Department of Urology, Nara Medical University, Nara, Japan.
Department of Radiation Oncology, Nara Medical University, Nara, Japan.
Andrologia. 2022 Feb;54(1):e14288. doi: 10.1111/and.14288. Epub 2021 Oct 24.
This study evaluated erectile function and sexual quality of life (QoL), and predictive factors for erectile dysfunction (ED) and the deterioration of sexual QoL in 70 patients who underwent low-dose-rate brachytherapy (LDR-BT) alone for prostate cancer without androgen deprivation therapy. Erectile function and sexual QoL were evaluated before and 1, 3, 6, 12, 24, 36, 48 and 60 months after LDR-BT. Binary logistic regression analysis was used to determine whether age, prostate volume, hypertension, diabetes, Brinkman's index, testosterone, baseline Sexual Health Inventory for Men (SHIM) score and post-implant dosimetry parameters could predict ED and deterioration of sexual QoL at 24 and 60 months after LDR-BT. After 24 and 60 months, ED was noted in 39 of 70 patients and 42 of 64 patients respectively. Furthermore, sexual QoL worsened in 42 of 70 and 43 of 64 patients respectively. Baseline SHIM score was identified as a significant predictor of ED (24 months: odds ratio [OR]: 0.83, p = 0.02; 60 months: OR: 0.83, p = 0.03) and the deterioration of sexual QoL (24 months: OR: 0.84, p = 0.03). LDR-BT for prostate cancer promoted decreased erectile function and sexual QoL, with high preimplant potency being a significant predictor of ED and the deterioration of sexual QoL.
本研究评估了 70 例接受低剂量率近距离放射治疗（LDR-BT）治疗前列腺癌而未接受雄激素剥夺治疗的患者的勃起功能和生活质量（QoL），以及勃起功能障碍（ED）和性 QoL 恶化的预测因素。在 LDR-BT 前、1、3、6、12、24、36、48 和 60 个月后，评估了勃起功能和性 QoL。采用二元逻辑回归分析来确定年龄、前列腺体积、高血压、糖尿病、布林克曼指数、睾酮、基线男性性健康问卷（SHIM）评分和植入后剂量学参数是否可以预测 LDR-BT 后 24 和 60 个月的 ED 和性 QoL 恶化。在 24 和 60 个月后，70 例患者中有 39 例和 64 例患者中有 42 例发生 ED。此外，70 例患者中有 42 例和 64 例患者中有 43 例性 QoL 恶化。基线 SHIM 评分是 ED 的显著预测因子（24 个月：优势比 [OR]：0.83，p=0.02；60 个月：OR：0.83，p=0.03）和性 QoL 恶化的预测因子（24 个月：OR：0.84，p=0.03）。前列腺癌的 LDR-BT 可降低勃起功能和性 QoL，高植入前勃起功能是 ED 和性 QoL 恶化的显著预测因子。
