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Radiation therapy is a curative intent treatment option for men with prostate cancer. Despite advancement in radiation therapy delivery, rectal toxicity still occurs. Hydrogel spacers offer the potential to reduce rectal toxicity for prostate cancer patients receiving radiation therapy. The concept is elegantly simple whereby a hydrogel compound is injected under ultrasound guidance during routine fiducial marker insertion or as a standalone procedure prior to radiotherapy. After radiation therapy, the body naturally reabsorbs the hydrogel material. The study aimed to provide a comprehensive narrative review and outline the practicalities of inserting hydrogel spacers and published data on the impact of hydrogel spacers on rectal dosimetry and toxicity.
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