For patients with prostate cancer, combination beam plus brachytherapy does not compromise long-term sexual function compared with external beam radiotherapy (EBRT), according to a study presented at the annual meeting of the American Society for Radiation Oncology, held from Sept. 14 to 18 in San Francisco.

Adam L. Liss, M.D., from the University of Michigan in Ann Arbor, and colleagues compared five-year sexual outcomes for EBRT versus combination beam plus brachytherapy (combo) for 91 patients with prostate cancer who underwent magnetic resonance imaging vessel-sparing radiotherapy. Of the patients, 49 were treated with combo and 42 with EBRT.

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The researchers found that the International Index of Erectile Function scale scores at two and five years (+/− sildenafil) were 16.5 and 20.8 and 15.4 and 16.9, respectively, for EBRT and combo. Based on a three-question scale, at five years post radiotherapy, 78.6 and 91.8 percent of EBRT and combo patients were able to be sexually active (P = 0.070). The dose to 90 percent of the structure to the corpus cavernosum and internal pudendal artery were lower for the combo group.

“Even with combination radiation protocols, which are capable of curing the majority of prostate cancers more than 90 percent of the time, avoidance of critical adjacent tissues, such as vessel-sparing, makes cure and quality of life an achievable goal for many men,” a coauthor said in a statement.


  1. “Majority of prostate cancer patients surveyed five years after treatment with vessel-sparing radiation therapy report preserved sexual function.” ASTRO. San Francisco. September 15, 2014.