title: [Sexual functions after treatment for rectal cancer: impact of doses in autonomic pelvic nerves].
abstract: OBJECTIVE
  Prospective evaluation of sexual function after treatment of rectal cancer and identification of predictive factors.
  
  
  METHODS
  Thirty-three patients were treated with curative intent by chemoradiation and surgery for localized rectal adenocarcinoma. Sexual toxicity was assessed four times (before treatment and at 2, 6 and 12 months) using validated questionnaires: QLQ C30 and EORTC CR38 for all, simplified IIEF for men and FSFI for women. A correlation was sought between the toxicity and clinical and dosimetric parameters by Fisher and Mann-Whitney tests.
  
  
  RESULTS
  In men, erections and sexual satisfaction decreased significantly from the acute phase and then stabilized (respective scores of 84.5 and 86/100 in the initial phase, 66 and 70.4 at the end of radiotherapy, 70 and 70 at 6 months and 68.5 and 70 at 12 months). For women, the changes were not significant. This study confirms some risk factors for sexual toxicity already mentioned (original function, age, tumor volume) and highlights new (dose to the seminal vesicles and above all, doses to pelvic autonomic plexus).
  
  
  CONCLUSIONS
  Sexual effects of combined treatment of rectal cancer have only recently been described but remain undervalued and poorly understood. The impact of the autonomic pelvic plexus doses is a completely new data that could be extended in the development of intensity-modulated radiotherapy.
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France. Electronic address: aurore.goineau@ico.unicancer.fr.
authors.forename: A
authors.initials: A
authors.lastname: Goineau
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France.
authors.forename: M-A
authors.initials: MA
authors.lastname: Mahé
authors.affiliation: Département de chirurgie digestive, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Paineau
authors.affiliation: Département de biostatistiques, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Campion
authors.affiliation: Département de radiothérapie, institut de cancérologie de l'Ouest René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Rio
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000528:radiation effects*; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*
keywords: Autonomic nervous system; Cancer rectal; Fonctions sexuelles; Radiotherapy; Radiothérapie; Rectal cancer; Sexual functions; Système nerveux autonome