Radiotherapy for Peyronie's disease: A European survey

Background and purpose. Peyronie's Disease ( PD) is a benign condition characterized by penile nodules, pain and curvature. Radiotherapy has been used for many years with positive outcomes, however all studies published were non-randomized or non-controlled. The purpose of this survey was to understand which treatment policy is followed in Europe before setting up a randomized trial. Materials and methods. A questionnaire was sent out to 908 European radiotherapy institutions, 402 questionnaires were sent back and filled out correctly (44.5%). The questionnaire consisted of different items, regarding number of patients referred, fraction dose, total dose and technique used, and eventually treatment outcome of clinical trials. Results. Seventy-three institutions irradiate PD (19%), 304 do not (81%). Reasons for not treating were insufficient referrals from urologists or no interest in treating benign diseases. The most common fraction dose is 2 (range 0.5-8) Gy and the total radiation dose 20 (range 3-30) Gy. Most of the institutions use electrons (n=44) or orthovoltage (n=32). Decreased pain is reported in about 80% of the cases, and side effects by eight institutions. Conclusions. So far, a large variation of treatment schedules for radiotherapy of PD has been detected in European countries. Although the results are good and side effects minimal, there is still a need to set up a European randomized trial to prospectively evaluate the efficacy of radiotherapy for PD.