Dimitri Gambachidze1, Cédric Lebacle2, Pierre Maroun2, Alexandre Escande2, Alberto Bossi2, Pierre Blanchard2, Eric Deutsch3, Christine Haie-Meder2, Cyrus Chargari4. 1. Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France. Electronic address: dimitri.gambachidze@gmail.com. 2. Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France. 3. Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1030, Villejuif, France; Université Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France. 4. Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France; INSERM, U1030, Villejuif, France; Université Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France; Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, France; French Military Health Service Academy, Ecole du Val-de-Grace, Paris, France.
Abstract
PURPOSE: Brachytherapy (BT) is an effective organ-preserving treatment for selected localized penile carcinoma, providing high local control rates. Long-term functional results however, are still insufficiently evaluated. METHODS AND MATERIALS: All consecutive patients treated with low-dose-rate or pulse-dose-rate BT in our institute for a localized penile cancer and who were in first complete remission and followed for at least 3 years were included. A self-reporting questionnaire was sent, to assess: 1/urinary function, 2/sexual function, 3/cosmetic aspect of the penis, and 4/quality of life. RESULTS: Thirty-nine patients fulfilled inclusion criteria and were sent the questionnaire. Twenty-three patients (59%) answered. Median age was 63.4 years, (interquartile range [IR]: 49.7-67.0). Median followup was 5.9 years (IR: 5.2-6.7). The urinary scores showed moderate lower urinary tract symptoms. During the followup, a urethral dilation or self-catheterization had been necessary in 30% and 13%, respectively. Sixteen (70%) patients continued to maintain a sexual activity and the erectile dysfunction was mild. Finally, quality of life was good with a median score of 80/100 (IR = 65-90) and was only impacted by pain (p = 0.02). Overall, 57% and 39% declared having none or moderate pain/discomfort, respectively. CONCLUSIONS: Although this questionnaire needs to be validated in an independent cohort, our results show the moderate impact of BT on functional outcomes, confirming that it is an adequate first-intent organ-sparing strategy in patients with localized penile carcinoma.
PURPOSE: Brachytherapy (BT) is an effective organ-preserving treatment for selected localized penile carcinoma, providing high local control rates. Long-term functional results however, are still insufficiently evaluated. METHODS AND MATERIALS: All consecutive patients treated with low-dose-rate or pulse-dose-rate BT in our institute for a localized penile cancer and who were in first complete remission and followed for at least 3 years were included. A self-reporting questionnaire was sent, to assess: 1/urinary function, 2/sexual function, 3/cosmetic aspect of the penis, and 4/quality of life. RESULTS: Thirty-nine patients fulfilled inclusion criteria and were sent the questionnaire. Twenty-three patients (59%) answered. Median age was 63.4 years, (interquartile range [IR]: 49.7-67.0). Median followup was 5.9 years (IR: 5.2-6.7). The urinary scores showed moderate lower urinary tract symptoms. During the followup, a urethral dilation or self-catheterization had been necessary in 30% and 13%, respectively. Sixteen (70%) patients continued to maintain a sexual activity and the erectile dysfunction was mild. Finally, quality of life was good with a median score of 80/100 (IR = 65-90) and was only impacted by pain (p = 0.02). Overall, 57% and 39% declared having none or moderate pain/discomfort, respectively. CONCLUSIONS: Although this questionnaire needs to be validated in an independent cohort, our results show the moderate impact of BT on functional outcomes, confirming that it is an adequate first-intent organ-sparing strategy in patients with localized penile carcinoma.
Authors: Vasileios I Sakalis; Riccardo Campi; Lenka Barreto; Herney Garcia Perdomo; Isabella Greco; Łukasz Zapala; Mithun Kailavasan; Tiago Antunes-Lopes; Jack David Marcus; Kenneth Manzie; John Osborne; Benjamin Ayres; Luc M F Moonen; Andrea Necchi; Juanita Crook; Pedro Oliveira; Lance C Pagliaro; Chris Protzel; Arie S Parnham; Maarten Albersen; Curtis A Pettaway; Philippe E Spiess; Scott T Tagawa; R Bryan Rumble; Oscar R Brouwer Journal: Eur Urol Open Sci Date: 2022-05-02