- 作者：Amy N. Solan ; Jamie A. Cesaretti ; Nelson N. Stone ; Richard G. Stock
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2009
- 出版时间：1 April 2009
- 年：2009
- 卷：73
- 期：5
- 页码：1468-1474
- 全文大小：217 K
Purpose
We evaluated the relationship between the onset of erectile dysfunction and dose to the penile bulb and neurovascular bundles (NVBs) after real-time ultrasound-guided prostate brachytherapy.Methods and Materials
One hundred forty-seven patients who underwent prostate brachytherapy met the following eligibility criteria: (1) treatment with 125I brachytherapy to a prescribed dose of 160 Gy with or without hormones without supplemental external beam radiation therapy, (2) identification as potent before the time of implantation based on a score of 2 or higher on the physician-assigned Mount Sinai Erectile Function Score and a score of 16 or higher on the abbreviated International Index of Erectile Function patient assessment, and (3) minimum follow-up of 12 months. Median follow-up was 25.7 months (range, 12–47 months).
Results
The 3-year actuarial rate of impotence was 23 % (34 of 147 patients). An additional 43 % of potent patients (49 of 113 patients) were using a potency aid at last follow-up. The penile bulb volume receiving 100 % of the prescription dose (V100) ranged from 0–0.05 cc (median, 0 cc), with a dose to the hottest 5 % (D5) range of 12.5–97.9 Gy (median, 40.8 Gy). There was no correlation between penile bulb D5 or V100 and postimplantation impotency on actuarial analysis. For the combined right and left NVB structures, V100 range was 0.3–5.1 cc (median, 1.8 cc), and V150 range was 0–1.5 cc (median, 0.31 cc). There was no association between NVB V100 or V150 and postimplantation impotency on actuarial analysis.
Conclusion
Penile bulb doses are low after real-time ultrasound-guided prostate brachytherapy. We found no correlation between dose to either the penile bulb or NVBs and the development of postimplantation impotency.