{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T21:30:08Z","timestamp":1786570208744,"version":"build-2736575974"},"reference-count":23,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP25K19095"],"award-info":[{"award-number":["JP25K19095"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["advancesradonc.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Advances in Radiation Oncology"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.adro.2026.102145","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:12:41Z","timestamp":1784304761000},"page":"102145","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Hydrogel Spacer on Radiation Proctitis After Prostate Cancer Radiation Therapy: A Large-Scale Claims Database Analysis"],"prefix":"10.1016","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7354-4063","authenticated-orcid":false,"given":"Kazuya","family":"Takeda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinsaku","family":"Okuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rei","family":"Umezawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaya","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyoshi","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiichi","family":"Jingu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.adro.2026.102145_bib0001","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1002\/cncr.20446","article-title":"Urinary and rectal complications of contemporary permanent transperineal brachytherapy for prostate carcinoma with or without external beam radiation therapy","volume":"101","author":"Sarosdy","year":"2004","journal-title":"Cancer"},{"key":"10.1016\/j.adro.2026.102145_bib0002","doi-asserted-by":"crossref","first-page":"5598","DOI":"10.3748\/wjg.v22.i24.5598","article-title":"Colostomy is a simple and effective procedure for severe chronic radiation proctitis","volume":"22","author":"Yuan","year":"2016","journal-title":"World J Gastroenterol"},{"key":"10.1016\/j.adro.2026.102145_bib0003","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.ijrobp.2015.04.030","article-title":"Hydrogel spacer prospective multicenter randomized controlled pivotal trial: Dosimetric and clinical effects of perirectal spacer application in men undergoing prostate image guided intensity modulated radiation therapy","volume":"92","author":"Mariados","year":"2015","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.adro.2026.102145_bib0004","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1016\/j.ijrobp.2016.12.024","article-title":"Continued benefit to rectal separation for prostate radiation therapy: Final results of a phase III trial","volume":"97","author":"Hamstra","year":"2017","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.adro.2026.102145_bib0005","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.ijrobp.2016.02.038","article-title":"Five-year biochemical results, toxicity, and patient-reported quality of life after delivery of dose-escalated image guided proton therapy for prostate cancer","volume":"95","author":"Bryant","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.adro.2026.102145_bib0006","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1016\/j.juro.2006.06.002","article-title":"Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer","volume":"176","author":"Zelefsky","year":"2006","journal-title":"J Urol"},{"key":"10.1016\/j.adro.2026.102145_bib0007","first-page":"81","article-title":"The role of image-guided radiotherapy in prostate cancer: A systematic review and meta-analysis","volume":"38","author":"Wang","year":"2023","journal-title":"Clin Transl Radiat Oncol"},{"key":"10.1016\/j.adro.2026.102145_bib0008","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.radonc.2016.10.009","article-title":"A multi-institutional analysis of prospective studies of carbon ion radiotherapy for prostate cancer: A report from the Japan Carbon ion Radiation Oncology Study Group (J-CROS)","volume":"121","author":"Nomiya","year":"2016","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.adro.2026.102145_bib0009","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1056\/NEJMoa2403365","article-title":"Phase 3 trial of stereotactic body radiotherapy in localized prostate cancer","volume":"391","author":"van As","year":"2024","journal-title":"N Engl J Med"},{"key":"10.1016\/j.adro.2026.102145_bib0010","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.ijrobp.2013.07.041","article-title":"Preliminary toxicity analysis of 3-dimensional conformal radiation therapy versus intensity modulated radiation therapy on the high-dose arm of the Radiation Therapy Oncology Group 0126 prostate cancer trial","volume":"87","author":"Michalski","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.adro.2026.102145_bib0011","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1007\/s00066-016-1040-6","article-title":"Hydrogel injection reduces rectal toxicity after radiotherapy for localized prostate cancer. Hydrogelinjektion vermindert die rektale Toxizit\u00e4t nach Radiotherapie bei lokalisiertem Prostatakarzinom","volume":"193","author":"Pinkawa","year":"2017","journal-title":"Strahlenther Onkol"},{"key":"10.1016\/j.adro.2026.102145_bib0012","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1111\/1754-9485.12945","article-title":"Late toxicities of prostate cancer radiotherapy with and without hydrogel SpaceAOR insertion","volume":"63","author":"Te Velde","year":"2019","journal-title":"J Med Imaging Radiat Oncol"},{"key":"10.1016\/j.adro.2026.102145_bib0013","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s13014-022-01998-4","article-title":"Patient-related risk factors for late rectal bleeding after hypofractionated radiotherapy for localized prostate cancer: A single-center retrospective study","volume":"17","author":"Kim","year":"2022","journal-title":"Radiat Oncol"},{"key":"10.1016\/j.adro.2026.102145_bib0014","article-title":"Toxicity after stereotactic body radiation therapy for prostate cancer in patients with inflammatory bowel disease: A multi-institutional matched case-control series","volume":"6","author":"Juarez","year":"2021","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.adro.2026.102145_bib0015","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2025.0491","article-title":"Bowel disorder incidence and rectal spacer use in patients with prostate cancer undergoing radiotherapy","volume":"8","author":"Folkert","year":"2025","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.adro.2026.102145_bib0016","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1016\/j.ijrobp.2007.11.044","article-title":"Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer","volume":"70","author":"Zelefsky","year":"2008","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.adro.2026.102145_bib0017","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/S0360-3016(98)00091-1","article-title":"Dose escalation with three-dimensional conformal radiation therapy affects the outcome in prostate cancer","volume":"41","author":"Zelefsky","year":"1998","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.adro.2026.102145_bib0018","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.ijrobp.2010.09.058","article-title":"Late toxicity after intensity-modulated radiation therapy for localized prostate cancer: An exploration of dose\u2013volume histogram parameters to limit genitourinary and gastrointestinal toxicity","volume":"82","author":"Pederson","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.adro.2026.102145_bib0019","doi-asserted-by":"crossref","DOI":"10.1016\/j.radonc.2023.109854","article-title":"Proton therapy for the management of localized prostate cancer: Long-term clinical outcomes at a comprehensive cancer center","volume":"188","author":"Sosa","year":"2023","journal-title":"Radiother Oncol"},{"key":"10.1016\/j.adro.2026.102145_bib0020","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.urology.2023.12.034","article-title":"Major complications and adverse events related to use of SpaceOAR hydrogel for prostate cancer radiotherapy","volume":"188","author":"Millot","year":"2024","journal-title":"Urology"},{"key":"10.1016\/j.adro.2026.102145_bib0021","article-title":"Real-world medical device reports of SpaceOAR hydrogel spacer: Analysis of the food and drug administration Manufacturer and User Facility Device Experience (MAUDE) database","volume":"10","author":"Hathout","year":"2025","journal-title":"Adv Radiat Oncol"},{"key":"10.1016\/j.adro.2026.102145_bib0022","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.urology.2023.09.016","article-title":"Real-world complications of the SpaceOAR hydrogel spacer: A review of the manufacturer and user facility device experience database","volume":"183","author":"Fernandez","year":"2024","journal-title":"Urology"},{"key":"10.1016\/j.adro.2026.102145_bib0023","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.ijrobp.2025.05.001","article-title":"Development and validation of a computable radiation therapy phenotype","volume":"123","author":"Madison","year":"2025","journal-title":"Int J Radiat Oncol Biol Phys"}],"container-title":["Advances in Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2452109426001521?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2452109426001521?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T20:55:42Z","timestamp":1786568142000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2452109426001521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["S2452109426001521"],"URL":"https:\/\/doi.org\/10.1016\/j.adro.2026.102145","relation":{},"ISSN":["2452-1094"],"issn-type":[{"value":"2452-1094","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Impact of Hydrogel Spacer on Radiation Proctitis After Prostate Cancer Radiation Therapy: A Large-Scale Claims Database Analysis","name":"articletitle","label":"Article Title"},{"value":"Advances in Radiation Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.adro.2026.102145","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.","name":"copyright","label":"Copyright"}],"article-number":"102145"}}