Testicular Dose in Prostate Cancer Radiotherapy

Boehmer, Dirk; Badakhshi, Harun; Kuschke, Wolf; Bohsung, Joerg; Budach, Volker

doi:10.1007/s00066-005-1282-1

Cited by 34 publications

(8 citation statements)

References 33 publications

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“…Excluded from this review were patients with seminoma because they are significantly younger and have had a semicastrating surgery. With pelvic radiotherapy using four-field techniques, the typical scattered dose to the testes was in the range of 2-4 Gy (8,11,12,21,22). The hormonal consequences were a significant increase in LH and FSH and a decrease of as much as 30% in testosterone levels (8)(9)(10)(11)(12)(13).…”

Section: Discussionmentioning

confidence: 98%

Incidental Testicular Irradiation From Prostate IMRT: It All Adds Up

King

Maxim

Hsu

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionmentioning

confidence: 98%

Incidental Testicular Irradiation From Prostate IMRT: It All Adds Up

King

Maxim

Hsu

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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“…Both chemotherapy and radiotherapy can In all irradiation fields, the transposed testicle (shaded) either lies outside the irradiation field or is shielded from radiation using multileaf collimators. result in impairment of spermatogenesis and testicular hormone production [5]. It is difficult to impossible to pharmacologically prevent the side effects of chemotherapy, but placement of leaves of multileaf collimators in the irradiation fields can often protect susceptible organs from radiation damage.…”

Section: Discussionmentioning

confidence: 99%

Surgical Repositioning of the Contralateral Testicle Before Irradiation of a Paratesticular Rhabdomyosarcoma for Preservation of Hormone Production

Grüschow

Kyank

Stuhldreier

et al. 2007

Pediatric Hematology and Oncology

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Little has been published so far about the possibility of preserving an uninvolved testicle by surgically transferring it out of the irradiation field. A then 16-year-old boy developed a right paratesticular embryonal rhabdomyosarcoma in 2003. Initial treatment consisted of orchiectomy and chemotherapy. Prior to local radiotherapy, the contralateral testicle was surgically transferred into the left groin region. Hyperfractionated, accelerated radiation therapy was administered to a total dose of 44.0 Gy. After radiotherapy, the testicle was returned. The patient's testosterone levels are still normal. No clinical abnormalities or signs of tumor had been observed as of June 2006.

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“…Scatter dose to testes from the full course of conventional pelvic EBRT (68–70 Gy) for prostate cancer has been reported to be approximately 2 Gy [6,8,20]. Recent IMRT data demonstrate a testicular dose ranging from 0.84 Gy with prostate-only treatment to 6.3 Gy with pelvic EBRT plus a prostate boost [21].…”

Section: Discussionmentioning

confidence: 99%

Hypofractionated passively scattered proton radiotherapy for low- and intermediate-risk prostate cancer is not associated with post-treatment testosterone suppression

et al. 2013

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Background.To investigate post-treatment changes in serum testosterone in low- and intermediate-risk prostate cancer patients treated with hypofractionated passively scattered proton radiotherapy.Material and methods.Between April 2008 and October 2011, 228 patients with low- and intermediate-risk prostate cancer were enrolled into an institutional review board-approved prospective protocol. Patients received doses ranging from 70 Cobalt Gray Equivalent (CGE) to 72.5 CGE at 2.5 CGE per fraction using passively scattered protons. Three patients were excluded for receiving androgen deprivation therapy (n = 2) or testosterone supplementation (n = 1) before radiation. Of the remaining 226 patients, pretreatment serum testosterone levels were available for 217. Of these patients, post-treatment serum testosterone levels were available for 207 in the final week of treatment, 165 at the six-month follow-up, and 116 at the 12-month follow-up. The post-treatment testosterone levels were compared with the pretreatment levels using Wilcoxon's signed-rank test for matched pairs.Results.The median pretreatment serum testosterone level was 367.7 ng/dl (12.8 nmol/l). The median changes in post-treatment testosterone value were as follows: +3.0 ng/dl (+0.1 nmol/l) at treatment completion; +6.0 ng/dl (+0.2 nmol/l) at six months after treatment; and +5.0 ng/dl (0.2 nmol/l) at 12 months after treatment. None of these changes were statistically significant.Conclusion.Patients with low- and intermediate-risk prostate cancer treated with hypofractionated passively scattered proton radiotherapy do not experience testosterone suppression. Our findings are consistent with physical measurements demonstrating that proton radiotherapy is associated with less scatter radiation exposure to tissues beyond the beam paths compared with intensity-modulated photon radiotherapy.

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Testicular Dose in Prostate Cancer Radiotherapy

Abstract: The dose received by the unshielded testes can be assessed as a risk for permanent infertility and impairment of hormonal function in prostate cancer patients treated with external-beam radiotherapy.

Cited by 34 publications

References 33 publications

Incidental Testicular Irradiation From Prostate IMRT: It All Adds Up

Incidental Testicular Irradiation From Prostate IMRT: It All Adds Up

Surgical Repositioning of the Contralateral Testicle Before Irradiation of a Paratesticular Rhabdomyosarcoma for Preservation of Hormone Production

Hypofractionated passively scattered proton radiotherapy for low- and intermediate-risk prostate cancer is not associated with post-treatment testosterone suppression

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