Effect of low dose-rate prostate brachytherapy on the sexual health of men with optimal sexual function before treatment:: analysis at ≥ 7 years of follow-up
Effect of low dose-rate prostate brachytherapy on the sexual health of men with optimal sexual function before treatment:: analysis at ≥ 7 years of follow-up
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DOI：
10.1111/j.1464-410x.2007.07016.x
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发表时间：
2007-08-01
影响因子：
4.5
通讯作者：
Stock, Richard G.
中科院分区：
文献类型：
--
作者：
Cesaretti, Jamie A.;Kao, Johnny;Stock, Richard G.
目的探讨低剂量率前列腺近距离放射治疗对治疗前前瞻性评价为>= 7年且性功能处于最佳状态的男性性健康的影响。患者和方法自1990年11月至1998年3月，共223例T1b至T3a前列腺癌患者，中位年龄66岁（50-82岁）。采用前瞻性生活质量测量，随访中位数（范围）为8.2（7-14.1）年。勃起功能（EF）从2000年6月开始使用医生指定的评分进行评估；采用经验证的国际EF指数（IIEF-5）作为补充方法量化晚期EF。没有调整来区分性功能是否有EF的药物干预。采用Pearson卡方检验和Student’st检验进行组间比较。结果223例男性患者中，131例（59%）在近距离治疗前有最佳EF；其中，51例（40%）在最后一次随访评估中使用磷酸二酯酶5型抑制剂（44.86%）、育亨宾（2.4%）或前列地尔（5.10%）。着床年龄是当前EF的高度预测指标；25名50-59岁男性中有23名（92%）目前EF为>= 2；60 ~ 69岁和70 ~ 78岁患者的EF分别为48/75（64%）和18/31(58%)，差异有统计学意义（P = 0.01）。目前IIEF-5评分>= 16也与种植年龄高度相关，即50-59岁，16/25 (64%)；60-69岁，20/75(27%)；70-78岁，6/31 (19%)（P < 0.001）。结论年龄< 60岁且在低剂量率前列腺近距离放疗前有最佳病灶的患者发生长期病灶的概率非常高。
Objective To evaluate the effect of low-dose rate prostate brachytherapy on the sexual health of men with >= 7 years of prospective evaluation and optimum sexual function before treatment.Patients and methods In all, 223 patients with T1b to T3a prostate cancer and a median (range) age of 66 (50-82) years were treated with permanent seed implantation from November 1990 to March 1998. They were followed for a median (range) of 8.2 (7-14.1) years using prospective quality-of-life measures. Erectile function (EF) was assessed using a physician-assigned score and beginning in June 2000; the validated International Index of EF (IIEF-5) was used as a complementary method to quantify late EF. No adjustment was made to differentiate sexual function with or with no pharmacological intervention for EF. Pearson's chi-square test and Student's t-test were used to compare the groups.Results Of the 223 men, 131 (59%) had optimal EF before their brachytherapy; of these, 51 (40%) at the last follow-up evaluation were using either a phosphodiesterase type 5 inhibitor (44, 86%), yohimbine (two, 4%) or alprostadil (five, 10%). The age at implantation was highly predictive of current EF; 23 of 25 (92%) men aged 50-59 years had a current EF of >= 2; those aged 60-69 and 70-78 years had an EF of >= 2 in 48/75 (64%) and 18/31 (58%) (P = 0.01). A current IIEF-5 score of >= 16 also correlated highly with age at implant, i.e. 50-59, 16/25 (64%); 60-69, 20/75 (27%) and 70-78 years, 6/31 (19%) (P < 0.001).Conclusion Patients aged < 60 years and with optimal EF before low-dose rate prostate brachytherapy have a very high probability of long-term EF.