ANNA/C-TRUS is a useful method monitoring patients with a risk of PCa. 50-75% of the usually performed biopsy cores could be spared and, after 12 years, 97% of the patients were either without evidence of a PCa or were diagnosed with a good prognosis tumor.
Most of the patients treated with LDR brachytherapy suffered an ED in correlation to the time interval with a significant loss in the third year after treatment. In this study, the most significant loss occured in the groups that had no or only mild erectile dysfunction before treatment.
Between 2007Between -2010, we conducted a multicenter phase 3 trial, including men with intermediate-to high risk localized T1b-4NX-0MX-0 prostate cancer. Patients were randomized (1:1) to conventional treatment (39x 2 Gy in 8 weeks) or hypofractionated treatment (19x 3.4 Gy in 6.5 weeks), in order to compare both regimens with respect to the relapse rate. Sexual function was assessed at baseline, and at 6, 12, 24 and 36 months after radiotherapy using the International Index of Erectile Function (IIEF). Patients were included if they returned the baseline IIEF and 1 during follow-up. IIEF domains (erectile function (EF), orgasmic function, sexual desire, intercourseand overall satisfaction) were compared between treatment arms using the independent t-test. The minimal clinically important difference (MCID) for the EF domain is 4. We used this MCID cut-off value to calculate the prevalence of 00 erectile deterioration, 00 which we defined as an EF score during follow-up of 4 below baseline, among the sexually active men.RESULTS: Of the enrolled 820 patients, 671 men returned the required questionnaires and were included in this analysis. Mean age at inclusion was 70 years. Hormone therapy was prescribed to 432 patients (64%). Fifty-one patients died during followup. The IIEF at 36 months was completed by 67% (n¼413). Mean EF scores (Fig. 1, solid lines), and other IIEF domains scores decreased during the first 12 months, but subsequently stabilized. No significant differences between treatment arms were found at any point. EF scores in hormone-naive patients (n¼239) (Fig. 1, dotted lines) were comparable at all times, whereas orgasmic function scores were significantly higher in patients treated with hypofractionation at 24 (p¼0.048) and 36 months (3.81 vs. 2.40, p¼0.043). Among sexually active men (n¼326), 00 erectile deterioration 00 rates ranged from 59-65% during follow-up, and were comparable between both arms.CONCLUSIONS: Sexual function following hypofractionated radiotherapy (19x 3.4 Gy) is comparable to conventional treatment (39x 2Gy).
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