title: Sexual, irritative, and voiding outcomes, following stereotactic body radiation therapy for prostate cancer.
abstract: BACKGROUND
  Urinary symptoms and sexual dysfunction are the two most common complaints following prostate radiotherapy. The impact of hypofractionated treatment on sexual function, irritative symptoms, and voiding symptoms has not been determined within the same patient population. Here we present our institutional data on sexual function, voiding function, irritative symptoms, and treatment response following SBRT.
  
  
  METHODS
  This retrospective analysis includes 102 non-metastatic patients treated with SBRT at a single institution between May 2008 and September 2014. The course of radiotherapy consisted of 36.25 Gy (range 35-40) over five daily fractions. International Prostate Symptom Score (IPSS), Sexual Health Inventory for Men (SHIM), and PSA were recorded at baseline, 1, 3, 6, 9, 12, 18, 24, and 36 months after treatment.
  
  
  RESULTS
  Median patient age was 72 years old with a median follow-up of 4.3 years. Pretreatment IPSS-I score was 5.21, increasing to 6.97 (p < .001) after 1 month. The mean IPSS-I score returned close to baseline after 3 months to 5.86 and decreased to below baseline after 2 years to 5.09. At 3 months, 9 months, and 2 years, 47.5, 76.2, and 91.1% of patients had reached IPSS-I resolution. The mean IPSS-O score prior to treatment was 5.31 and there was an increase in the score to 6.45 (p = 0.344) at 1 month. The score remained close to baseline and decreased to 4.00 at 2 years and significantly decreased to 3.74 (p = 0.035) at 3 years. 64.4, 82.1, and 96.0% of patients had IPSS-O resolution by 3 months, 9 months, and 2 years. The mean SHIM score prior to treatment was 13.52 and continually decreased to below baseline a year after treatment to 10.56 (p < .001). SHIM score began to improve at 18 months, but was still significantly less than baseline at 12.12 (p = .01).
  
  
  CONCLUSIONS
  While an increase in AUA/IPSS score initially occurred, all patients resume normal activities immediately following treatment and the AUA/IPSS symptoms improved from baseline. Irittative symptoms take longer to resolve when compared to obstructive voiding symptoms in patients treated with SBRT. Three year PSA response, reported toxicity, erectile function preservation, and urinary function improvement, shows favorable results.
authors: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. zhrana88@gmail.com.
authors: Zaker
authors: Z
authors: Rana
authors: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. bobbyhong@gmail.com.
authors: Robert L
authors: RL
authors: Hong
authors: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. musabu5@gmail.com.
authors: Mustafa
authors: M
authors: Abugideiri
authors: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. dmcrae@virginiahospitalcenter.com.
authors: Donald
authors: D
authors: McRae
authors: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. gcernica@gmail.com.
authors: George
authors: G
authors: Cernica
authors: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. rmordkin@yahoo.com.
authors: Robert
authors: R
authors: Mordkin
authors: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. abjoel@hotmail.com.
authors: Andrew B
authors: AB
authors: Joel
authors: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. gbernstein@virginiahospitalcenter.com.
authors: Gregory
authors: G
authors: Bernstein
authors: Department of Radiation Oncology Medicine, Virginia Hospital Center, 1701 N George Mason Dr, Arlington, VA 22205, USA. nmn3087@virginiahospitalcenter.com.
authors: Nadim M
authors: NM
authors: Nasr
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000601:surgery*; D016634:Radiosurgery / Q000009:adverse effects*; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology* / Q000209:etiology; D014555:Urination Disorders / Q000453:epidemiology* / Q000209:etiology