Value of radiotherapy for Peyronie's disease: presentation of 56 new case studies and review of the literature

Fifty-six patients with Peyronie's Disease who were treated with radiotherapy at Penrose Cancer Hospital were studied retrospectively. All were treated with orthovoltage, mainly with total dosages of 1000 to 1400 roentgens (from around 950 to 1330 rad), in 11 to 17 days. Penile induration was present in all patients; 87% had curvature of the penis during erection and 70% had pain during intercourse. After treatments, more than half the patients had complete resolution of pain. The overall response rate was 79%. The mean interval treatment-response was 2.8 months; 41% had already improved at the end of therapy or within one month afterwards. Improvement of induration and penile deviation was less successful; there were almost no complete responders and about 40% had partial responses. Interval treatment-response was also longer (from 6 to 9 months). The size and location of the indurated placque did not influence response. The dosage, however, might influence the results; patients whose induration responded received a dose with a mean higher than non-responders. This difference was statistically significant. The duration of symptoms prior to treatment seems to be important. Eighty-one percent of responders had symptoms for less than five months; 76% of those with longer symptomatology did not benefit from irradiation. Failure by other methods of treatment did not preclude a response. Review of the literature shows that untreated patients have a benign course; a high percentage have eventual improvement or resolution of symptoms. However, spontaneous improvement occurs slowly and treatment seems to accelerate the process of recovery. Radiotherapy seems to be at least as successful as any other method of treatment. It should be recommended to patients who are troubled by their symptoms as a localized, painless, fast method of treatment, with no particular complications