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A randomised, double-blind, placebo-controlled trial of nightly sildenafil citrate to preserve erectile function after radiation treatment for prostate cancer

Authors

  • Dragan Ilic,

    1. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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  • Ben Hindson,

    1. Department of Surgery, Monash University, Melbourne, Victoria, Australia
    2. William Buckland Radiotherapy Centre (WBRC), The Alfred Hospital, Melbourne, Victoria, Australia
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  • Gillian Duchesne,

    1. Department of Biochemistry, Monash University, Melbourne, Victoria, Australia
    2. Department of Medical Radiations, Monash University, Melbourne, Victoria, Australia
    3. Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
    4. Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
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  • Jeremy L Millar

    Corresponding author
    1. Department of Surgery, Monash University, Melbourne, Victoria, Australia
    2. William Buckland Radiotherapy Centre (WBRC), The Alfred Hospital, Melbourne, Victoria, Australia
    • Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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  • D Ilic PhD; B Hindson FRANZCR; G Duchesne MD, FRANZCR; JL Millar FAChPM, FRANZCR.
  • Conflict of interest: None.
  • Trial registration: ACTRN12606000116527.

Correspondence

Associate Professor Jeremy L Millar, William Buckland Radiotherapy Centre (WBRC), The Alfred Hospital, Melbourne, Vic. 3004, Australia.

Email: jeremy.millar@monash.edu

Abstract

Introduction

Erectile dysfunction (ED) is a common adverse event associated with treatment for prostate cancer. This study aimed to identify whether early, regular use of sildenafil after radiation treatment for prostate cancer is effective at reducing the rate of ED at 2 years.

Methods

A randomised controlled trial with 27 men planned for radiation treatment for localised prostate cancer recruited from a single radiotherapy centre in Australia. Men were randomised to receive daily sildenafil, or a placebo tablet, for 6 months. The primary end-point was erectile function, as measured by the International Index of Erectile Function (IIEF) score, at 2-year follow-up. The abridged IIEF-5 survey was also used during the treatment period, and could be derived from the full IIEF at other time-points. Two-sided Student's t-tests and Mann–Whitney U-tests were used for the analysis of continuous outcomes, with Fisher's exact test for dichotomous outcomes.

Results

No difference was seen at 2 years in the primary end-point, and IIEF scores did not differ significantly between groups during the study. Men in the sildenafil group exhibited significantly better IIEF-5 scores at 4 weeks (P = 0.02) and 6 months (P = 0.02). There was no difference in erectile function scores between the two groups throughout the treatment period. No significant difference in adverse events was identified between the two groups.

Conclusion

There was no evidence from this trial that sildenafil provides long-term erectile function for patients while on medication. Regular use of sildenafil may improve short-term sexual function for patients while on medication. Larger trials are required to examine the effectiveness of implementing sildenafil for prostate cancer patients undergoing radiation treatment.

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