Brachytherapy with or without XRT

Quality of life data from brachytherapy is just beginning to emerge. Cross-sectional data from Davis etal.34 showed that brachytherapy is associated with erectile dysfunction and irritation/obstruction urinary side effects that improve in the first 12 months after treatment, and a decrease in erectile function. Scores from the SF-36 were no different than age-matched controls. Sanchez-Ortiz etal.60 also used the SF-36/ UCLA PCI and found that among pretreatment potent men, 51% developed erectile dysfunction; however, this finding did not correlate with androgen deprivation, SF-36 scores or satisfaction rates. Brandeis etal.31 also performed a cross-sectional study and found the same pattern of SF-36, sexual function and urinary function changes, but also found that patients who had combination brachytherapy/XRT had even lower sexual and urinary function scores. Krupski etal.61 also performed a cross-sectional study using the FACT G, AUASI and a separate sexual function inventory. Brachytherapy/XRT patients reported more urinary irritation and sexual function loss compared to brachyetherapy alone.

Lee etal.62 performed one of the first longitudinal studies with pretreatment data to include modern brachytherapy. Using the FACT-G, FACT-P and International Prostate Symptom Score (IPSS), they found that FACT G and P scales declined at 1 and 3 months, but returned to baseline by 12 months. The IPSS scores doubled for 1 and 3 months, but returned to baseline by 12 months.

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