キクチ エイジ   KIKUCHI EIJI
  菊地栄次
   所属   医学部医学科 腎泌尿器外科学
   職種   主任教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Relationship between radiation doses and erectile function deterioration in patients with localized prostate cancer treated with permanent prostate brachytherapy.
掲載誌名 正式名:International Journal of Urology
ISSNコード:09198172
掲載区分国外
巻・号・頁 27(12),1087-1093頁
著者・共著者 Shigeta Keisuke, Kikuchi Eiji, Matsushima Masashi, Ogihara Koichiro, Kosaka Takeo, Mizuno Ryuichi, Tanaka Tomoki, Shigematsu Naoyuki, Oya Mototsugu.
担当区分 2nd著者,責任著者
発行年月 2020/09
概要 Objectives: To investigate the relationship between radiation doses in prostate brachytherapy and deterioration of erectile function in patients with localized prostate cancer.

Methods: A longitudinal survey study was carried out among 261 prostate cancer patients who received prostate brachytherapy. A total of 48 patients were potent at baseline and they did not receive any supplemental therapy preoperatively. Dosimetry parameters of the whole prostate gland, prostate apex, urethra and rectum were collected using the VariSeed 8.0 treatment planning system (Varian Medical Systems, Palo Alto, CA, USA). We carried out a logistic regression analysis to clarify the relationship between radiation doses and erectile function deterioration, which was assessed using the International Index of Erectile Function-15 questionnaire.

Results: The median patient age was 66 years (range 53-70 years) with a median follow-up time of 44 months (36-71 months). The mean total International Index of Erectile Function-15 score decreased from 49.9 at baseline to 34.7 after 12 months (P < 0.001), but gradually plateaued within 36 months. Erectile function deterioration was noted in 32 (66.7%) patients 36 months after prostate brachytherapy. In an analysis of risk factors for erectile function deterioration after prostate brachytherapy, age ≥70 years (P = 0.029), prostate V100 ≥95% (P = 0.024), apex V100 ≥95% (P = 0.024), apex V150 ≥70% (P = 0.009) and apex D90 ≥150 Gy (P = 0.011) correlated with erectile function deterioration. A multivariate analysis identified an age of ≥70 years (odds ratio 7.91, P = 0.024) and apex V150 ≥70% (odds ratio 7.75, P = 0.007) as independent risk factors for erectile function deterioration after prostate brachytherapy.

Conclusions: An excessive radiation dose, particularly to the prostate apex area, and an advanced age might have a negative impact on the preservation of potency after prostate brachytherapy.
DOI doi: 10.1111/iju.14358
PMID 32893378