Erectile function after brachytherapy with external beam radiation for prostate cancer

Area of Science:

• Oncology
• Radiation Oncology
• Urology

Background:

• Sexual potency is a critical factor influencing treatment decisions for prostate cancer patients.
• Understanding the impact of combined high-dose rate (HDR) brachytherapy and external beam radiation therapy (EBRT) on erectile function is essential.

Purpose of the Study:

• To assess erectile function following Iridium-192 HDR brachytherapy combined with EBRT for prostate cancer.
• To evaluate the efficacy of sildenafil in restoring sexual potency after this treatment regimen.

Main Methods:

• Forty-two patients with prostate cancer (T1c to T3bN0M0) received 22Gy HDR brachytherapy and 36.8Gy EBRT.
• Erectile function was measured using the International Index of Erectile Function questionnaire (IIEF-5) pre-treatment and at 3 and 12 months post-treatment.
• Potency was defined as an IIEF-5 score of 11 or higher.

Main Results:

• Mean IIEF-5 scores significantly decreased from pre-treatment (10.5) to 3 months (4.5) and 12 months (3.8) post-treatment (p < 0.001).
• Of 17 potent patients at baseline, 10 (58.8%) maintained potency at 12 months.
• In 10 patients treated with sildenafil, mean IIEF-5 scores improved from 6.2 at 3 months to 13.6 at 12 months (p < 0.001), with 80% recovery.

Conclusions:

• Combined HDR brachytherapy and EBRT can be performed with favorable outcomes for maintaining sexual potency in prostate cancer patients.
• Sildenafil demonstrates significant efficacy in restoring erectile function post-treatment.