In a nutshell
This study compared the side effects of external beam radiation therapy (EBRT) and hypofractioned EBRT (H-EBRT) on erectile and sexual function. Researchers reported similar effects of EBRT and H-EBRT on erectile and sexual function up to 3 years after treatment.
Radiation therapy is a common treatment for localized (confined) prostate cancer. External beam radiation therapy (EBRT) involves directing high-energy rays from outside the body at the tumor site to kill cancer cells. EBRT is associated with effective cancer control. Increasing evidence is suggesting that hypofractioned EBRT (H-EBRT) can achieve similar results. H-EBRT involves giving larger doses of radiation per treatment, reducing the number of total treatments. Fewer treatments are generally more convenient for the patient and can decrease health care costs. A common side effect of radiation therapy is erectile dysfunction. However, the impact of H-EBRT on sexual and erectile function has not been fully studied.
Methods & findings
The aim of this study was to compare the effects of EBRT and H-EBRT on sexual and erectile function.
820 men with intermediate- to high-risk localized prostate cancer were included in this study. Men were randomly assigned to either EBRT (78 Gy in 39 fractions of 2 Gy over 8 weeks) or H-EBRT (64.6 Gy in 19 fractions of 3.4 Gy over 6.5 weeks). 39% of men were undergoing hormone therapy at the same time. A questionnaire measured sexual function before treatment and at 6, 12, 24, and 36 months.
33 patients were prescribed medication for erectile dysfunction (such as Cialis or Viagra). Of these 14 men were undergoing H-EBRT and 19 were undergoing EBRT.
On average, erectile function decreased over time with both EBRT and H-EBRT. No significant differences were observed between radiation treatments. Orgasmic function, intercourse satisfaction, and overall satisfaction all decreased similarly in both groups. Sexual desire remained the same before and after treatment.
Men undergoing H-EBRT without additional hormone therapy had significantly better orgasmic function 3 years after treatment compared to men undergoing EBRT without hormone therapy.
Overall, 14.6% of men had partial or full erectile function before treatment. Of these, 34.4% developed severe erectile dysfunction following H-EBRT. This was comparable to 39.3% of men following EBRT. Approximately one third of all patients with full erectile function before treatment retained this ability at 3 years, regardless of radiation treatment received.
The bottom line
Researchers concluded that EBRT and H-EBRT have a similar effect on erectile function up to 3 years after treatment. An advantage in orgasmic function was observed among men undergoing H-EBRT without additional hormone therapy.
Published By :
The journal of sexual medicine
Sep 21, 2016
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