放射治疗后前列腺癌患者的射精功能：系统综述与Meta分析
Ejaculatory function after radiotherapy for prostate cancer: a systematic review and meta-analysis
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影响因子:5.8
分区:医学2区 / 肿瘤学3区 泌尿学与肾脏学2区
发表日期:2024 Sep 14
作者:
Umar Ghaffar, Behzad Abbasi, Kevin D Li, Nikit Venishetty, Nizar Hakam, Adrian Fernandez, Robert Pearce, Hiren V Patel, Marvin N Carlisle, Benjamin N Breyer
DOI:
10.1038/s41391-024-00882-4
keywords:
摘要
关于前列腺放射对射精功能影响的资料极为有限。我们进行了系统综述和Meta分析，以评估男性在接受前列腺放射治疗后的射精结果。我们检索了PubMed、Embase和Web of Science，识别出17篇评估放射后射精功能的文章。主要结局指标为无射精率，次要结局包括射精量（EV）、射精不适感以及射精功能评分（EFS）的平均下降。我们采用纽卡斯尔-奥康纳量表评估研究质量，并使用逆方差法和随机效应模型计算合并比例。我们共识别出17项观察性研究，涉及2156名患者，报告了放射后射精特征。7项研究使用外束放射治疗（EBRT），7项为近距离放射（brachytherapy），1项为立体定向放射治疗（SRT），2项则使用外部或近距离放射治疗。10项研究报告了无射精率。合并比例显示，无射精、EV降低和EjD（射精障碍）的患者比例分别为18%（95% CI，11-36%）、85%（95% CI，81-89%）和24%（95% CI，16-35%）。另有5项研究报道放疗后EFS的下降。接受放疗的患者其射精可能发生显著变化，如完全无射、射精量减少和EjD。对患者进行相关咨询，告知其潜在副作用具有重要意义。
Abstract
Scant data exists on the impacts of prostate radiation on ejaculatory function. We performed a systematic review and meta-analysis to assess ejaculatory outcomes in men after prostate radiation.We queried PubMed, Embase, and Web of Science to identify 17 articles assessing ejaculatory function post-radiation. The primary outcome was anejaculation rate and secondary outcomes included ejaculatory volume (EV), ejaculatory discomfort, and mean decline in ejaculatory function scores (EFS). We assessed study quality with the Newcastle-Ottawa scale. We calculated pooled proportions using inverse variance and random effects models.We identified 17 observational studies with 2156 patients reporting ejaculatory profiles post-radiation. Seven studies utilized external beam radiation therapy, 7 brachytherapy, 1 stereotactic RT and 2 utilized either external or brachytherapy. Ten studies reported an anejaculation rate. Pooled proportion of patients having anejaculation, decreased EV and EjD were 18% (95% CI, 11-36%), 85% (95% CI, 81-89%) and 24% (95% CI, 16-35%), respectively. Five studies reported decline in EFS post-radiation.Patients receiving radiation treatment may experience significant changes in their ejaculation, such as the absence of ejaculation, reduced EV, and EjD. It is important to counsel them about these potential side effects.