S2691
RTT - Patient experience and quality of life
ESTRO 2026
treatment erectile dysfunction. This study aimed to evaluate the association between the maximum radiation dose received by the penile bulb and the erectile function three months after hypofractionated radiotherapy for prostate cancer. Material/Methods: This retrospective study included patients with localized prostate cancer treated with hypofractionated radiotherapy. The penile bulb was contoured on planning CT scans, and the maximum dose (Dmax) was recorded for each patient (EQD2, α / β = 3 Gy). Erectile function was assessed at 3 months post-treatment using the International Index of Erectile Function questionnaire (IIEF-5). Scores range from 5 to 25, with lower scores indicating worse erectile function.The association between Dmax and IIEF-5 scores was analyzed using Spearman correlation. Results: A total of 30 patients with a median age of 67 years (range : 59–77) were included. Twelve patients (40%) received 60 Gy in 20 fractions, and eighteen patients (60%) received 68 Gy in 25 fractions. Only 3 patients (10%) did not receive hormonal therapy.Based on IIEF- 5 scores, 24 patients presented with mild, 3 with moderate, and 3 with severe erectile dysfunction. The maximal dose to the penile bulb (Dmax) ranged from 4.97 to 86.2 Gy (mean ± SD = 42.5 ± 18.3 Gy). Following radiobiological conversion to EQD2, the mean value was 48.6 ± 21.2 Gy. A significant negative correlation was observed between Dmax (EQD2) and IIEF-5 scores (r = -0.55, p < 0.01), indicating that higher radiation doses to the penile bulb are associated with worse erectile function. Conclusion: Radiation dose to the penile bulb may drive to early erectile dysfunction after hypofractionated radiotherapy. However, the complexity of the structures involved in sexual function is considerable and should be taken into account Keywords: Hypofractionation – Erectile function- prostate
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