Does hormonal therapy influence sexual function in men receiving 3D conformal radiation therapy for prostate cancer?
OBJECTIVE
We evaluated the effect of three-dimensional conformal radiation therapy (3D-CRT) with or without hormonal therapy (HT) on sexual function (SF) in prostate cancer patients whose SF was known before all treatment.


METHODS
Between March 1996 and March 1999, 144 patients received 3D-CRT (median dose = 70.2 Gy, range 66.6-79.2 Gy) for prostate cancer and had pre- and post-therapy SF data. All SF data were obtained with the O'Leary Brief SF Inventory, a self-administered, multidimensional, validated instrument. We defined total sexual potency as erections firm enough for penetration during intercourse. Mean follow-up time was 21 months (SD +/- 11 months). The Wilcoxon signed-rank test was used to test for significance of the change from baseline.


RESULTS
Before 3D-CRT, 87 (60%) of 144 men were totally potent as compared to only 47 (47%) of 101 at 1-year follow-up. Of the 60 men totally potent at baseline and followed for at least 1 year, 35 (58%) remained totally potent. These changes corresponded to a significant reduction in SF (p < 0.05). Patients who had 3D-CRT alone were more likely to be totally potent at 1 year than those receiving 3D-CRT with HT (56% vs. 31%, p = 0.012); however, they were also more likely to be potent at baseline (71% vs. 44%, p = 0.001). Although these two groups had a significant reduction in SF from baseline, their change was not significantly different from each other.


CONCLUSIONS
These data indicate that 3D-CRT causes a significant reduction in total sexual potency as compared to pretreatment baseline. The addition of HT does not appear to increase the risk of sexual dysfunction.
Chen
C T
CT
Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107-5097, USA.
Valicenti
R K
RK
Lu
J
J
Derose
T
T
Dicker
A P
AP
Strup
S E
SE
Mulholland
S G
SG
Hirsch
I H
IH
McGinnis
D E
DE
Gomella
L G
LG
D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D007172:Erectile Dysfunction / Q000139:chemically induced / Q000209:etiology*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008297:Male; D020360:Neoadjuvant Therapy; D010410:Penile Erection / Q000187:drug effects* / Q000528:radiation effects*; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D011795:Surveys and Questionnaires
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D007987:Gonadotropin-Releasing Hormone