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.
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.
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).
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.
Radiation oncology (London, England) 2015 Aug 28*** epublish ***
Zaker Rana, Robert L Hong, Mustafa Abugideiri, Donald McRae, George Cernica, Robert Mordkin, Andrew B Joel, Gregory Bernstein, Nadim M Nasr
Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA zhrana88@gmail com , Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA bobbyhong@gmail com , Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA musabu5@gmail com , Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA dmcrae@virginiahospitalcenter com , Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA gcernica@gmail com , Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA rmordkin@yahoo com , Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA abjoel@hotmail com , Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA, Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA