taking the time to submit a letter to the editor in regard to our recent publication on the use of hydrogel spacers during low-dose-rate brachytherapy. Their letter states that “this is the first study reporting late rectal toxicity after hydrogel spacer injection during iodine-125 LDR prostate brachytherapy” and discuss potential confounders that may explain why differences in late toxicity were not measured in our study. Our study deserves clarification as we investigated several scientific questions that focused primarily on periprocedural outcomes. We urged caution about any interpretations about the effect of hydrogel spacers on late toxicity. As stated in our original conclusion, “Further research is necessary to investigate whether the routine use of hydrogel with LDR brachytherapy translates into reductions in late rectal toxicity, an endpoint which was not available for investigation in this report, given many patients flew in from other states for their implants and did not have any follow-up with us.” Letter to the editor regarding “Rectal spacing, prostate coverage, and periprocedural outcomes after hydrogel spacer injection during low-dose-rate brachytherapy implantation”BrachytherapyVol. 19Issue 4PreviewWith interest, we read the recent paper by Kahn et al., (1) reporting dosimetric impact and periprocedural outcomes after transperineal injection of hydrogel spacer (DuraSeal Dural Sealant System; Covidien, Mansfield, MA) during iodine-125 low-dose-rate (LDR) prostate brachytherapy. They observed that using hydrogel spacer creates a significant distance between the rectum and prostate 13.9 ± 5.2 mm vs. 6.5 ± 5.0 mm (p < 0.0001), resulting in statistically significant reduction in the dose to 1 cc, 2 cc, and 5 cc of the rectum relative to prescription dose (1). Full-Text PDF