Long-term outcomes following proton therapy for prostate cancer in young men with a focus on sexual health

Clement K. Ho, Curtis M. Bryant, Nancy P. Mendenhall, Randal H. Henderson, William M. Mendenhall, Romaine C. Nichols, Christopher G. Morris, Dvaraju Kanmaniraja, Derek J. Hamlin, Zuofeng Li, Bradford S. Hoppe

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background: We investigated long-term outcomes for men ≤60 years old treated with proton therapy (PT). Methods: Of 254 men ≤60 years old were treated with proton therapy alone for prostate cancer. Risk stratification included 56% with low-, 42% with intermediate- and 2% with high-risk disease. Patients received 76–82 Gy at 2 Gy/fraction or 70–72.5 Gy at 2.5 Gy/fraction. Before treatment and every 6–12 months for 5 years, patients were evaluated by a physician, answered health-related quality of life surveys, including the EPIC, IIEF and IPSS, and had PSA evaluated. Results: Median follow-up for the cohort was 7.1 years; 7-year biochemical-free survival was 97.8%. Eight men (one high-risk; five intermediate-risk and two low-risk) experienced biochemical progression, including one who died of disease 9 years after treatment. Potency (erections firm enough for sexual intercourse) was 90% at baseline and declined to 72% at the first-year follow-up, but declined to only 67% at 5 years. Only 2% of patients developed urinary incontinence requiring pads. The bowel habits mean score declined from a baseline of 96 to 88 at 1 year, which improved over the following years to 93 at 5 years. Conclusions: Young men with prostate cancer continue to have excellent results with respect to 7-year biochemical control and 5-year erectile function, without clinically significant urinary incontinence 5 years after proton therapy. Comparative effectiveness studies of proton therapy with surgery and IMRT are needed.

Original languageEnglish (US)
Pages (from-to)582-588
Number of pages7
JournalActa Oncologica
Issue number5
StatePublished - May 4 2018
Externally publishedYes

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging


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