Patient-reported sexual toxicity after radiation therapy in long-term prostate cancer survivors

Olsson, Caroline; Alsadius, David; Pettersson, Niclas; Tucker, Susan L.; Wilderäng, Ulrica; Johansson, Karl-Axel; Steineck, Gunnar

doi:10.1038/bjc.2015.275

Cited by 20 publications

(7 citation statements)

References 22 publications

(46 reference statements)

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“…Toxicity was evaluated at baseline, 1, and 6 months post-operatively, and every 6 months thereafter. It was impossible to evaluate erectile dysfunction (ED) for all 12 patients because of incomplete ED status at the time of salvage brachytherapy, although sexual toxicity is often evaluated after radiation therapy [ 10 ], and such evaluation is important for re-irradiation studies.…”

Section: Methodsmentioning

confidence: 99%

Focal partial salvage low-dose-rate brachytherapy for local recurrent prostate cancer after permanent prostate brachytherapy with a review of the literature

Kunogi¹,

Wakumoto²,

Yamaguchi³

et al. 2016

jcb

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PurposeTo investigate the treatment results for focal partial salvage re-implantation against local recurrence after permanent prostate brachytherapy.Material and methodsBetween January 2010 and September 2015, 12 patients were treated with focal partial salvage re-implantation for local recurrence after low-dose-rate brachytherapy using 125I seeds. The focal clinical target volume (F-CTV) was delineated on positive biopsy areas in a mapping biopsy, combining the cold spots on the post-implant dosimetry for initial brachytherapy. The F-CTV was expanded by 3 mm to create the planning target volume (PTV) as a margin to compensate for uncertainties in image registration and treatment delivery. The prescribed dose to the PTV was 145 Gy. The characteristics and biochemical disease-free survival (BdFS) rates were analyzed. Genitourinary (GU) and gastrointestinal (GI) toxicities were evaluated using the Common Terminology Criteria for Adverse Events version 4.ResultsThe median prostate-specific antigen (PSA) level at re-implantation was 4.09 ng/ml (range: 2.91-8.24 ng/ml). The median follow-up time was 56 months (range: 6-74 months). The median RD2cc and UD10 were 63 Gy and 159 Gy, respectively. The 4-year BdFS rate was 78%, which included non-responders. Biochemical recurrence occurred in two patients after 7 and 31 months, respectively. The former was treated with hormonal therapy after biochemical failure, and the latter underwent watchful waiting (PSA at the last follow-up of 53 months: 7.3 ng/ml) at the patient's request. No patients had grade 3 GU/GI toxicities or died after salvage re-implantation.ConclusionsThe partial salvage low-dose-rate brachytherapy used to treat local recurrence after permanent prostate brachytherapy is well-tolerated, with high biochemical response rates. This treatment can be not only a method to delay chemical castration but also a curative treatment option in cases of local recurrence of prostate carcinoma after seed implantation.

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Section: Methodsmentioning

confidence: 99%

Focal partial salvage low-dose-rate brachytherapy for local recurrent prostate cancer after permanent prostate brachytherapy with a review of the literature

Kunogi¹,

Wakumoto²,

Yamaguchi³

et al. 2016

jcb

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“…In collaboration with a Swedish company, Health Navigator, that specializes in health care management and new innovative care solutions, an interactive app (Interaktor), for smartphones and tablet computers has been developed. The theoretical underpinning in the developmental process was person-centered care [ 24 ]. In person-centered care, the importance of integrating the patients’ perspective in the care process and attaining interaction between the patient and the care provider is emphasized.…”

Section: Introductionmentioning

confidence: 99%

Adherence to Report and Patient Perception of an Interactive App for Managing Symptoms During Radiotherapy for Prostate Cancer: Descriptive Study of Logged and Interview Data

Langius‐Eklöf¹,

Christiansen²,

Lindström³

et al. 2017

JMIR Cancer

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BackgroundPatients undergoing radiotherapy for prostate cancer experience symptoms related to both the cancer itself and its treatment, and it is evident that patients with prostate cancer have unmet supportive care needs related to their disease. Over the past decade, there has been an increase in the amount of research within the field of mobile health and the use of apps as tools for managing illness. The main challenge is to develop a mobile technology to its full potential of being interactive in real time. The interactive app Interaktor, which aims to identify and manage symptoms in real time includes (1) a function for patients’ assessment of the occurrence, frequency, and distress of symptoms; (2) a connection to a monitoring Web interface; (3) a risk assessment model that sends alerts via text message to health care providers; (4) continuous access to evidence-based self-care advice and links to relevant websites for more information; and (5) graphs for the patients and health care providers to view the history of symptom reporting.ObjectiveThe aim of the study was to investigate user behavior, adherence to reporting, and the patients’ experiences of using Interaktor during radiotherapy for localized advanced prostate cancer.MethodsThe patients were instructed to report daily during the time of treatment and then for an additional 3 weeks. Logged data from patients’ use of the app were analyzed with descriptive statistics. Interview data about experiences of using the app were analyzed with content analysis.ResultsA total of 66 patients participated in the study. Logged data showed that adherence to daily reporting of symptoms was high (87%). The patients used all the symptoms included in the app. Of the reports, 15.6% generated alerts to the health care providers. Overall, the patients found that it was easy and not particularly time-consuming to send a daily report, and many described it as becoming a routine. Reporting symptoms facilitated reflection on their symptoms and gave them a sense of security. Few technological problems were reported.ConclusionsThe use of Interaktor increased patients’ sense of security and their reflections on their own well-being and thereby served as a supportive tool for the self-management of symptoms during treatment of prostate cancer. Some further development of the app’s content might be beneficial for future use.

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“…An overview of our methodological approach is illustrated in Figure . Information on the investigated three cohorts and the study‐specific questionnaire is summarized below; details on the complete study population and information about the development/validation of the questionnaire can be found in [9–11].…”

Section: Methods and Main Outcome Measuresmentioning

confidence: 99%

Radiation Dose to the Penile Structures and Patient-Reported Sexual Dysfunction in Long-Term Prostate Cancer Survivors

Thor

Olsson

et al. 2015

The Journal of Sexual Medicine

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Aim The involvement of various penile structures in radiotherapy (RT)-induced sexual dysfunction among prostate cancer survivors remains unclear and domains beyond erectile dysfunction such as orgasm, and pain have typically not been considered. The purpose of this study was to investigate sexual dysfunction post-RT for localized prostate cancer and to examine whether radiation dose to different penile structures can explain these symptoms. Methods We investigated sexual dysfunction in two treated prostate cancer cohorts and in one non-pelvic-irradiated cohort, 328 sexually active men part of an unselected, population-based study conducted in 2008. The treated subjects were prescribed primary/salvage external-beam RT to 70 Gy@2.0 Gy/fraction. Absorbed RT doses (Dmean and Dmax) of the corpora cavernosa (CC), the penile bulb (PB), and the total penile structure (CC + PB) were related to 13 patient-reported symptoms on sexual dysfunction by means of factor analysis (FA) and logistic regression. Results Three distinct symptom domains were identified across all cohorts: “erectile dysfunction” (ED, two to five symptoms), “orgasmic dysfunction” (OD, two to four symptoms), and “pain” (two to three symptoms). The strongest predictor for ED symptoms was CC + PB Dmax (P = 0.001–0.03), CC and PB Dmean predicted OD symptoms equally well (P = 0.03 and 0.02–0.05, respectively), and the strongest predictor for pain symptoms was CC + PB Dmean (P = 0.02–0.03). Conclusion Sexual dysfunction following RT was separated into three main domains with symptoms related to erectile dysfunction, orgasmic dysfunction, and pain. Chances for intact sexual functionality may be increased if dose to the total penile structure can be restricted for these domains in the planning of RT.

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Patient-reported sexual toxicity after radiation therapy in long-term prostate cancer survivors

Cited by 20 publications

References 22 publications

Focal partial salvage low-dose-rate brachytherapy for local recurrent prostate cancer after permanent prostate brachytherapy with a review of the literature

Focal partial salvage low-dose-rate brachytherapy for local recurrent prostate cancer after permanent prostate brachytherapy with a review of the literature

Adherence to Report and Patient Perception of an Interactive App for Managing Symptoms During Radiotherapy for Prostate Cancer: Descriptive Study of Logged and Interview Data

Radiation Dose to the Penile Structures and Patient-Reported Sexual Dysfunction in Long-Term Prostate Cancer Survivors

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