Transperineal injection of hyaluronic acid in the anterior perirectal fat to decrease rectal toxicity from radiation delivered with low-dose-rate brachytherapy for prostate cancer patients

The hyaluronic and non-hyaluronic groups were similar for most patients, in tumor, treatment, and dosimetric characteristics. Patients treated with brachytherapy I-125 and rectal protection with HA had significantly smaller incidence of mucosal damage at the proctoscopic examinations (5% vs. 36%, p=0.002) and no macroscopic rectal bleeding (0% vs. 12%, p=0.047) than those treated with brachytherapy I-125 alone without HA. No toxicity was produced from the HA or its injection. The increased distance between the rectal wall and the prostate, as a result from the injection of HA in the perirectal fat, has significantly decreased the rectal dose from low-dose-rate brachytherapy. Patients treated with brachytherapy I-125 and protection rectal with HA had significantly smaller incidence of mucosal damage at the proctoscopic examinations and no macroscopic rectal bleeding than those treated with brachytherapy I-125 alone without HA.