Potency following high-dose three-dimensional conformal radiotherapy and the impact of prior major urologic surgical procedures in patients treated for prostate cancer

• Published in: International journal of radiation oncology, biology, physics Vol. 33; no. 1; pp. 15 - 22
• Main Authors: Chinn, Daniel M., Holland, John, Crownover, Richard L., Roach, Mack
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 30.08.1995; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Conformal radiation therapy; Diseases of the urinary system; Follow-Up Studies; Humans; Impotence; Male; Medical sciences; Middle Aged; Penile Erection - radiation effects; Postoperative Complications; Potency; Prostate cancer; Prostatectomy - adverse effects; Prostatic Neoplasms - radiotherapy; Prostatic Neoplasms - surgery; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Sexual dysfunction; Transurethral prostatectomy; Potency; Conformal radiation therapy; Impotence; Prostate cancer; Transurethral prostatectomy; Sexual dysfunction; Human; Postoperative; Urinary system disease; Erection disorders; Prostate disease; Male; Malignant tumor; Radiotherapy; Treatment; Surgery; Secondary effect; Prostatectomy; Male genital diseases; High dose; Treatment planning; Prostate; Comparative study
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/0360-3016(95)97508-X

To assess the impact of high-dose three-dimensional conformal radiotherapy (3DCRT) on potency in patients treated for clinically localized prostate cancer and to identify factors that might predict the outcome of sexual function following treatment. One hundred twenty-four consecutive patients treated with 3DCRT for localized prostate cancer at UCSF between 1991-1993 were included in this retrospective analysis. Patient responses were obtained from a mailed questionnaire, telephone interviews, or departmental records. Medial follow-up was 21 months. Sixty patients reported having sexual function prior to 3DCRT, including 47 who were fully potent and 13 who were marginally potent. Of the remaining 64 patients, 45 were impotent, 7 were on hormones, 1 was status-postorchiectomy, and 11 were not evaluable. Following 3DCRT, 37 of 60 patients (62%) retained sexual function sufficient for intercourse. Of those with sexual function before irradiation, 33 of 47 (70%) of patients fully potent and 4 of 13 (31%) of patients marginally potent maintained function sufficient for intercourse (p < 0.01). Potency was retained in 6 of 15 (40%) patients with a history of a major urologic surgical procedure (MUSP) and in 31 of 45 (69%) with no history of a MUSP (p < 0.04). Transurethral resection of the prostate was the MUSP in eight of these patients, with four (50%) maintaining sexual function. Patients who receive definitive 3DCRT for localized prostate cancer appear to maintain potency similar to patients treated with conventional radiotherapy. However, patients who are marginally potent at presentation or who have a history of a MUSP appear to be at increased risk of impotence following 3DCRT.