BOSTONMen who underwent three-dimensional conformal
radiation therapy (3D CRT) for prostate cancer had significant loss in sexual
function, but the addition of hormonal therapy did not exacerbate that loss,
according to a poster presented at the 42nd Annual Meeting of the American
Society for Therapeutic Radiology and Oncology (ASTRO).
Christopher T. Chen, MD, a resident in the Department of
Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas
Jefferson University, Philadelphia, reported on a study of 144 men who
completed sexual function questionnaires before treatment and at 6-month
intervals when they returned for follow-up.
The patients were from a database of prostate cancer patients
Richard K. Valicenti, MD, assistant professor of radiation oncology, Jefferson
Medical College, and lead author of the study.
Dr. Chen reported that 1 year after 3D CRT, 47% (47 of 101
patients) were totally potent, compared with 60% (87 of 144 patients) before
treatment (see Table). The percentage increased slightly to 50% (10 of 20)
among those who had at least 3 years of follow-up.
The 55 patients who also received hormonal therapy were less
likely to be potent before and after radiotherapy than the men who only had 3D
Less than half of the hormonal therapy patients (24, or 44%)
were potent at the outset, compared with nearly three fourths (63, or 71%) of
the 89 men who had 3D CRT alone. A year later the percentages dropped to 31%
and 56%, respectively. In the small group of men who had been followed for 3
years, potency recovered to 40% and 60%, respectively.
Dr. Chen and Dr. Valicenti concluded that the difference in the
degree of potency loss was not significant between the two groups.
The patients also reported decreases in ejaculatory ability and
quality of sex life. At baseline, 59% of all patients were at least partially
satisfied with their sex life: 51% of the hormonal therapy plus 3D CRT group vs
65% of the 3D CRT-only group. At 1 year, partial satisfaction was measured at
55% of all patients: 42% of the hormonal group and 63% of the 3D CRT-only
"The quality of the data is very good," Dr. Chen
said, stressing that the patients were queried before they started treatment
and every 6 months afterward. Many studies ask patients to recollect potency
before treatment, he noted. "But the patients can’t remember. It can be
5 years since they started therapy," he said.
In this study, the mean follow-up time was 21 months, and the
men were given a definition of sexual potency as erections firm enough for
penetration during intercourse on at least two occasions in the previous 30