Orijinal Araştırma

Stereotaktik Radyoterapi Sonrası Radyasyona Bağlı Erektil Disfonksiyon ile İlişkili Faktörlerin Değerlendirilmesi

10.4274/jarem.galenos.2021.21939

  • Selvi Tabak Dinçer
  • Emre Uysal

Gönderim Tarihi: 03.09.2021 Kabul Tarihi: 01.10.2021 J Acad Res Med 2021;11(3):254-261

Amaç:

Erektil disfonksiyon (ED), prostat kanseri radyoterapisinin sıklıkla gözlenen bir yan etkisidir. Stereotaktik vücut radyoterapi (SBRT), ultrahipofraksiyone (UH)-RT 4-5 fraksiyonda uygulanan RT tekniğidir. SBRT’nin cinsel işlev üzerindeki etkisi halen tartışmalıdır. Bu çalışmanın amacı, klinik olarak lokalize prostat kanseri olan hastalarda SBRT ve ED arasındaki olası ilişkiyi analiz etmektir.

Yöntemler:

Ocak 2013 ile Aralık 2019 arasında, düşük-orta riskli prostat kanseri tanısı nedeniyle SBRT +/- hormonoterapi tedavisi uygulanan ve tedavi öncesinde ED olmayan 55 hastada ED’yi etkileyen faktörler analiz edildi. RT planlanırken penil bulb (PB) riskli organ (OAR) olarak tanımlanmıştır. Hastalara fraksiyon başına 7-7.25 Gy, toplam doz 35-36.25 Gy/ 5 fraksiyon olacak şekilde Cyberknife ile gün aşırı SBRT uygulandı. Hastaların erektil fonksiyon durumu tedaviye başlamadan önce ve 3. ayda, 1. yılda ve 2. yılda IIEF-5 skorları kullanılarak değerlendirildi. Hastalar tedavi sonrası potens durumuna göre gruplandırıldı.

Bulgular:

Ortanca hasta yaşı 68,5 yıl ve ortanca takip süresi 58 aydı. SBRT’den sonra hastaların %56,4’ünde erektil fonksiyon korunmuştur. Planlanan hedef hacime (PTV) proksimal seminal veziküllerin dahil edilmesi ve hasta yaşı tek değişkenli analizde potens olan ve olmayan gruplar arasında anlamlı olarak farklı bulundu (p=0,028 ve p=0,036). Çok değişkenli analizde, PTV’nin büyük olması ve PTV’ye seminal veziküllerin proksimal üçte birinin dahil edilmesi ED gelişimi açısından istatistiksel olarak anlamlı bulundu (p=0,038 ve p=0,020).

Sonuç:

Prostat kanser tedavisinde her ne kadar modern radyoterapi teknikleri kullanılsa da erektil fonksiyon etkilenebilmektedir. ED’nin karmaşık mekanizması göz önüne alındığında, potensteki düşüşü sadece risk altındaki organların aldığı dozlara bağlamak doğru olmaz.

Anahtar Kelimeler: Erektil disfonksiyon, prostat kanseri, radyoterapi, stereotaktik beden radyoterapisi

Etik Kurul Onayı: Çalışma protokolü İstanbul Prof. Dr. Cemil Taşcıoğlu Şehir Hastanesi Etik Kurulu tarafından onaylandı (karar no: 369, tarih: 22.09.2020).

Hasta Onamı: Retrospektif çalışma.

Hakem Değerlendirmesi: Editörler kurulu tarafından değerlendirilmiştir.

Yazarlık Katkıları: Cerrahi ve Medikal Uygulama - S.T.D., E.U., Konsept - S.T.D., Dizayn - S.T.D., Veri Toplama veya İşleme - S.T.D., E.U., Analiz veya Yorumlama - S.T.D., E.U., Literatür Arama - S.T.D., E.U., Yazan - S.T.D.

Çıkar Çatışması: Yazarlar tarafından çıkar çatışması bildirilmemiştir.

Finansal Destek: Yazarlar tarafından finansal destek almadıkları bildirilmiştir.


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