Erectile function preservation after radiotherapy using a dose-optimization approach on sexual structures for...

Area of Science:

• Oncology
• Radiation Oncology
• Urology

Background:

• Erectile function is crucial for quality of life in prostate cancer patients.
• Radiotherapy for prostate cancer can lead to erectile dysfunction.
• Preserving sexual health is a key treatment goal.

Purpose of the Study:

• To evaluate a dose-optimization strategy targeting sexual structures to minimize erectile dysfunction post-radiotherapy.
• To assess the impact of this approach on erectile function in localized prostate cancer patients.

Main Methods:

• Twenty-three men with localized prostate cancer and no baseline erectile dysfunction were enrolled.
• Patients received 76-78Gy radiation dose with dose optimization on internal pudendal arteries (IPA), penile bulb, and corpus cavernosum.
• Erectile function was assessed using the International Index of Erectile Function (IIEF-5) score for 2 years post-radiotherapy.

Main Results:

• At 2 years post-radiotherapy, 67% of patients had no erectile dysfunction, 11% mild, and 22% severe.
• No significant differences in erectile function were observed based on dosimetric values, age, comorbidity, or smoking status.
• Biochemical-relapse-free survival was 100% at 2 years.

Conclusions:

• Dose-optimization on sexual structures is effective in preserving erectile function after radiotherapy for localized prostate cancer.
• This approach achieved excellent outcomes, with 78% of patients experiencing no or mild erectile dysfunction at 2 years.
• The strategy supports improved quality of life for treated patients.