- •TLD-measured dose to testes in rectal cancer radiotherapy is clinically significant.
- •Testes point doses calculated by planning software is similar to TLD-measured doses.
- •Testes dose can be well estimated by planning software outside the radiation fields.
- •The manuscript also briefly discusses and summarizes the previous works on this issue.
Radiation received by the testes in the course of radiotherapy for rectal cancer may cause oligospermia and azospermia. We sought to determine the dose to the scrotum and testes with thermoluminescence dosimetry (TLD), and compare it to the dose calculated by 3D planning software.
The TLDs were fixed to the scrotum in six points anteriorly and posteriorly in two fractions of radiotherapy. All patients received a 50–50.4 Gy total dose in prone position with 3D-planning. The average dose of TLD measurements was compared to the average of 6 relevant point doses calculated by the planning software.
The mean scrotal dose of radiation in 33 patients as measured by TLD was 3.77 Gy (7.5% of the total prescribed dose), and the mean of point doses calculated by the planning software was 4.11 Gy (8.1% of the total dose), with no significant difference. A significant relationship was seen between the position of the inferior edge of the fields and the mean scrotal dose (P = .04). Also body mass index (BMI) was inversely related with the scrotal dose (P = .049).
We found a dose of about 4 Gy received by the scrotum and testes from a total prescribed dose of 50 Gy in the radiotherapy of rectal carcinoma patients, with TLD measurements confirming testicular dose estimations by the planning software. This dose could be significantly harmful for spermatogenesis. Thus careful attention to the testicular dose in radiotherapy of rectal cancer for men desiring continued fertility is a necessity.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Physica Medica: European Journal of Medical Physics
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Male infertility in cancer patients: review of the literature.Int J Urol. 2010; 17: 327-331
- Effects of chemotherapy and radiotherapy on spermatogenesis in humans.Fertil Steril. 2013; 100: 1180-1186
- Spermatogenesis after cancer treatment: damage and recovery.J Natl Cancer Inst Monogr. 2005; 34: 12-17
- Testicular function after radiotherapy for rectal cancer: a review.J Sex Med. 2011; 8: 3220-3226
- Testicular dose and hormonal changes after radiotherapy of rectal cancer.Radiother Oncol. 2005; 75: 83-88
- Male gonadal dose in adjuvant 3-d-pelvic irradiation after anterior resection of rectal cancer: influence to fertility.Strahlenther Onkol. 2003; 179: 754-759
- Radiation therapy induced changes in male sex hormone levels in rectal cancer patients.Radiother Oncol. 2003; 68: 213-215
- Risk of hypogonadism from scatter radiation during pelvic radiation in male patients with rectal cancer.Int J Radiat Oncol Biol Phys. 2009; 74: 1481-1486
- Impact of scattered radiation on testosterone deficiency and male hypogonadism in rectal cancer treated with external beam pelvic irradiation.Middle East J Cancer. 2010; 1: 115-122
- Radiation dose to testes and risk of infertility from radiotherapy for rectal cancer.Oncol Rep. 2006; 15: 729-733
- Prediction of scattered dose to the testes in abdominopelvic radiotherapy.Clin Oncol (R Coll Radiol). 2001; 13: 120-125
Accepted: December 18, 2017
Received in revised form: December 16, 2017
Received: August 10, 2016
© 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.