Biodegradable spacers in gyn cancer radiotherapy: possibilities and prospects (a brief literature review)

Exceeding the tolerable doses in the most irradiated volumes of organs at risk (OAR) is the leading course of hemorrhagic and fistula complications and the major limitation factor for radical and palliative radiotherapy in GYN cancer patients, especially for interstitial and hybrid brachytherapy insertions. The obvious way to increase the safety of radiotherapy in GYN cancer multimodal treatment is to increase the distance between OAR and target therapeutic area. A similar problem in prostate cancer patients is successfully resolved with different types of spacers, which are inserted between the rectum and prostate. A brief literature review summarizes the limited global experience in the use of biodegradable spacers for GYN primary and recurrent tumors treatment, in the light of improved modern radiotherapy and brachytherapy techniques, and positive results of different spacers application in prostate cancer. Clinical trials results, published at 2012-2025 in medical journals and electronic databases (RSCI, PubMed, Scopus, WoS, ResearchGate) had been analyzed. In general, the use of biodegradable spacers is a promising option for improving the oncological results and safety of primary and recurrent gynecological tumors radiation treatment, especially during interstitial and hybrid brachytherapy.