Erectile Function Durability Following Permanent Prostate Brachytherapy

Taira, Al V.; Merrick, Gregory S.; Galbreath, Robert W.; Butler, Wayne M.; Wallner, Kent E.; Kurko, Brian S.; Anderson, Richard L.; Lief, Jonathan H.

doi:10.1016/j.ijrobp.2008.11.058

Cited by 55 publications

(23 citation statements)

References 31 publications

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“…Irradiation of the penile bulb is a considerable issue because this organ is considered at risk for erectile damage [18]. As this dosimetric parameter was not included in the pre-operative planning evaluation, the lack of data is a limitation in our study.…”

Section: Discussionmentioning

confidence: 99%

Impact of post-implant dosimetric parameters on the quality of life of patients treated with low-dose rate brachytherapy for localised prostate cancer: results of a single-institution study

et al. 2015

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BackgroundTo assess the relationship between dosimetric parameters and the quality of life (QL) outcomes of patients with low-intermediate-risk localised prostate cancer (LPC) treated with low-dose-rate brachytherapy (LDR-BT).Materials and methodsWe evaluated the participants in two consecutive prospective studies of the QL of patients treated with LDR-BT for LPC. QL was evaluated by means of a patient-completed questionnaire assessing non functional [physical (PHY) and psychological (PSY) well-being, physical autonomy (POW), social relationships (REL)] and functional scales [urinary (URI), rectal (REC), and sexual (SEX) function]; a scale for erectile function (ERE) was included in the second study. Urethra (D10 ≤ 210 Gy) and rectal wall constraints (V100 ≤ 0.5 cc) were used for pre-planning dosimetry and were assessed with post planning computerized tomography one month later for each patient.ResultsQL was assessed in 251 LPC patients. Dosimetry did not influence the non-functional scales. As expected, a progressive impairment in sexual and erectile function was reported one month after LDR-BT, and became statistically significant after the third year. Rectal function significantly worsened after LDR-BT, but the differences progressively decreased after the 1-year assessment. Overall urinary function significantly worsened immediately after LDR-BT and then gradually improved over the next three years. Better outcomes were reported for V100 rectal wall volumes of ≤ 0.5 cc and D10 urethra values of ≤ 210 Gy.ConclusionsThe findings of this study show that dosimetric parameters influence only functional QL outcomes while non-functional outcomes are only marginally influenced.

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Section: Discussionmentioning

confidence: 99%

Impact of post-implant dosimetric parameters on the quality of life of patients treated with low-dose rate brachytherapy for localised prostate cancer: results of a single-institution study

et al. 2015

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“…This led to the utilization of cPAP as a molecular marker of prostate cancer for many years before the discovery of PSA as a more reliable, if not perfect, marker. However, it has been recently suggested that the contribution of PAP screening should be reevaluated in the light of recent results showing that secretion of PAP in the serum may constitute a prognostic factor for patients with high risk cancer (43). On the contrary, the expression of cPAP seems to be inversely correlated with prostate carcinogenesis (for review, see Ref.…”

Section: Discussionmentioning

confidence: 99%

CaV3.2 T-type Calcium Channels Are Involved in Calcium-dependent Secretion of Neuroendocrine Prostate Cancer Cells

Gackière

Bidaux

Delcourt

et al. 2008

Journal of Biological Chemistry

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Because prostate cancer is, in its early stages, an androgen-dependent pathology, treatments aiming at decreasing testosterone plasma concentration have been developed for many years now. However, a significant proportion of patients suffer a relapse after a few years of hormone therapy. The androgenindependent stage of prostate cancer has been shown to be associated with the development of neuroendocrine differentiation. We previously demonstrated that neuroendocrine prostate cancer cells derived from LNCaP cells overexpress CaV3.2 T-type voltage-dependent calcium channels. We demonstrate here using prostatic acid phosphatase as a marker of prostate secretion and FM1-43 fluorescence imaging of membrane trafficking that neuroendocrine differentiation is associated with an increase in calcium-dependent secretion which critically relies on CaV3.2 T-type calcium channel activity. In addition, we show that these channels are expressed by neuroendocrine cells in prostate cancer tissues obtained from patients after surgery. We propose that CaV3.2 T-type calcium channel up-regulation may account for the alteration of secretion during prostate cancer development and that these channels, by promoting the secretion of potential mitogenic factors, could participate in the progression of the disease toward an androgen-independent stage.Prostate cancer is, in its early stages, an androgen-dependent pathology, meaning that its progression relies on the presence of active steroid male hormones. Treatments developed for many years have been based on this characteristic feature of prostate cancer and, thus, aimed at decreasing the plasma concentration of testosterone or dihydrotestosterone, the prostate active androgen. Although these treatments are particularly valuable in the early development of the disease, leading to the regression of cancers, about a third of the patients suffer a relapse after a few years of hormone therapy. At this stage of hormone refractory disease, deprivation of androgens has no further incidence on the growth of the prostate cancer, and no curative therapy is currently effective (for review, see Ref. 1).The androgen-independent stage of prostate cancer has been shown to be associated with, among others, the development of neuroendocrine differentiation (2). These neuroendocrine features include the appearance of neuroendocrine cell foci surrounded by proliferating epithelial cells (3). Because neuroendocrine prostate cells in normal, hyperplastic, or cancerous tissue secrete many neuropeptides with mitogenic activities like parathyroid hormone-related peptide, calcitonin, or gastrin-related peptides, it has been proposed that paracrine secretion of neurosecretory products released by neuroendocrine cells could be responsible for the progression of cancer toward an androgen-independent stage (for review, see Ref. 4). Indeed, it has been shown for instance that the expression of neuroendocrine markers like chromogranin A is correlated with tumor dedifferentiation (5) and that the presence of neuroendo...

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“…In a recent study of Merrick team, in the 226 patients with prostate cancer and preimplant erectile function assessed by IIEF6, the 7-year actuarial rate potency preservation was 55.6% with median postimplant IIEF of 22 in potent patients. Potent patients were statistically younger, had higher preimplant IIEF and were less likely to be diabetic [ 15 ]. Potency preservation and median IIEF scores following brachytherapy are durable.…”

Section: Discussionmentioning

confidence: 99%

“…Potency preservation and median IIEF scores following brachytherapy are durable. Thoughtful dose sparing of proximal penile structures and early penile rehabilitation may further improve these results [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Erectile function after permanent 125I prostate brachytherapy for localized prostate cancer

Soh

Delaunay

Thoulouzan

et al. 2013

Basic Clin. Androl.

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Background and purposeTo analyze erectile function in men treated by prostate brachytherapy (PB) for localized prostate cancer.Material and methodsOf a series of 270 sexually active men treated by PB, 241 (89%), mean age 65 yr (range, 43–80 yr), participated in a study on erectile function that was evaluated using the International Index of Erectile Function 5-item (IIEF-5) questionnaire before implantation and by postal survey after a mean follow-up of 36 months (range, 6–70 months).ResultsAfter PB, 27 patients (11%) had no erectile dysfunction (ED), 36 (15%) had mild ED, 58 (24%) had mild to moderate ED, 24 (10%) had moderate ED, 53 (22%) had severe ED and 43 (18%) were not sexually active. In patients with a preimplant IIEF score >12 (cut-off for intercourse with penetration), 73% had a deterioration of erectile function by at least one class after PB. Risk factors for ED after PB were age, preimplant IIEF score and prostate volume. Median time to ED onset was 16 months and was shorter with androgen deprivation (p = 0.007), diabetes (p = 0.03) and age over 55 (p = 0.01).ConclusionsFollowing PB, the majority of patients progressively develop or major ED after a free interval that may last several months.SupportLigue Nationale contre le Cancer, France

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Erectile Function Durability Following Permanent Prostate Brachytherapy

Cited by 55 publications

References 31 publications

Impact of post-implant dosimetric parameters on the quality of life of patients treated with low-dose rate brachytherapy for localised prostate cancer: results of a single-institution study

Impact of post-implant dosimetric parameters on the quality of life of patients treated with low-dose rate brachytherapy for localised prostate cancer: results of a single-institution study

CaV3.2 T-type Calcium Channels Are Involved in Calcium-dependent Secretion of Neuroendocrine Prostate Cancer Cells

Erectile function after permanent 125I prostate brachytherapy for localized prostate cancer

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