Radiation dose-volume effects and the penile bulb.
The dose, volume, and clinical outcome data for penile bulb are reviewed for patients treated with external-beam radiotherapy. Most, but not all, studies find an association between impotence and dosimetric parameters (e.g., threshold doses) and clinical factors (e.g., age, comorbid diseases). According to the data available, it is prudent to keep the mean dose to 95% of the penile bulb volume to <50 Gy. It may also be prudent to limit the D70 and D90 to 70 Gy and 50 Gy, respectively, but coverage of the planning target volume should not be compromised. It is acknowledged that the penile bulb may not be the critical component of the erectile apparatus, but it seems to be a surrogate for yet to be determined structure(s) critical for erectile function for at least some techniques.
Roach
Mack
M
Department of Radiation Oncology, University of California-San Francisco, San Francisco, CA 94143-1708, USA. mroach@radonc.ucsf.edu
Nam
Jiho
J
Gagliardi
Giovanna
G
El Naqa
Issam
I
Deasy
Joseph O
JO
Marks
Lawrence B
LB
D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008954:Models, Biological; D010410:Penile Erection / Q000528:radiation effects; D010413:Penis / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000528:radiation effects*; D011832:Radiation Injuries / Q000150:complications*; D011879:Radiotherapy Dosage; D014057:Tomography, X-Ray Computed