| Predictors of response to sildenafil citrate following radiation therapy for prostate cancer. | |
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MedLine Citation:
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PMID: 19210713 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Phosphodiesterase type 5 inhibitor (PDE5) use is a treatment strategy for prostate cancer patients with post-radiation therapy (RT) erectile dysfunction (ED). AIM: To define the predictors of sildenafil response in men treated with RT for prostate cancer. MAIN OUTCOME MEASURES: International Index of Erectile Function (IIEF). METHODS: Patients were enrolled prospectively if they met the following criteria: (i) either a three-dimensional conformal external beam (EBRT) or brachytherapy (BT) with or without androgen deprivation (AD) for prostate cancer; (ii) self-reported ability to have sexual intercourse prior to RT; (iii) experienced onset of ED following RT; (iv) candidates for sildenafil citrate use; (v) followed-up periodically; and (vi) completed the IIEF at least 12 months after RT. Failure to respond to sildenafil was defined as IIEF-erectile function (EF) domain score of <22. RESULTS: One hundred fifty-two patients met all the criteria: 110 in the EBRT group and 42 in the BT group. Mean age was 62 years. The mean follow-up was 38 months. Mean radiation dose for EBRT was 78 Gy and for BT was 101 Gy. Thirty-five patients received AD, 25% of EBRT, and 62% of BT patients. Sixty-one percent of the patients receiving AD had exposure only pre-RT, whereas 39% had pre- and post-RT AD exposure. The mean duration of AD was 4.6 months. Post-RT IIEF-EF domain score at >24 months was 17. Successful response to sildenafil occurred in 68% of men at 12 months after RT, 50% at 24 months, and 36% at 36 months. On multivariable analysis, predictors of failure to respond to sildenafil were: older age, longer time after RT, AD > 4 months duration, and RT dose > 85 Gy. Modality of radiation delivery was not predictive of sildenafil failure. CONCLUSIONS: A steady decrease in sildenafil response was seen with increasing duration after RT. Several factors were predictive of sildenafil failure. |
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Authors:
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Patrick E Teloken; Marilyn Parker; Najeeb Mohideen; John P Mulhall |
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Publication Detail:
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Type: Journal Article Date: 2009-02-05 |
Journal Detail:
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Title: The journal of sexual medicine Volume: 6 ISSN: 1743-6109 ISO Abbreviation: - Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-04-02 Completed Date: 2009-08-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101230693 Medline TA: J Sex Med Country: United States |
Other Details:
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Languages: eng Pagination: 1135-40 Citation Subset: IM |
Affiliation:
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Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center and Department of Urology, Weill Cornell Medical College, New York, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Cyclic Nucleotide Phosphodiesterases, Type 5
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antagonists & inhibitors* Dose-Response Relationship, Radiation Erectile Dysfunction / drug therapy*, etiology* Follow-Up Studies Humans Male Middle Aged Phosphodiesterase Inhibitors / therapeutic use* Piperazines / therapeutic use* Prospective Studies Prostatic Neoplasms / complications*, radiotherapy* Purines / therapeutic use Radiotherapy Dosage Severity of Illness Index Sulfones / therapeutic use* Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Phosphodiesterase Inhibitors; 0/Piperazines; 0/Purines; 0/Sulfones; 139755-83-2/sildenafil; EC 3.1.4.35/Cyclic Nucleotide Phosphodiesterases, Type 5 |
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