Vessel-sparing Radiotherapy for Localized Prostate Cancer to Preserve Erectile Function: A Single-arm Phase 2 Trial

Spratt, Daniel E.; Lee, Jae; Dess, Robert T.; Narayana, Vrinda; Evans, Cheryl; Liss, Adam L.; Winfield, Raymond J.; Schipper, Matthew J.; Lawrence, Theodore S.; McLaughlin, Patrick W.

doi:10.1016/j.eururo.2017.02.007

Cited by 58 publications

(40 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, only the penile bulb was identified as an avoidance structure in the present study. Radiation injury and erectile function is known to be complex , and vessel‐sparing techniques have been shown to provide promising results , but no effort was made to spare these structures in the present study. Further, while the present study included baseline sexual aid utilization, the impact of continued or new sexual aid use on erectile function was limited given the nature of EPIC‐26.…”

Section: Discussionmentioning

confidence: 99%

Erectile function after stereotactic body radiotherapy for localized prostate cancer

et al. 2017

Self Cite

View full text Add to dashboard Cite

ObjectiveTo elucidate the functional erection rate after prostate stereotactic body radiotherapy (SBRT) and to develop a comprehensive prognostic model of outcomes after treatment. Patients and MethodsBetween 2008 and 2013, 373 consecutive men with localized prostate cancer were treated with SBRT at a single academic institution as part of a prospective clinical trial or prospective registry. Prospective longitudinal patient-reported healthrelated quality of life (HRQoL) data was collected using the Expanded Prostate Cancer Index Composite (EPIC)-26 instrument. Functional erections were strictly defined as 'firm enough for intercourse' according to EPIC-26. Detailed comorbidity data were also collected. Logistic regression models were used to predict 24-and 60-month functional erection rates. Observed erection rates after SBRT were compared with those after other radiation therapies (external beam radiation therapy [EBRT] and brachytherapy) using prospectively validated models. ResultsThe median (interquartile range) follow-up was 56 (37-73) months and the response rate at 2 years was 84%. For those with functional erections at baseline, 57% and 45% retained function at 24 and 60 months, respectively. On multivariable analysis for 24-month erectile function, significant variables included higher baseline sexual HRQoL (adjusted odds ratio [aOR] 1.55 per 10 points, 95% confidence interval [CI] 1.37-1.74; P < 0.001) and older age (aOR 0.66 per 10 years, 95% CI 0.43-1.00; P = 0.05). At 60 months, baseline HRQoL and age remained associated with erectile function, along with body mass index (aOR 0.45, 95% CI 0.26-0.78; P < 0.001). The 24-and 60-month models had excellent discrimination (c-index 0.81 and 0.84, respectively). Erection rates after SBRT were not statistically different from model-predicted rates after EBRT or brachytherapy for the whole cohort and the cohort with baseline erectile function. ConclusionsIntermediate-to long-term post-SBRT erectile function results are promising and not significantly different from other radiotherapy techniques. Clinicians can use our prognostic model to counsel patients regarding expected erectile function after SBRT.

show abstract

Section: Discussionmentioning

confidence: 99%

Erectile function after stereotactic body radiotherapy for localized prostate cancer

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…Anxiety, depressed mode, wellbeing, and sense of meaningfulness for patients were no difference between prostatectomy and observation group ( Figure 4). Erection function and urination control were the main concerns for clinicians and patients [26][27][28] .…”

Section: Discussionmentioning

confidence: 99%

Do prostatectomy suitable for localized prostate cancer patient: evidence from meta-analysis

Luo¹,

Yi²,

Hu³

et al. 2019

Preprint

View full text Add to dashboard Cite

Objective:To evaluate the role of prostatectomy for localized prostate cancer patient. Methods: A systematic search was conducted using PubMed, and Web of Science through March 22, 2019 according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to identify studies reporting on prostatectomy for localized prostate cancer patient. Results: Of a total of 1827 studies, 6 were considered for evidence synthesis. A total of 4476 patients in 4 studies were included for survival analysis, 2,779 patients received prostatectomy and 1,697 patients were received no treatment but regularly followed up. Two other studies were included for adverse effects analysis. Prostatectomy displayed a significantly decreased risk of death of 35% compared with observation (OR=0.65, 95%CI 0.53-0.81, P<0.0001). Pooled data indicated prostatectomy reduced 55% risk of disease progression (OR=0.45, 95% CI 0.34-0.60, P<0.00001). Anxiety, depressed mode, wellbeing, and sense of meaningfulness for patients were no difference between prostatectomy and observation group. However, prostatectomy increased 2.77 folds risk of erection dysfunction (OR=2.77, 95% CI, 1.60–4.81, P=0.0003 Conclusion: Prostatectomy prolonged survival and deferred disease progression compared to observation for localized prostate cancer patients. Symptoms between two groups were not significant difference except for erection function. Patients should decide prostatectomy or not after balancing the survival benefit and erection dysfunction.

show abstract

“…Recently, the use of magnetic resonance imaging scans planned "vessel sparing" IMRT (most delivered with combined IMRT and brachytherapy) reported erections suitable for intercourse of 87% at 2 years for men potent at baseline, which was substantially better than predicted. 22 Several studies have looked at the association between penile bulb radiation dose and ED following external beam Sexual function improved with rectal spacer e13 RT. 23 In the Radiation Therapy Oncology Group 9406 trial, there was higher ED for those with penile bulb dose greater than the median (52.5 Gy).…”

Section: Discussionmentioning

confidence: 99%

Sexual quality of life following prostate intensity modulated radiation therapy (IMRT) with a rectal/prostate spacer: Secondary analysis of a phase 3 trial

Hamstra

Mariados

Sylvester

et al. 2018

Practical Radiation Oncology

View full text Add to dashboard Cite

show abstract

Vessel-sparing Radiotherapy for Localized Prostate Cancer to Preserve Erectile Function: A Single-arm Phase 2 Trial

Cited by 58 publications

References 43 publications

Erectile function after stereotactic body radiotherapy for localized prostate cancer

Erectile function after stereotactic body radiotherapy for localized prostate cancer

Do prostatectomy suitable for localized prostate cancer patient: evidence from meta-analysis

Sexual quality of life following prostate intensity modulated radiation therapy (IMRT) with a rectal/prostate spacer: Secondary analysis of a phase 3 trial

Contact Info

Product

Resources

About