Erectile function following proton therapy for prostate cancer in men 60 years and younger.

Abstract

49 Background: A recent investigation into male sexual health and function provided comparative data on sexual function in men treated with EBRT, prostatectomy, and brachytherapy using the PROSTQA database. However, there was a disproportionate percentage of men below 60 years old in the EBRT (N=34, 14%) and brachytherapy (N=54, 21%) subsets compared with surgery (N=249, 49%). Thus, we investigated erectile dysfunction (ED) in young men treated with proton therapy (PT). Methods: 190 men, 60 years old or younger were treated for prostate cancer with definitive PT without androgen deprivation therapy (ADT) on a University of Florida Proton Therapy Institute IRB-approved protocol. Before treatment and q 6 months, men answered the Expanded Prostate Index Composite (EPIC) questionnaire. Men were excluded from analysis because of lack of baseline EPIC (n=10) or follow up EPIC at 2 years (n=23), leaving 157 men for analysis. Potency was defined as a positive response to having “erections firm enough for intercourse,” and sexual function (SF) scores were calculated for EPIC-26. Results: Potency rates prior to treatment and 2 years following treatment were 89% and 72%, respectively. A multivariate analysis showed that dose >78 CGE (p=0.0141) and baseline SF score (p=0.0002) were significantly associated with potency outcome. Potency rates by risk factor stratification are reported in the table. Conclusions: The present study results suggest comparable potency rates following PT in younger men with data recently reported for prostatectomy. We are currently working to provide additional information on potency rates following PT for patients facing these difficult treatment decisions. [Table: see text]