Impact of Rectal Spacer Placement on Treatment Precision

In this segment, the expert faculty discuss how accurate rectal spacer placement directly shapes prostate radiotherapy planning and long-term patient outcomes. They explain that rectal spacers provide essential safety by reliably separating the rectum from high-dose regions during modern radiotherapy regimens. This separation allows radiation oncologists to confidently escalate dose and employ advanced techniques like simultaneous boosts to intraprostatic tumors, improving local control even when lesions sit close to the rectal wall.

A key anatomical challenge is at the prostate apex, where the gland and rectum naturally abut and where planning margins can inadvertently expose the rectum to full prescription dose. The panel describes refining their technique to achieve more apical-dominant spacing, and the radiation oncologist confirms that this provides the greatest clinical benefit. By removing the apex as a dose-limiting constraint, optimized spacer placement enhances safety, supports more aggressive and precise treatment, and improves overall quality of life for patients.