Abstract
Aim: To assess the predictors of the onset of impotence 1 year after radiotherapy for prostate cancer. Patients and methods: In a multi-centric prospective study, the International Index of Erectile Function (IIEF) questionnaire-based potency of 91 hormone-naïve and potent patients (IIEF1-5 > 11 before radiotherapy) was assessed. At the time of this analysis, information on potency 1 year after treatment was available for 62 of 91 patients (42 treated with hypofractionation: 2.35–2.65 Gy/fr, 70–74.2 Gy; 20 with conventional fractionation: 74–78 Gy). Prospectively collected individual information and Dmax/Dmeanto the penile bulb were available; the corresponding 2 Gy-equivalent values (EQD2_max/EQD2_mean) were also considered. Predictors of 1‑year impotency were assessed through uni- and multi-variable backward logistic regression: The best cut-off values discriminating between potent and impotent patients were assessed by ROC analyses. The discriminative power of the models and goodness-of-fit were measured by AUC analysis and the Hosmer–Lemeshow (H&L) test. Results: At 1‑year follow-up, 26 of 62 patients (42 %) became impotent. The only predictive variables were baseline IIEF1-5 values (best cut-off baseline IIEF1-5 ≥ 19), Dmax≥ 68.5 Gy and EQD2_max≥ 74.2 Gy. The risk of 1‑year impotence may be predicted by a two-variable model including baseline IIEF1-5 (OR: 0.80, p = 0.003) and EQD2_max≥ 74.2 Gy (OR: 4.1, p = 0.022). The AUC of the model was 0.77 (95% CI: 0.64–0.87, p = 0.0007, H&L: p = 0.62). The 1‑year risk of impotency after high-dose radiotherapy in potent men depends on the EQD2_maxto the penile bulb and on baseline IIEF1-5 values. Conclusion: A significant reduction in the risk may be expected mainly when sparing the bulb in patients with no/mild baseline impotency (IIEF1-5 > 17).
| Original language | German |
|---|---|
| Pages (from-to) | 297-304 |
| Number of pages | 8 |
| Journal | Strahlentherapie und Onkologie |
| Volume | 192 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 1 2016 |
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Keywords
- Dose-response
- Erectile dysfunction
- Predictive models
- Prostate cancer
- Radiotherapy
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Oncology
Cite this
Baseline-Status und Dosis auf den Bulbus penis als Prädiktoren für Impotenz ein Jahr nach Radiotherapie bei Prostatakrebs. / Cozzarini, Cesare; Rancati, Tiziana; Badenchini, Fabio; Palorini, Federica; Avuzzi, Barbara; Degli Esposti, Claudio; Girelli, Giuseppe; Improta, Ilaria; Vavassori, Vittorio; Valdagni, Riccardo; Fiorino, Claudio.
In: Strahlentherapie und Onkologie, Vol. 192, No. 5, 01.05.2016, p. 297-304.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Baseline-Status und Dosis auf den Bulbus penis als Prädiktoren für Impotenz ein Jahr nach Radiotherapie bei Prostatakrebs
AU - Cozzarini, Cesare
AU - Rancati, Tiziana
AU - Badenchini, Fabio
AU - Palorini, Federica
AU - Avuzzi, Barbara
AU - Degli Esposti, Claudio
AU - Girelli, Giuseppe
AU - Improta, Ilaria
AU - Vavassori, Vittorio
AU - Valdagni, Riccardo
AU - Fiorino, Claudio
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Aim: To assess the predictors of the onset of impotence 1 year after radiotherapy for prostate cancer. Patients and methods: In a multi-centric prospective study, the International Index of Erectile Function (IIEF) questionnaire-based potency of 91 hormone-naïve and potent patients (IIEF1-5 > 11 before radiotherapy) was assessed. At the time of this analysis, information on potency 1 year after treatment was available for 62 of 91 patients (42 treated with hypofractionation: 2.35–2.65 Gy/fr, 70–74.2 Gy; 20 with conventional fractionation: 74–78 Gy). Prospectively collected individual information and Dmax/Dmeanto the penile bulb were available; the corresponding 2 Gy-equivalent values (EQD2_max/EQD2_mean) were also considered. Predictors of 1‑year impotency were assessed through uni- and multi-variable backward logistic regression: The best cut-off values discriminating between potent and impotent patients were assessed by ROC analyses. The discriminative power of the models and goodness-of-fit were measured by AUC analysis and the Hosmer–Lemeshow (H&L) test. Results: At 1‑year follow-up, 26 of 62 patients (42 %) became impotent. The only predictive variables were baseline IIEF1-5 values (best cut-off baseline IIEF1-5 ≥ 19), Dmax≥ 68.5 Gy and EQD2_max≥ 74.2 Gy. The risk of 1‑year impotence may be predicted by a two-variable model including baseline IIEF1-5 (OR: 0.80, p = 0.003) and EQD2_max≥ 74.2 Gy (OR: 4.1, p = 0.022). The AUC of the model was 0.77 (95% CI: 0.64–0.87, p = 0.0007, H&L: p = 0.62). The 1‑year risk of impotency after high-dose radiotherapy in potent men depends on the EQD2_maxto the penile bulb and on baseline IIEF1-5 values. Conclusion: A significant reduction in the risk may be expected mainly when sparing the bulb in patients with no/mild baseline impotency (IIEF1-5 > 17).
AB - Aim: To assess the predictors of the onset of impotence 1 year after radiotherapy for prostate cancer. Patients and methods: In a multi-centric prospective study, the International Index of Erectile Function (IIEF) questionnaire-based potency of 91 hormone-naïve and potent patients (IIEF1-5 > 11 before radiotherapy) was assessed. At the time of this analysis, information on potency 1 year after treatment was available for 62 of 91 patients (42 treated with hypofractionation: 2.35–2.65 Gy/fr, 70–74.2 Gy; 20 with conventional fractionation: 74–78 Gy). Prospectively collected individual information and Dmax/Dmeanto the penile bulb were available; the corresponding 2 Gy-equivalent values (EQD2_max/EQD2_mean) were also considered. Predictors of 1‑year impotency were assessed through uni- and multi-variable backward logistic regression: The best cut-off values discriminating between potent and impotent patients were assessed by ROC analyses. The discriminative power of the models and goodness-of-fit were measured by AUC analysis and the Hosmer–Lemeshow (H&L) test. Results: At 1‑year follow-up, 26 of 62 patients (42 %) became impotent. The only predictive variables were baseline IIEF1-5 values (best cut-off baseline IIEF1-5 ≥ 19), Dmax≥ 68.5 Gy and EQD2_max≥ 74.2 Gy. The risk of 1‑year impotence may be predicted by a two-variable model including baseline IIEF1-5 (OR: 0.80, p = 0.003) and EQD2_max≥ 74.2 Gy (OR: 4.1, p = 0.022). The AUC of the model was 0.77 (95% CI: 0.64–0.87, p = 0.0007, H&L: p = 0.62). The 1‑year risk of impotency after high-dose radiotherapy in potent men depends on the EQD2_maxto the penile bulb and on baseline IIEF1-5 values. Conclusion: A significant reduction in the risk may be expected mainly when sparing the bulb in patients with no/mild baseline impotency (IIEF1-5 > 17).
KW - Dose-response
KW - Erectile dysfunction
KW - Predictive models
KW - Prostate cancer
KW - Radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=84963783811&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84963783811&partnerID=8YFLogxK
U2 - 10.1007/s00066-016-0964-1
DO - 10.1007/s00066-016-0964-1
M3 - Articolo
AN - SCOPUS:84963783811
VL - 192
SP - 297
EP - 304
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
SN - 0179-7158
IS - 5
ER -