Publication

Erectile function following brachytherapy, external beam radiotherapy, or radical prostatectomy in prostate cancer patients

Journal Paper/Review - Dec 28, 2015

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Citation
Putora P, Engeler D, Haile S, Graf N, Buchauer K, Schmid H, Plasswilm L. Erectile function following brachytherapy, external beam radiotherapy, or radical prostatectomy in prostate cancer patients. Strahlenther Onkol 2015; 192:182-9.
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Type
Journal Paper/Review (English)
Journal
Strahlenther Onkol 2015; 192
Publication Date
Dec 28, 2015
Issn Print
Issn Electronic
1439-099X
Pages
182-9
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Brief description/objective

BACKGROUND AND PURPOSE
For localized prostate cancer, treatment options include external beam radiotherapy (EBRT), radical prostatectomy (RP), and brachytherapy (BT). Erectile dysfunction (ED) is a common side-effect. Our aim was to evaluate penile erectile function (EF) before and after BT, EBRT, or RP using a validated self-administered quality-of-life survey from a prospective registry.

MATERIAL AND METHODS
Analysis included 478 patients undergoing RP (n = 252), EBRT (n = 91), and BT (n = 135) with at least 1 year of follow-up and EF documented using IIEF-5 scores at baseline, 6 weeks, 6 months, 1 year, and annually thereafter.

RESULTS
Differences among treatments were most pronounced among patients with no or mild initial ED (IIEF-5 ≥ 17). Overall, corrected for baseline EF and age, BT was associated with higher IIEF-5 scores than RP (+ 7.8 IIEF-5 score) or EBRT (+ 3.1 IIEF-5 score). EBRT was associated with better IIEF-5 scores than RP (+ 4.7 IIEF-5 score). In patients undergoing EBRT or RP with bilateral nerve sparing (NS), recovery of EF was observed and during follow-up, the differences to BT were not statistically significant. Overall age had a negative impact on EF preservation (corrected for baseline IIEF).

CONCLUSION
In our series, EF was adversely affected by each treatment modality. Considered overall, BT provided the best EF preservation in comparison to EBRT or RP.