ESTRO 2025 - Abstract Book

S1979

Clinical - Urology

ESTRO 2025

Results: After a median follow-up of 23 months, 52.3% (n=23) of patients developed erectile dysfunction (ED+), while 47.7% (n=21) remained free of ED (ED−). ED+ patients received significantly higher mean doses to the crura, IPA, and penile base PB compared to ED− patients (22.05 vs 12.6 Gy [p=0.004], 31.55 vs 16.23 Gy [p <0.001], and 35.1 vs 23 Gy [p=0.009], respectively). A significant difference was also observed in the D2% delivered to the crura, IPA, and PB, with ED+ patients receiving higher doses (56.32 vs 34.08 Gy [p <0.001], 52.91 vs 34.97 Gy [p=0.039], and 54.46 vs 36.33 Gy [p <0.001], respectively) . Specific dose cutt-offs were significantly associated with the development of ED: Dmean crura > 20 Gy, D2% crura > 55 Gy, Dmean IPA > 15 Gy, D2% IPA > 40 Gy, Dmean PB > 20 Gy, and D2% PB > 54 Gy (p=0.044, p=0.001, p=0.006, p=0.005, p<0.001, and p=0.009, respectively). No correlation was observed between ADT and ED+ development (p = 0.23). A greater decline in sexual functioning, as measured by the EORTC QLQ-PR25 questionnaire, was observed in patients receiving higher radiation doses to the crura, IPA, and PB (Table 1).

Conclusion: Maintaining a Dmean crura, D2% crura, Dmean IPA, D2% IPA, Dmean PB, D2% PB below 20 Gy, 55 Gy, 15 Gy 40 Gy, 20 Gy and 54 Gy respectively may significantly reduce the risk of developing erectile dysfunction (ED+) and improve overall quality of life for patients undergoing following (HFPRT).

Keywords: Hypofractionated prostate RT, Erectil dysfonction