Aspermia following lower truncal irradiation in Hodgkin's disease

Abstract

Very little is known concerning the radiation affects on the spermatogenic epithelium of the human. This was studied by serial semen analysis in male patients with Hodgkin's disease. Dosimetry in vivo indicated that with an average daily dose of 12.0 rads, the testes receive a total dose of 140 to 300 rads during the inverted Y‐inguinal field treatment. Of 10 consecutive patients entered into the study, all were documented as being aspermic in the immediate post‐irradiation period. Comparison is made with those cases of accidental single dose irradiation of the testes reported in the literature. The fractionated irradiation caused aspermia for longer periods and more consistently than similar or larger single doses. This is new human evidence which supports the observation in animals that a particular mode of fractionated irradiation may be both more effective and efficient than single dose irradiation in producing the above specified endpoints.

A study of reproductive function in patients with seminoma treated with radiotherapy and orchidectomy: (SWOG-8711)

“…Serum testosterone concentration did not significantly change with RT dose. Time to recovery of SC was dose dependent, but seemed to be longer than that found by Rowley et al ( 17)) consistent with the suggestion by Speiser et al (20) that fractionated radiation has a more profound effect than single doses.…”

“…Several papers ( 13,19,20) examined men treated for soft-tissue sarcomas or Hodgkin's disease with RT only with no obvious involvement of the testicles. The sarcoma group had 27 patients, and the testicular doses ranged from 0.01 to 25 Gy (they were measured directly in 17 and calculated in the rest).…”

Preservation of Fertility in Pediatric and Adolescent Patients With Cancer

“…The oocyte median lethal dose for radiation therapy is less than 2 Gy, 33 and sperm production is susceptible to damage at doses of more than 1.2 Gy. 28,34 Testicular Leydig cell function seems to be present at radiation doses up to 20 Gy. 2 Recognizing the risks associated with both radiation and chemotherapy, the American Society of Clinical Oncology 35 has recommended that oncologists address the possibility of infertility with patients treated during their reproductive years and be prepared to discuss fertilitypreservation options or refer patients to reproductive specialists as indicated.…”

Recovery of a low mutant frequency after ionizing radiation-induced mutagenesis during spermatogenesis

“…The testis is one of the most radiosensitive organs and the spermatogonia are the most radiosensitive cell types in adult testes in terms of cell killing by IR [18][19][20][21][22]. For example, aspermia was observed in male patients with Hodgkin's disease after receiving lower trunk fractionated irradiation therapy [23]. Further, spermatids are susceptible to IR-induced mutations using the SL test [24], dominant lethal assay [25] and ESTRs [26].…”