Alterations in Hormone Levels After Adjuvant Chemoradiation in Male Rectal Cancer Patients

Yoon, F.; Perera, Francisco; Fisher, Barbara; Stitt, Larry

doi:10.1016/j.ijrobp.2008.09.027

Cited by 19 publications

(11 citation statements)

References 25 publications

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“…We have previously shown that RT for rectal cancer is associated with increased risk of endocrine hypogonadism (11), and this finding was recently confirmed in a prospective study (22). In the present study, we found that S-testosterone below 8 nmol/L was statistically significantly associated with moderate-severe ED.…”

Section: Discussionsupporting

confidence: 86%

Sexual Function in Males After Radiotherapy for Rectal Cancer

Bruheim

Guren

Dahl

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionsupporting

confidence: 86%

Sexual Function in Males After Radiotherapy for Rectal Cancer

Bruheim

Guren

Dahl

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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“…For conventional pelvic radiation therapy, the drop is approximately 10-30%; this reaches a nadir, on average, several months post-treatment and can persist for years thereafter [28-33]. In addition to precipitating clinical hypogonadism, with its adverse effects [15], this testosterone decline may undermine the utility of PSA as a tumor response marker [10].…”

Section: Discussionmentioning

confidence: 99%

Low incidence of new biochemical and clinical hypogonadism following hypofractionated stereotactic body radiation therapy (SBRT) monotherapy for low- to intermediate-risk prostate cancer

et al. 2011

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BackgroundThe CyberKnife is an appealing delivery system for hypofractionated stereotactic body radiation therapy (SBRT) because of its ability to deliver highly conformal radiation therapy to moving targets. This conformity is achieved via 100s of non-coplanar radiation beams, which could potentially increase transitory testicular irradiation and result in post-therapy hypogonadism. We report on our early experience with CyberKnife SBRT for low- to intermediate-risk prostate cancer patients and assess the rate of inducing biochemical and clinical hypogonadism.MethodsTwenty-six patients were treated with hypofractionated SBRT to a dose of 36.25 Gy in 5 fractions. All patients had histologically confirmed low- to intermediate-risk prostate adenocarcinoma (clinical stage ≤ T2b, Gleason score ≤ 7, PSA ≤ 20 ng/ml). PSA and total testosterone levels were obtained pre-treatment, 1 month post-treatment and every 3 months thereafter, for 1 year. Biochemical hypogonadism was defined as a total serum testosterone level below 8 nmol/L. Urinary and gastrointestinal toxicity was assessed using Common Toxicity Criteria v3; quality of life was assessed using the American Urological Association Symptom Score, Sexual Health Inventory for Men and Expanded Prostate Cancer Index Composite questionnaires.ResultsAll 26 patients completed the treatment with a median 15 months (range, 13-19 months) follow-up. Median pre-treatment PSA was 5.75 ng/ml (range, 2.3-10.3 ng/ml), and a decrease to a median of 0.7 ng/ml (range, 0.2-1.8 ng/ml) was observed by one year post-treatment. The median pre-treatment total serum testosterone level was 13.81 nmol/L (range, 5.55 - 39.87 nmol/L). Post-treatment testosterone levels slowly decreased with the median value at one year follow-up of 10.53 nmol/L, significantly lower than the pre-treatment value (p < 0.013). The median absolute fall was 3.28 nmol/L and the median percent fall was 23.75%. There was no increase in biochemical hypogonadism at one year post-treatment. Average EPIC sexual and hormonal scores were not significantly changed by one year post-treatment.ConclusionsHypofractionated SBRT offers the radiobiological benefit of a large fraction size and is well-tolerated by men with low- to intermediate-risk prostate cancer. Early results are encouraging with an excellent biochemical response. The rate of new biochemical and clinical hypogonadism was low one year after treatment.

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“…In current study, with short term patients follow up, we could not establish whether the changes in plasma levels of FSH and LH, and the reduction in testosterone levels were a temporary or permanent finding in patients who received chemoradiotherapy to a maximum total tumor dose of 50.40 Gy. Yoon et al indicated that chemoradiation in men with rectal cancer caused persistent increases in FSH and LH levels and decreases in testosterone levels (17). Moreover, another study by Joos et al (18) indicated a temporary hormone elevation in patients with testicular scatter doses as low as 0.55 Gy.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Relationship Between Testicular Dose and Hormonal Changes After Radiotherapy in Patients With Rectal Cancer

Sourati

Malekzadeh

Bakhshandeh

et al. 2015

Rep Radiother Oncol

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Background: Colorectal cancer globally affects more than 1 million people every year. It is more common in men and it is the second most common cause of cancer mortality. Optimal treatment of colorectal cancer is a multidisciplinary approach which can be included of surgery, medical oncology, and radiation therapy. Objectives: The aim of this study was evaluation of relationship between testicular dose and hormonal changes after radiotherapy in male patients with rectal cancer. Patients and Methods: In this study 25 patients with rectal cancer were enrolled. The serum levels of luteinize hormone (LH), follicle stimulating hormone (FSH), and testosterone (T) before and 3 -6 weeks after chemoradiotherapy were compared and testicular dose was determined using a 3-dimension treatment planning system and relationship between hormonal changes and testicular dose was assessed. Results: 25 patients with rectal cancer with mean (± SD) age of 56.08 (± 14.30) years were evaluated. The mean (± SD) testes dose was 2.35 (± 2.32) Gy that was 6.09% of total dose. The levels of FSH and LH significantly increased (P = 0.001), however, the level of testosterone non -significantly decreased after 3 -6 weeks of radiation therapy (P = 0.79). No significant correlation was found between testes dose and sex hormones change (LH, P = 0.33; FSH, P = 0.16; testosterone, P = 0.95). Furthermore the testes dose did not correlate with the lower border of treatment field (P = 0.26), total given dose to the patients (P = 0.81) and tumor location (P = 0.09). Conclusions:The testes dose in this study was 6.09% of total dose. Radiotherapy of rectal cancer causes damage to the testis, as shown by increased levels of gonadotropins after radiotherapy. The radiation therapy significantly increased LH, FSH and non-significantly decreased testosterone level in patients with rectal cancer. No correlation could be found between changes of hormones and doses to the testis, probably due to the low number of evaluated patients. Larger studies are needed to establish the correlation between testicular radiation dose and hormonal changes in this group of patients.

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Alterations in Hormone Levels After Adjuvant Chemoradiation in Male Rectal Cancer Patients

Cited by 19 publications

References 25 publications

Sexual Function in Males After Radiotherapy for Rectal Cancer

Sexual Function in Males After Radiotherapy for Rectal Cancer

Low incidence of new biochemical and clinical hypogonadism following hypofractionated stereotactic body radiation therapy (SBRT) monotherapy for low- to intermediate-risk prostate cancer

Evaluation of Relationship Between Testicular Dose and Hormonal Changes After Radiotherapy in Patients With Rectal Cancer

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