Sexual function no worse when fewer external beam radiation treatments used

The HYPRO trial was designed to detect whether hypofractionation (fewer radiation treatments) was inferior to conventional fractionation (over about 8 weeks of treatment). A previous report from the HYPRO trial investigators looked at outcomes of late-term urinary and rectal function. In the current report, the investigators report on sexual function outcomes.

To briefly recap, 820 intermediate-/high-risk patients were randomly assigned to one of two external beam radiation treatment protocols:

  • Conventional fractionation: 78 Gy in 39 treatments
  • Hypofractionation: 64.6 Gy in 19 treatments

Thirty-nine percent of the 820 patients also had adjuvant hormone therapy lasting up to 6 months.

It should also be noted that men averaged 71 years of age at the time of treatment.

After an average (median) follow-up of 37 months:

  • Among those with partial or full erectile function at baseline, erectile dysfunction occurred in
    • 34.4 percent of those who had hypofractionation
    • 39.3 percent of those who had conventional fractionation.
    • This difference was not statistically significant.
  • Orgasmic function among those who did not have hormone therapy was higher for the hypofractionation group, but the difference was statistically significant.
  • Overall, sexual function scores declined after treatment, but there was no difference between two treatments.

Two other randomized clinical trials have also reported no difference in sexual function. Both the Fox Chase trial (see this link) and the M. D. Anderson trial (see this link) found hypofractionation made no difference in sexual outcomes. This should give some comfort to patients and radiation oncologists considering hypofractionation.

Note: This commentary was written by Allen Edel for The “New” Prostate Cancer InfoLink.


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