Pugh Thomas J, Mahmood Usama, Swanson David A, Munsell Mark F, Wang Run, Kudchadker Rajat J, Bruno Teresa L, Frank Steven J
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX.
Brachytherapy. 2015 Mar-Apr;14(2):160-5. doi: 10.1016/j.brachy.2014.08.045. Epub 2014 Sep 23.
To prospectively determine sexual function, bother, and potency preservation in men treated with prostate brachytherapy and twice-weekly tadalafil.
From 2005 to 2011, men treated with low-dose-rate prostate brachytherapy were treated on a prospective registration study. All patients were prescribed tadalafil 10mg twice weekly. The expanded prostate cancer index composite questionnaire was administered before treatment and at each followup. A subgroup analysis of men with sexual potency at baseline was performed.
A total of 237 men were analyzed. Median age was 64 years (range, 44-86). Median followup was 24.8 months (range, 1-60). At baseline, 175 men (74%) reported erections firm enough for sexual activity and 148 (62%) were potent (erections firm enough for intercourse). Statistically significant changes in sexual function/bother were appreciated from baseline throughout the analysis period, although absolute changes were relatively small and did not meet criteria for clinical significance. At 24-months followup, 72% reported erections firm enough for sexual activity and 56% were potent. Of men with potency at baseline, 89% had erections firm enough for sexual activity and 76% remained potent 24 months after treatment.
Peri-procedural tadalafil and prostate brachytherapy resulted in high rates of sexual potency preservation and no clinically significant effect on sexual quality of life.
前瞻性地确定接受前列腺近距离放射治疗并每周服用两次他达拉非的男性的性功能、困扰程度和性功能保留情况。
2005年至2011年，对接受低剂量率前列腺近距离放射治疗的男性进行前瞻性登记研究。所有患者均被处方每周两次服用10mg他达拉非。在治疗前及每次随访时均使用扩展前列腺癌指数综合问卷。对基线时具有性功能的男性进行亚组分析。
共分析了237名男性。中位年龄为64岁（范围44 - 86岁）。中位随访时间为24.8个月（范围1 - 60个月）。在基线时，175名男性（74%）报告勃起硬度足以进行性活动，148名（62%）有性功能（勃起硬度足以进行性交）。在整个分析期间，性功能/困扰程度与基线相比有统计学上的显著变化，尽管绝对变化相对较小且未达到临床意义标准。在24个月随访时，72%的患者报告勃起硬度足以进行性活动，56%有性功能。在基线时有性功能的男性中，89%的患者勃起硬度足以进行性活动，76%在治疗后24个月仍有性功能。
围手术期使用他达拉非和前列腺近距离放射治疗导致性功能保留率较高，且对性生活质量无临床显著影响。
