Patient-reported sexual toxicity after radiation therapy in long-term prostate cancer survivors.

BACKGROUND - To present an overview of patient-reported sexual toxicity in sexually active long-term prostate cancer survivors treated with radiation therapy.

METHODS - We used patient-reported outcomes from a study-specific questionnaire surveying symptoms after prostate cancer radiation therapy. Data from 518 men treated at the Sahlgrenska University Hospital in Sweden from 1993 to 2006 were analysed. The men had undergone primary or salvage external beam radiation therapy (EBRT) or EBRT combined with high-dose rate brachytherapy (BT). We also used information from 155 non-treated reference men from the general population with no history of prostate cancer, matched for age and residency.

RESULTS - Median time from treatment to follow-up was 5 years (range: 1-14 years). Among the 16 investigated symptoms on erectile function, libido, orgasm, and seminal fluid, 9 symptoms in the primary EBRT group and 10 in both the salvage EBRT and the EBRT+BT groups were statistically significantly more prevalent in survivors than in reference men. Erectile dysfunction was influenced by both age and time to follow-up, whereas symptoms relating to orgasm and seminal fluid were influenced by time to follow-up only. Not being sexually active was almost one and a half times as common in survivors as in reference men.

CONCLUSIONS - The presented symptom profiles can help to develop personalized therapy for prostate cancer through a better understanding of which radiation-induced toxicities to be addressed in the clinic and can also assist in identifying suitable interventions for existing symptoms.British Journal of Cancer advance online publication 4 August 2015. doi:10.1038/bjc.2015.275 www.bjcancer.com.

Br J Cancer. 2015 Aug 4. doi: 10.1038/bjc.2015.275. [Epub ahead of print]

Olsson CE1, Alsadius D2, Pettersson N3, Tucker SL4, Wilderäng U2, Johansson KA3, Steineck G5.

1 1] Regional Cancer Centre West, Region Västra Götaland, Gothenburg, Sweden [2] Department of Radiation Physics, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
2 Division of Clinical Cancer Epidemiology, Department of Oncology, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
3 Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden.
4 Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
5 1] Division of Clinical Cancer Epidemiology, Department of Oncology, The Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden [2] Division of Clinical Cancer Epidemiology, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.