open access
Prostatic irradiation-induced sexual dysfunction: a review and multidisciplinary guide to management in the radical radiotherapy era (Part I defining the organ at risk for sexual toxicities)
open access
Abstract
Prostate cancer is the most common malignancy and the second leading cause of cancer-related death in men. Radiotherapy is a curative option that is administered via external beam radiation, brachytherapy, or in combination. Erectile, ejaculatory and orgasm dysfunction(s) is/are known potential and common toxicities associated with prostate radiotherapy. Our multidisciplinary team of physicians and/or scientists have written a three (3) part comprehensive review of the pathogenesis and management radiation-induced sexual dysfunction. Part I reviews pertinent anatomy associated with normal sexual function and then considers the pathogenesis of prostate radiation-induced sexual toxicities. Next, our team considers the associated radiobiological (including the effects of time, dose and fractionation) and physical (treatment planning and defining a novel Organ at Risk (OAR)) components that should be minded in the context of safe radiation treatment planning. The authors identify an OAR (i.e., the prostatic plexus) and provide suggestions on how to minimize injury to said OAR during the radiation treatment planning process.
Abstract
Prostate cancer is the most common malignancy and the second leading cause of cancer-related death in men. Radiotherapy is a curative option that is administered via external beam radiation, brachytherapy, or in combination. Erectile, ejaculatory and orgasm dysfunction(s) is/are known potential and common toxicities associated with prostate radiotherapy. Our multidisciplinary team of physicians and/or scientists have written a three (3) part comprehensive review of the pathogenesis and management radiation-induced sexual dysfunction. Part I reviews pertinent anatomy associated with normal sexual function and then considers the pathogenesis of prostate radiation-induced sexual toxicities. Next, our team considers the associated radiobiological (including the effects of time, dose and fractionation) and physical (treatment planning and defining a novel Organ at Risk (OAR)) components that should be minded in the context of safe radiation treatment planning. The authors identify an OAR (i.e., the prostatic plexus) and provide suggestions on how to minimize injury to said OAR during the radiation treatment planning process.
Keywords
Prostate cancer; Erectile dysfunction; Ejaculatory dysfunction; Orgasmic dysfunction; Radiation therapy; Organ at risk
About this articleTitle
Prostatic irradiation-induced sexual dysfunction: a review and multidisciplinary guide to management in the radical radiotherapy era (Part I defining the organ at risk for sexual toxicities)
Journal
Reports of Practical Oncology and Radiotherapy
Issue
Pages
367-375
Published online
2020-05-01
DOI
10.1016/j.rpor.2020.03.007
Bibliographic record
Rep Pract Oncol Radiother 2020;25(3):367-375.
Keywords
Prostate cancer
Erectile dysfunction
Ejaculatory dysfunction
Orgasmic dysfunction
Radiation therapy
Organ at risk
Authors
Marigdalia K. Ramirez-Fort
Marc J. Rogers
Roberto Santiago
Sean S. Mahase
Melissa Mendez
Yi Zheng
Xiang Kong
James A. Kashanian
M. Junaid Niaz
Shearwood McClelland
Xiaodong Wu
Neil H. Bander
Peter Schlegel
John P. Mulhall
Christopher S. Lange