Erectile dysfunction after external beam radiotherapy for prostate cancer.

Area of Science:

• Oncology
• Urology
• Radiotherapy

Background:

• Prospective studies on sexual quality of life after conformal radiotherapy for prostate cancer are limited.
• Conformal radiotherapy (RT) is a common treatment for prostate cancer, but its impact on sexual function requires further investigation.

Purpose of the Study:

• To evaluate the incidence and progression of erectile dysfunction (ED) in prostate cancer patients following conformal radiotherapy (RT).
• To identify predictive factors for ED before and after RT.

Main Methods:

• 123 prostate cancer patients completed the Expanded Prostate Cancer Index Composite (EPIC) questionnaire before and over 1 year after RT.
• Patients had not received antiandrogen treatment; RT dose was 70.2-72 Gy.
• Multivariate analysis assessed risk factors including age, comorbidities, and phosphodiesterase-5 (PDE-5) inhibitor use for ED.

Main Results:

• Sexual function and bother scores declined by the end of RT and continued to decrease.
• Erectile ability was preserved in 70% and sufficient erections for intercourse in 53% at 16 months post-RT.
• Higher patient age and diabetes predicted pre-existing and post-RT ED; nightly erections before RT were prognostically favorable.

Conclusions:

• Erectile dysfunction incidence progressively increases after conformal radiotherapy for prostate cancer.
• Patient age and diabetes are significant risk factors for ED, both before and after RT.
• Pre-treatment erectile function, specifically nightly erections, is a favorable prognostic indicator for sexual function post-RT.