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Different irradiation machines and their effects on testes’ exposure levels and sex hormones profile in patients with rectal cancer

Published online by Cambridge University Press:  07 July 2010

Ahmad Ameri ,
Mehdi Sobhani ,
Asadollah Alidoosti ,
Ali Akbar Sharafi ,
Azim Arbabi ,
Farnaz Taslimi  and
Human Fazlalizadeh
Ahmad Ameri
Affiliation:
Shaheed Beheshti University of Medical Sciences, Tehran, Iran
Mehdi Sobhani
Affiliation:
Shaheed Beheshti University of Medical Sciences, Tehran, Iran
Asadollah Alidoosti
Affiliation:
Shaheed Beheshti University of Medical Sciences, Tehran, Iran
Ali Akbar Sharafi
Affiliation:
Iran University of Medical Sciences, Tehran, Iran
Azim Arbabi
Affiliation:
Shaheed Beheshti University of Medical Sciences, Tehran, Iran
Farnaz Taslimi
Affiliation:
Shaheed Beheshti University of Medical Sciences, Tehran, Iran
Human Fazlalizadeh
Affiliation:
Shaheed Beheshti University of Medical Sciences, Tehran, Iran
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Abstract

Objective: Complications of pelvic irradiation for rectal cancer have gained more attention because of increased survival of patients. The aim of this study was to compare testes doses when pelvis is irradiated using Cobalt 60 (Co60) for rectal cancer in comparison with linear accelerator (LINAC) and its effect on sex hormones levels.

Materials and Methods: In a cohort study, 28 rectal cancer patients that were candidate to receive pelvic radiotherapy were recruited in the study consecutively. They were sequentially assigned to receive radiotherapy using Co60 teletherapy or LINAC. Serum sex hormones levels were measured before and 3–6 weeks after irradiation. Testes absorption doses were measured three times during whole course of irradiation in nine patients.

Results: Testes doses in LINAC group were significantly lower than Co60 group (p < 0.001). Serum follicular-stimulating hormone (FSH) and luteinising hormone (LH ) levels increased after irradiation in both groups and there was not a significant relation between FSH and LH levels with treatment machine (p < 0.2 and p < 0.6, respectively). Serum testosterone level decreased significantly in Co60 group (p < 0.05) but not in LINAC group (p < 0.3).

Discussion: It seems using LINAC for pelvic irradiation in patient with rectal cancer cannot prevent hormonal changes and we suggest using extra shield to decrease testes doses below the toxic levels.

Keywords

Rectal cancersex hormonesradiation machinetesticular doses
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 9 , Issue 2 , June 2010 , pp. 99 - 105
Copyright
Copyright © Cambridge University Press 2010

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References

1.Hermann, RM, Henkel, K, Christiansen, H, Vorwerk, H, Hille, A, Hess, CF, Schmidberger, H. Testicular dose and hormonal changes after radiotherapy of rectal cancer. Radiother Oncol 2005; 75: 83–88.CrossRefGoogle ScholarPubMed
2.NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA 1990; 264: 1444–1450.CrossRefGoogle Scholar
3.Kinsella, TJ, Trivette, G, Rowland, J, Sorace, R, Miller, R, Fraass, B, Steinberg, SM, Glatstein, E, Sherins, RJ. Long-term follow-up of testicular function following radiation therapy for early-stage Hodgkin's disease. J Clin Oncol 1989; 7: 718–724.CrossRefGoogle ScholarPubMed
4.Shapiro, E, Kinsella, TJ, Makuch, RW, Fraass, BA, Glatstein, E, Rosenberg, SA, Sherins, RJ. Effects of fractionated irradiation of endocrine aspects of testicular function. J Clin Oncol 1985; 3: 1232–1239.CrossRefGoogle ScholarPubMed
5.Hansen, PV, Trykker, H, Svennekjaer, IL, Hvolby, J. Long-term recovery of spermatogenesis after radiotherapy in patients with testicular cancer. Radiother Oncol 1990; 18: 117–125.CrossRefGoogle ScholarPubMed
6.Howell, SJ, Shalet, SM. Spermatogenesis after cancer treatment: damage and recovery. J Natl Cancer Inst Monographs 2005; 34: 12–17.CrossRefGoogle Scholar
7.Bruheim, K, Svartberg, J, Carlsen, E, Dueland, S, Haug, E, Skovlund, E, Tveit, KM, Guren, MG. Radiotherapy for rectal cancer is associated with reduced serum testosterone and increased FSH and LH. Int J Radiat Oncol Biol Phys 2008; 70: 722–727.CrossRefGoogle ScholarPubMed
8.Izard, MA. Leydig cell function and radiation: a review of the literature. Radiother Oncol 1995; 34: 1–8.CrossRefGoogle ScholarPubMed
9.Shores, MM, Sloan, KL, Matsumoto, AM, Moceri, VM, Felker, B, Kivlahan, DR. Increased incidence of diagnosed depressive illness in hypogonadal older men. Arch Gen Psychiatry 2004; 61: 162–167.CrossRefGoogle ScholarPubMed
10.Mannaerts, GH, Schijven, MP, Hendrikx, A, Martijn, H, Rutten, HJ, Wiggers, T. Urologic and sexual morbidity following multimodality treatment for locally advanced primary and locally recurrent rectal cancer. Eur J Surg Oncol 2001; 27: 265–272.CrossRefGoogle ScholarPubMed
11.Schmitt, G, Glaeser, L, Kotsch, E. [Advantages and disadvantages of a 5.7 MeV linear accelerator compared to a 60Co-unit (author's transl)]. Strahlentherapie 1978; 154: 257–260.Google ScholarPubMed
12.Budgell, GJ, Cowan, RA, Hounsell, AR. Prediction of scattered dose to the testes in abdominopelvic radiotherapy. Clin Oncol (R Coll Radiol) 2001; 13: 120–125.Google Scholar
13.Piroth, MD, Hensley, F, Wannenmacher, M, Zierhut, D. [Male gonadal dose in adjuvant 3-d-pelvic irradiation after anterior resection of rectal cancer. Influence to fertility]. Strahlenther Onkol 2003; 179: 754–759.CrossRefGoogle ScholarPubMed
14.Dueland, S, Guren, MG, Olsen, DR, Poulsen, JP, Magne Tveit, K. Radiation therapy induced changes in male sex hormone levels in rectal cancer patients. Radiother Oncol 2003; 68: 249–253.CrossRefGoogle ScholarPubMed
15.Takizawa, S, Horii, I. Endocrinological assessment of toxic effects on the male reproductive system in rats treated with 5-fluorouracil for 2 or 4 weeks. J Toxicol Sci 2002; 27: 49–56.CrossRefGoogle ScholarPubMed