Prospective evaluation of a specific technique of sexual function preservation in external beam radiotherapy for prostate cancer
| Autor: | Patrice Jalade, Ariane Lapierre, Alain Ruffion, Hamza Samlali, Ciprian Enachescu, Olivier Chapet, Corina Udrescu |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Urology Prospective evaluation 030218 nuclear medicine & medical imaging 03 medical and health sciences Prostate cancer 0302 clinical medicine Erectile Dysfunction medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies External beam radiotherapy Aged Full Paper Radiotherapy business.industry Prostatic Neoplasms General Medicine Middle Aged medicine.disease Surgery Penile bulb Erectile dysfunction 030220 oncology & carcinogenesis Total dose Biochemical relapse Sexual function business |
| Zdroj: | The British Journal of Radiology. 90:20160877 |
| ISSN: | 1748-880X 0007-1285 |
| DOI: | 10.1259/bjr.20160877 |
| Popis: | Sexual preservation is an important issue in the treatment of localized prostate cancer. A technique of irradiation was developed to better preserve this function and has been evaluated.Eleven patients, with no erectile dysfunction (ED), were treated with daily IMRT-IGRT (total dose: 76-78 Gy). The pudendal arteries, penile bulb and cavernous body were delineated on the planning CT scan. The doses to these structures (with a 5 mm margin) were optimized to be as low as possible. The erectile function was documented using IIEF-5 scores at baseline, 6 months, 1 and 2 years. No ED was defined by an IIEF5 ≥ 20/25, a mild ED by an IIEF5 score of 17-19 and an important ED by a score17.The mean age was 68.4 years. At the median follow-up of 36 months, there was no biochemical relapse. Before RT, the mean IIEF5 score in all 11 patients was 23.4 (range, 20-25). At 6, 12, 18 and 24 months after RT, the mean IIEF scores were 21.2 (14-25), 21.3 (14-25), 21.8 (16-25) and 21.8 (16-25), respectively. At 2 years, 8 patients (72.7%) had no ED and 2 patients (18.2%) experienced a mild ED. The only patient with an important ED had a medical treatment and recovered a satisfactory IIEF score from 16 to 24.The results of this technique of optimisation for sexual preservation are encouraging. Despite a mean age close to 70 years at the time of treatment, 90.9% of the patients had no to mild ED at 2 years. This rate increases at 100% with medical treatment. Advances in knowledge: Dose optimization on sexual organs is possible and could decrease the ED rates. |
| Databáze: | OpenAIRE |
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