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

Putora, Paul Martin; Engeler, Daniel S.; Haile, Sarah R.; Graf, Nicole; Buchauer, Konrad; Schmid, Hans‐Peter; Plaßwilm, Ludwig

doi:10.1007/s00066-015-0928-x

Cited by 17 publications

(12 citation statements)

References 46 publications

(28 reference statements)

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“…A clear deterioration was found in erectile function with an IIEF‐5 score short‐term decrease after 6 weeks in all groups, as well as a long‐term reduction compared to baseline. These results are in accordance with the literature .…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Long‐term oncological and functional follow‐up in low‐dose‐rate brachytherapy for prostate cancer: results from the prospective nationwide Swiss registry

et al. 2020

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P.V. and P.M.P. are sharing first authorship. ObjectiveTo evaluate the long-term oncological, functional and toxicity outcomes of low-dose-rate brachytherapy (LDR-BT) in relation to risk factors and radiation dose in a prospective multicentre cohort. ConclusionOur results are in line with other studies showing that LDR-BT is associated with good oncological outcomes together with good functional results.

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Section: Discussionsupporting

confidence: 93%

“…The temporal pattern was very similar in the three groups of patients, so that erectile function before implantation strongly influenced the outcome (Fig. B), as reported elsewhere .…”

Section: Resultssupporting

confidence: 82%

Long‐term oncological and functional follow‐up in low‐dose‐rate brachytherapy for prostate cancer: results from the prospective nationwide Swiss registry

et al. 2020

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“…For other outcome domains of interest, such as sexual functioning and well-being [28, 29] there are not enough data available yet.…”

Section: Moderate Hypofractionationmentioning

confidence: 99%

Hypofractionated radiotherapy for localized prostate cancer

Höcht¹,

Aebersold

Albrecht

et al. 2016

Strahlenther Onkol

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AimThis article gives an overview on the current status of hypofractionated radiotherapy in the treatment of prostate cancer with a special focus on the applicability in routine use.MethodsBased on a recently published systematic review the German Society of Radiation Oncology (DEGRO) expert panel added additional information that has become available since then and assessed the validity of the information on outcome parameters especially with respect to long-term toxicity and long-term disease control.ResultsSeveral large-scale trials on moderate hypofractionation with single doses from 2.4–3.4 Gy have recently finished recruiting or have published first results suggestive of equivalent outcomes although there might be a trend for increased short-term and possibly even long-term toxicity. Large phase 3 trials on extreme hypofractionation with single doses above 4.0 Gy are lacking and only very few prospective trials have follow-up periods covering more than just 2–3 years.ConclusionUntil the results on long-term follow-up of several well-designed phase 3 trials become available, moderate hypofractionation should not be used in routine practice without special precautions and without adherence to the highest quality standards and evidence-based dose fractionation regimens. Extreme hypofractionation should be restricted to prospective clinical trials.

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“…Additionally, they are very heterogeneous, which makes it difficult to compare. Indeed, the populations are not comparable; some studies included patients with high-grade CaP non eligible for BT treatment [7,10,15], and others included patients with preoperative ED [16,17] or high percentage of preoperative HT [7]. The methods of treatment were also heterogeneous, with different BT techniques [15,18], dissimilar questionnaires validated or not [17], and adjuvant treatment sometimes not mentioned.…”

Section: Discussionmentioning

confidence: 99%

“…We used the IIEF-5, which is a validated, simple, and reproducible questionnaire, recommended as the best tool to assess ED after radiation therapy for CaP [5]. This questionnaire has been already employed in other studies, but with several inclusion bias such as preoperative ED patients not excluded [16], low number of patients [19], or IIEF-5 not used for all patients [10]. For our study, we selected patients with an IIEF-5 score > 16 to avoid a bias due to preoperative ED.…”

Section: Discussionmentioning

confidence: 99%

Prospective four years of evaluation of erectile function after low-dose-rate prostate brachytherapy using baseline IIEF-5 > 16

Schoentgen

Marolleau²,

Delage

et al. 2019

jcb

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Purpose Prostate brachytherapy (BT) is a validated treatment for localized prostate cancer (CaP) and an attractive therapy option for patients seeking to preserve erectile function (EF). The aim of this paper is to prospectively assess EF evolution during 4 years after BT. Material and methods Between February 2007 and July 2012, 179 patients underwent an exclusive Iodine-125 BT, for low-intermediate favorable risk CaP of whom, 102 had an initial international index of erectile function 5 score (IIEF-5) > 16 and were included in the study. Of those, 12.7% received neo-adjuvant hormonotherapy (HT) to decrease the prostate volume. Post-BT intake of phosphodiesterase inhibitors (PDE5i) was not an exclusion criterion. Erectile function was prospectively assessed using a validated questionnaire IIEF-5 before treatment and annually for 4 years. Results At 1-year follow-up, 54% of patients preserved an IIEF-5 > 16 and only 8% suffered from severe ED. During the next 3 years, the results were not statistically different. The mean IIEF-5 lost 4 points during the first year, 17 vs. 21, and remained stable during the following 3 years. We did not find any significant differences in the proportion of patients treated by PDE5i (18-20%). As for patients with a normal preoperative IIEF-5 (> 21) ( n = 52), 35-42% preserved a normal EF and 71-77% maintained an IIEF-5 > 16, including 13-19% of patients who needed PDE5i. Those results were stable for over 4 years. Conclusions During the first 4 years after BT, more than half of patients maintained an IIEF-5 > 16, and EF results remained stable. Severe erectile dysfunction (ED) was very rare.

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

Abstract: 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.

Cited by 17 publications

References 46 publications

Long‐term oncological and functional follow‐up in low‐dose‐rate brachytherapy for prostate cancer: results from the prospective nationwide Swiss registry

Long‐term oncological and functional follow‐up in low‐dose‐rate brachytherapy for prostate cancer: results from the prospective nationwide Swiss registry

Hypofractionated radiotherapy for localized prostate cancer

Prospective four years of evaluation of erectile function after low-dose-rate prostate brachytherapy using baseline IIEF-5 > 16

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