Acute changes in sexual function, hormonal profiles, and psychological status following intensity-modulated radiotherapy in male patients with nasopharyngeal carcinoma.

PURPOSE: To evaluate the acute effects of intensity-modulated radiotherapy (IMRT) on sexual function, sex hormone levels, and psychological status in male patients with nasopharyngeal carcinoma, and to further assess the associations between changes in sexual function and hormonal and psychological parameters.

METHODS

Eighty-five male patients with nasopharyngeal carcinoma who received IMRT were retrospectively included. Erectile function was evaluated using the International Index of Erectile Function-5 (IIEF-5), and ejaculatory function was assessed using the Chinese Index of Premature Ejaculation (CIPE). Serum sex hormone levels, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E2), prolactin (PRL), and progesterone (P), as well as psychological status assessed by the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), were extracted from clinical records at baseline and 30 days after radiotherapy. Paired comparisons (paired t-tests or Wilcoxon signed-rank tests) and Pearson correlation analyses were performed.

RESULTS

Within 30 days following IMRT, both IIEF-5 and CIPE scores significantly decreased compared with baseline (both p < 0.001). Post-treatment levels of FSH and PRL were significantly increased, whereas T and P levels were significantly decreased (all p < 0.001). No significant changes were observed in LH or E2 levels. Correlation analyses revealed weak associations between sexual function scores and sex hormone levels (|r| < 0.2). SAS and SDS scores did not change significantly after radiotherapy, and psychological scores showed a weak negative correlation with sexual function scores.

CONCLUSION

In male patients with nasopharyngeal carcinoma, IMRT is associated with a significant decline in sexual function during the acute phase, accompanied by alterations in sex hormone profiles. Sexual function changes showed weak associations with both hormonal and psychological factors.