University of Colorado School of Medicine, Aurora, CO, USA.
Department of Biostatistics and Bioinformatics, Duke School of Medicine, Durham, NC, USA.
Prostate Cancer Prostatic Dis. 2021 Mar;24(1):128-134. doi: 10.1038/s41391-020-0247-x. Epub 2020 Jul 9.
Erectile dysfunction (ED) is a prevalent side effect of prostate cancer treatment. We hypothesized that the previously reported rates of ED may have improved with the advent of modern technology. The purpose of this project was to evaluate modern external beam radiotherapy and brachytherapy techniques to determine the incidence of radiotherapy (RT) induced ED.
A systematic review of the literature published between January 2002 and December 2018 was performed to obtain patient reported rates of ED after definitive external beam radiotherapy, ultrafractionated stereotactic radiotherapy, and brachytherapy (BT) to the prostate in men who were potent prior to RT. Univariate and multivariate analyses of radiation dose, treatment strategy, and length of follow-up were analyzed to ascertain their relationship with RT-induced ED.
Of 890 articles reviewed, 24 met inclusion criteria, providing data from 2714 patients. Diminished erectile function status post RT was common and similar across all studies. The median increase in men reporting ED was 17%, 26%, 23%, and 23%, 3DCRT, IMRT, low dose rate BT, and SBRT, respectively, at 2-year median follow-up.
ED is a common side effect of RT. Risk of post-RT ED is similar for both LDR brachytherapy and external beam RT with advanced prostate targeting and penile-bulb sparing techniques utilized in modern RT techniques.
勃起功能障碍（ED）是前列腺癌治疗的常见副作用。我们假设，随着现代技术的出现，以前报告的 ED 发生率可能已经有所改善。本项目的目的是评估现代外束放射治疗和近距离放射治疗技术，以确定放射治疗（RT）引起的 ED 发生率。
对 2002 年 1 月至 2018 年 12 月期间发表的文献进行系统回顾，以获得在 RT 前有能力的男性中接受根治性外束放疗、超分割立体定向放疗和前列腺近距离放疗后报告的 ED 发生率。对放射剂量、治疗策略和随访时间的单变量和多变量分析，以确定它们与 RT 引起的 ED 的关系。
在 890 篇综述文章中，有 24 篇符合纳入标准，提供了 2714 名患者的数据。在所有研究中，RT 后勃起功能障碍的状态都很常见且相似。在中位随访 2 年时，报告 ED 的男性中，3DCRT、IMRT、低剂量率 BT 和 SBRT 分别有 17%、26%、23%和 23%的男性报告 ED 增加。
ED 是 RT 的常见副作用。在现代 RT 技术中使用先进的前列腺靶向和阴茎球部保护技术时，LDR 近距离放疗和外束 RT 后发生 ED 的风险相似。
