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2015 ; 10
(ä): 182
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Sexual, irritative, and voiding outcomes, following stereotactic body radiation
therapy for prostate cancer
#MMPMID26310244
Rana Z
; Hong RL
; Abugideiri M
; McRae D
; Cernica G
; Mordkin R
; Joel AB
; Bernstein G
; Nasr NM
Radiat Oncol
2015[Aug]; 10
(ä): 182
PMID26310244
show ga
BACKGROUND: Urinary symptoms and sexual dysfunction are the two most common
complaints following prostate radiotherapy. The impact of hypofractionated
treatment on sexual function, irritative symptoms, and voiding symptoms has not
been determined within the same patient population. Here we present our
institutional data on sexual function, voiding function, irritative symptoms, and
treatment response following SBRT. METHODS: This retrospective analysis includes
102 non-metastatic patients treated with SBRT at a single institution between May
2008 and September 2014. The course of radiotherapy consisted of 36.25 Gy (range
35-40) over five daily fractions. International Prostate Symptom Score (IPSS),
Sexual Health Inventory for Men (SHIM), and PSA were recorded at baseline, 1, 3,
6, 9, 12, 18, 24, and 36 months after treatment. RESULTS: Median patient age was
72 years old with a median follow-up of 4.3 years. Pretreatment IPSS-I score was
5.21, increasing to 6.97 (p?.001) after 1 month. The mean IPSS-I score returned
close to baseline after 3 months to 5.86 and decreased to below baseline after 2
years to 5.09. At 3 months, 9 months, and 2 years, 47.5, 76.2, and 91.1% of
patients had reached IPSS-I resolution. The mean IPSS-O score prior to treatment
was 5.31 and there was an increase in the score to 6.45 (p?=?0.344) at 1 month.
The score remained close to baseline and decreased to 4.00 at 2 years and
significantly decreased to 3.74 (p?=?0.035) at 3 years. 64.4, 82.1, and 96.0% of
patients had IPSS-O resolution by 3 months, 9 months, and 2 years. The mean SHIM
score prior to treatment was 13.52 and continually decreased to below baseline a
year after treatment to 10.56 (p?.001). SHIM score began to improve at 18
months, but was still significantly less than baseline at 12.12 (p?=?.01).
CONCLUSIONS: While an increase in AUA/IPSS score initially occurred, all patients
resume normal activities immediately following treatment and the AUA/IPSS
symptoms improved from baseline. Irittative symptoms take longer to resolve when
compared to obstructive voiding symptoms in patients treated with SBRT. Three
year PSA response, reported toxicity, erectile function preservation, and urinary
function improvement, shows favorable results.