UroToday - Dose-Volume Parameters of the Corpora Cavernosa Do Not Correlate with Erectile Dysfunction After External Beam Radiotherapy for Prostate Cancer: Results from A Dose-Escalation Trial - Abstract

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Monday, 11 February 2008

Department of Radiation Oncology, Erasmus MC- den Hoed Cancer Center,

Rotterdam, The Netherlands.

To analyze the correlation between dose-volume parameters of the corpora

cavernosa and erectile dysfunction (ED) after external beam radiotherapy

(EBRT) for prostate cancer.

Between June 1997 and February 2003, a randomized dose-escalation trial

comparing 68 Gy and 78 Gy was conducted. Patients at our institute were

asked to participate in an additional part of the trial evaluating sexual

function. After exclusion of patients with less than 2 years of follow-up,

ED at baseline, or treatment with hormonal therapy, 96 patients were

eligible. The proximal corpora cavernosa (crura), the superiormost 1-cm

segment of the crura, and the penile bulb were contoured on the planning

computed tomography scan and dose-volume parameters were calculated.

Two years after EBRT, 35 of the 96 patients had developed ED. No

statistically significant correlations between ED 2 years after EBRT and

dose-volume parameters of the crura, the superiormost 1-cm segment of the

crura, or the penile bulb were found. The few patients using potency aids

typically indicated to have ED.

No correlation was found between ED after EBRT for prostate cancer and

radiation dose to the crura or penile bulb. The present study is the largest

study evaluating the correlation between ED and radiation dose to the

corpora cavernosa after EBRT for prostate cancer. Until there is clear

evidence that sparing the penile bulb or crura will reduce ED after EBRT, we

advise to be careful in sparing these structures, especially when this

involves reducing treatment margins.

Written by

van der Wielen GJ, Hoogeman MS, Dohle GR, van Putten WL, Incrocci L.

Reference

Int J Radiat Oncol Biol Phys. 2007 Dec 28. Epub ahead of print.

doi:10.1016/j.ijrobp.2007.10.052

PubMed Abstract

PMID:18164862

I have heard before that damage to the penile bulb was causative to ED

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