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Alterations of Sexual and Erectile Functions after Brachytherapy for Prostate Cancer Based on Patient-Reported
László Gesztesi1, Zsuzsa S Kocsis2, Kliton Jorgo1,3
1National Institute of Oncology, Centre of Radiotherapy, Budapest, Hungary.
Prostate Cancer
|February 5, 2024
Summary
High-dose-rate brachytherapy (HDRBT) offers better sexual function recovery than low-dose-rate brachytherapy (LDRBT) for localized prostate cancer patients. HDRBT showed lasting sexual function improvements in hormone-naive patients, unlike LDRBT.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Brachytherapy is a common treatment for localized prostate cancer.
- Both high-dose-rate brachytherapy (HDRBT) and low-dose-rate brachytherapy (LDRBT) are utilized.
- Sexual side effects significantly impact patient quality of life post-treatment.
Purpose of the Study:
- To compare the side effects of HDRBT versus LDRBT on sexual function and well-being.
- To evaluate patient-reported outcomes in localized prostate cancer treated with HDRBT or LDRBT.
- To assess the impact of hormone therapy status on sexual function outcomes following brachytherapy.
Main Methods:
- Prospective study (PROMOBRA) comparing mono LDR (145 Gy) and mono HDR (19/21 Gy) brachytherapy.
- 123 patients received LDRBT, and 117 patients received HDRBT for localized low-risk/low-intermediate-risk prostate cancer.
- Patient-reported outcome measurement (PROM) questionnaires (EORTC QLQ-PR-25, IIEF, IIEF-5) were administered pre-treatment and at multiple follow-up points up to 2 years.
Main Results:
- In hormone-naive patients, LDRBT led to significant, lasting decreases in erectile function, orgasm, sexual desire, and satisfaction.
- HDRBT in hormone-naive patients resulted in transient decreases in sexual function, with recovery observed.
- Hormone-receiving patients showed better orgasm function and sexual desire with HDRBT compared to LDRBT at multiple time points.
Conclusions:
- Both HDRBT and LDRBT are safe for localized prostate cancer treatment.
- HDRBT demonstrates a more advantageous profile for preserving sexual function in hormone-naive patients compared to LDRBT.
- HDRBT may offer superior sexual function outcomes, particularly in hormone-naive prostate cancer patients.
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