P.C. Levendag

Sexual (dys)function after radiotherapy for prostate cancer: a review

PURPOSEnProstate cancer has become the most common nonskin malignant neoplasm in older men in Western countries. As treatment efficacy has improved, issues related to posttherapy quality of life and sexual functioning have become more important.nnnMETHODS AND MATERIALSnWe discuss the various methods used to evaluate erectile and sexual dysfunction and the definition of potency. The etiologies of erectile dysfunction after external beam radiotherapy and brachytherapy for prostate cancer are also reviewed. The literature is summarized, and comparative studies of radiation and surgery are surveyed briefly.nnnRESULTSnRates of erectile dysfunction vary from 6 to 84% after external beam radiotherapy and from 0 to 51% after brachytherapy. In most of the studies, the analysis is retrospective, the definition of erectile dysfunction is not clear, only one question about sexual functioning is asked, and nonvalidated instruments are used. The etiology of erectile dysfunction after radiation for prostate cancer is not completely understood.nnnCONCLUSIONSnBecause erectile function is only one component of sexual function, it is necessary to assess sexual desire, satisfaction, frequency of intercourse, and other such factors when evaluating the effects of therapy. Patients should be offered sexual counseling and informed about the availability of effective treatments for erectile dysfunction, such as sildenafil, intracavernosal injection, and vacuum devices.

mTHPC mediated interstitial photodynamic therapy of recurrent nonmetastatic base of tongue cancers : Development of a new method

Interstitial photodynamic therapy (iPDT) can be an option in the management of locally recurrent base of tongue cancer after (chemo)radiation treatment. The purpose of the current study was to develop a technique to implant light sources into the tumor tissue.

Adjunctive treatment of keloids: comparison of photodynamic therapy with brachytherapy

BackgroundThe aesthetic result after brachytherapy, especially hypopigmentation, remains a significant problem. Given that brachytherapy may be carcinogenic, it is difficult to recommend this treatment in young patients. For these reasons, there is a need for alternatives to radiation.MethodsThe purpose of this study was to evaluate the effectiveness of adjuvant photodynamic therapy (PDT) using aminolevulinic acid after keloid excision and to compare it to keloid excision followed by brachytherapy. To assess outcome, the Patient and Observer Scar Assessment Scale (POSAS) was used.ResultsThirty-four patients treated for 45 keloids were evaluated. Twenty-two patients (27 lesions) received brachytherapy and 12 (18 lesions) received PDT. The observers scored a mean POSAS of 19.1 (range 13.0–34.0) for brachytherapy and 24.6 (range 11.0–37.0) for PDT (pu2009=u20090.005). The independent observers scored a mean POSAS of 14.6 (range 10.0–20.0) for brachytherapy and 18.6 (range 9.0–42.0) for PDT (pu2009=u20090.018). The patients reported a significantly better mean POSAS score after brachytherapy (22.8, range 7.0–53.0) than following PDT (34.2, range 11.0–63.0). The patients’ POSAS score showed no significant difference for the item “general impression” for both treatment groups; the observers scored significantly higher for PDT treatment. The independent observers revealed a higher score for general impression after PDT although not reaching significance.ConclusionsPatients and observers appear to be more satisfied with the results after brachytherapy than PDT. However, patients still have a positive general impression after PDT. Adjunctive aminolevulinic acid–PDT for the treatment of keloids could be used as an alternative for brachytherapy.Level of Evidence: Level IV, therapeutic study.