Highlights
- •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.
Abstract
Purpose
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.
Methods
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.
Results
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).
Conclusion
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.
Keywords
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Article info
Publication history
Accepted:
December 18,
2017
Received in revised form:
December 16,
2017
Received:
August 10,
2016
Identification
Copyright
© 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.
