Better preservation of erectile function in localized prostate cancer patients with modern proton therapy: Is it cost‐effective?

Guo, Li; Xia, Yunfei; Huang, Yixiang; Okat, Deniz; Qiu, Bo; Doyen, J.; Bondiau, Pierre‐Yves; Bénézery, Karen; Gao, Jin; Qian, Chao‐Nan

doi:10.1002/pros.24417

The Prostate

2022

DOI: 10.1002/pros.24417

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Better preservation of erectile function in localized prostate cancer patients with modern proton therapy: Is it cost‐effective?

Li Guo

Yunfei Xia

Yixiang Huang

et al.

Abstract: Background: Stereotactic body radiation therapy (SBRT) has gradually been recognized as favorable curative treatment for localized prostate cancer (PC).However, the high rate of erectile dysfunction (ED) after traditional photon-based SBRT remains an ongoing challenge that greatly impacts the quality of life of PC survivors. Modern proton therapy allows higher conformal SBRT delivery and has the potential to reduce ED occurrence but its cost-effectiveness remains uninvestigated.Methods: A Markov decision model… Show more

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2024

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Cited by 3 publications

References 38 publications

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Economic evaluation of stereotactic radiotherapy and stereotactic radiosurgery technologies in the treatment of cancers: a systematic review

Rezapour,

Gholampour,

Barzegar

et al. 2024

Expert Review of Pharmacoeconomics & Outcomes Research

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Economic evaluation of stereotactic radiotherapy and stereotactic radiosurgery technologies in the treatment of cancers: a systematic review

Rezapour,

Gholampour,

Barzegar

et al. 2024

Expert Review of Pharmacoeconomics & Outcomes Research

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Markov models for clinical decision‐making in radiation oncology: A systematic review

McCullum,

Karagoz,

Dede

et al. 2024

J Med Imag Rad Onc

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The intrinsic stochasticity of patients' response to treatment is a major consideration for clinical decision‐making in radiation therapy. Markov models are powerful tools to capture this stochasticity and render effective treatment decisions. This paper provides an overview of the Markov models for clinical decision analysis in radiation oncology. A comprehensive literature search was conducted within MEDLINE using PubMed, following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Only studies published from 2000 to 2023 were considered. Selected publications were summarized in two categories: (i) studies that compare two (or more) fixed treatment policies using Monte Carlo simulation and (ii) studies that seek an optimal treatment policy through Markov Decision Processes (MDPs). Relevant to the scope of this study, 61 publications were selected for detailed review. The majority of these publications (n = 56) focused on comparative analysis of two or more fixed treatment policies using Monte Carlo simulation. Classifications based on cancer site, utility measures and the type of sensitivity analysis are presented. Five publications considered MDPs with the aim of computing an optimal treatment policy; a detailed statement of the analysis and results is provided for each work. As an extension of Markov model‐based simulation analysis, MDP offers a flexible framework to identify an optimal treatment policy among a possibly large set of treatment policies. However, the applications of MDPs to oncological decision‐making have been understudied, and the full capacity of this framework to render complex optimal treatment decisions warrants further consideration.

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Erectile Dysfunction and Penile Bulb Dose Following Definitive Prostate Radiation Therapy

Nouri,

Kalantari Khandani,

Javadinia

et al. 2024

Int J Cancer Manag

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Background: Erectile dysfunction (ED) is a common side effect of prostate cancer treatment, affecting up to 50% of patients after radiation therapy. Objectives: This study aims to analyze the correlation between the dose received by the penile bulb (PB) and ED in men who underwent definitive radiation therapy for early-stage prostate cancer without androgen deprivation therapy. Methods: The study included 40 patients who received 3D conformal radiation therapy (3D-CRT) for localized prostate cancer and were reported to be potent before treatment, as determined by the International Index of Erectile Function (IIEF-15) questionnaire. The dose to the PB was measured using dose volume histograms (DVHs), and the IIEF-15 questionnaire was completed again 3 months after 3D-CRT. The Pearson correlation coefficient and linear regression test were used to examine the correlation between the ED score and PB doses. Statistical significance was considered if the P value was less than 0.05. Results: The mean age of the patients was 75.5 ± 5.70 years. The average ED score based on the questionnaire was 15 ± 10.55. Twenty percent of the patients had moderate ED, while 80% had mild ED (all patients reported a decrease in potency after 3D-CRT). However, the correlation between the ED score and the PB mean dose was not statistically significant. Conclusions: This study revealed ED in all prostate cancer patients after 3D-CRT, but no significant correlation was found between the dose received by the PB and radiotherapy-induced impotence.

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Better preservation of erectile function in localized prostate cancer patients with modern proton therapy: Is it cost‐effective?

Cited by 3 publications

References 38 publications

Economic evaluation of stereotactic radiotherapy and stereotactic radiosurgery technologies in the treatment of cancers: a systematic review

Economic evaluation of stereotactic radiotherapy and stereotactic radiosurgery technologies in the treatment of cancers: a systematic review

Markov models for clinical decision‐making in radiation oncology: A systematic review

Erectile Dysfunction and Penile Bulb Dose Following Definitive Prostate Radiation Therapy

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