Testicular dose and hormonal changes after radiotherapy of rectal cancer

Hermann, Robert Michael; Henkel, Kai-Olaf; Christiansen, Hans; Vorwerk, Hilke; Hille, Andrea; Hess, Clemens F.; Schmidberger, Heinz

doi:10.1016/j.radonc.2004.12.017

Cited by 78 publications

(52 citation statements)

References 18 publications

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“…Consistently, Zagars and Pollack demonstrated a significant drop in testosterone levels in 85 patients receiving a testicular dose of 2 Gy (10). In present survey, the mean testes dose was 6.09% (2.35 ± 2.13 Gy) of total prescribed dose given to the patients that was similar to testicular irradiation dose during radiotherapy for rectal cancer which previously was measured by Hermann et al (14). They demonstrated that the mean testes dose was 7.1% (3.56 Gy) of total dose (50 Gy) measured with an ionisation chamber.…”

Section: Discussionsupporting

confidence: 86%

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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Section: Discussionsupporting

confidence: 86%

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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“…Dueland et al found a 25% fall in s-testosterone 4 Á6 weeks after a pelvine dose of 45 Á60 Gy for rectal cancer, with measured testicular doses of 3.7 Á13.7 Gy [37]. Others have found similar fall in testosterone, and these patients should be informed about the risk of endocrine failure and the high risk of permanent infertility [38].…”

Section: Radiotherapymentioning

confidence: 96%

Gonadal dysfunction and fertility problems in cancer survivors

et al. 2007

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“…Also the selected radiation doses are important in cancer patients receiving ionizing radiation for treatment of cancers such as prostate, testicular or rectal. The routine daily radiation dose is 2 Gy in radiotherapy of these cancers and mean cumulative radiation exposure to the testicles at the end of treatment is shown to be about 3.56 Gy [18,19]. Therefore, if there exist genome instability in a non target tissue like peripheral blood lymphocytes, then a similar effect is expected to occur in germ cells.…”

Section: Micronuclei Assaymentioning

confidence: 99%

Increased frequency of micronuclei in lymphocytes of infertile males after exposure to gamma irradiation: a possible sign of genomic instability

Moghbelinejad

Mozdarani

Aleyasin

2011

J Assist Reprod Genet

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Purpose Induced chromosomal instability and micronucleus (MN) formation in blood lymphocytes of infertile men in comparison with fertile men exposed to gamma radiation was investigated. Methods Blood samples of healthy and infertile donors were irradiated by 2 and 4 Gy Co-60 gamma-rays, then cultured in RPMI-1640 complete medium containing 1% phytoheamaglutinin (PHA) and incubated in a CO 2 incubator. Cytochalasin-B was added to the cultures at a final concentration of 4 μg/ml. Finally, harvesting, slide making, and analysis were performed according to standard procedures. Results We observed a statistically significant difference between the frequencies of micronuclei in lymphocytes of infertile individuals, compared to healthy donors, before and after exposure to gamma rays. Although higher in azoospermia patients, the frequency of MN was not statistically different between infertile groups. Conclusions This study indicates that genomic instability in infertile men could probably contribute to the development of an impaired reproductive capacity.

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Testicular dose and hormonal changes after radiotherapy of rectal cancer

Cited by 78 publications

References 18 publications

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

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

Gonadal dysfunction and fertility problems in cancer survivors

Increased frequency of micronuclei in lymphocytes of infertile males after exposure to gamma irradiation: a possible sign of genomic instability

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