Lower GI 2017

Pelvic OARs constraints: genitals

- Dose to penile bulb (PB)/structures involved in erection - Most experience from prostate ca RT - Controversial results, some evidence for constraining PB<40-50Gy - Lack of prospective trials including dose-volume data (no data to my knowledge in the rectal ca. context) - Very relevant «confounding» factors: baseline situation, ageing, vascular problems, psychological aspects - Prospective data suggests that avoiding overlap between PTV and PB may largely reduce erectile dysfunctions

Cozzarini 2016 prostate ca pts, IIEF1-5 based impotence