Abstract
The aim of this study was to investigate incidental testicular doses during intensity
modulated radiation therapy (IMRT) in patients treated with prostate radiotherapy
only (PORT) and whole pelvis radiotherapy (WPRT). A total of 34 prostate cancer patients
with intermediate and high risk were included in this prospective study. Each patient
in the intermediate risk group received a total of 78 Gy in 39 fractions for prostate
and seminal vesicles. In patients in the high risk group, 2 Gy daily fraction dose
for pelvic lymphatics was given to 50 Gy, and then 78 Gy was given to prostate and
seminal vesicles volumes. Treatment plans were created for all patients using the
IMRT technique with 6MV. Testicular doses were measured for WPRT and PORT by thermoluminescence
dosimetry (TLD) detectors placed on testis surface. Testicular doses measured for
WPRT and PORT were compared. The isocenter to testicular distance for WPRT and PORT
was 16.83-cm (13.20 to 18.80-cm) and 11.15 cm (9.10 to 13.00-cm), respectively. The
mean testicular dose measurements of TPS and TLD per fraction during PORT were 2.41
cGy (1.95 to 3.60 cGy) and 3.70 cGy (2.80 to 5.10 cGy), respectively (p = 0.00). In WPRT irradiation, mean testicular dose values of TPS and TLD per fraction
were measured as 3.85 cGy (2.00 to 5.70 cGy) and 5.85 cGy (4.25 to 7.55 cGy), respectively
(p = 0.00). The cumulative mean scattered dose for PORT irradiation of 78 Gy in 39 fractions
was 144.30 cGy. The mean cumulative dose received by the testis for the high-risk
prostate patient was 228.15 cGy. There was a significant difference in testicular
dose between WPRT and PORT irradiation. Testicular doses decreased significantly with
increasing isocenter-testis distance. Incidental testicular dose during prostate radiotherapy
can be significantly detrimental to spermatogenesis. Therefore, the testicles should
be contoured as an organ at risk for the estimation of absorbed doses. The use of
in vivo dosimetry is recommended for accurate measurement of testicular dose in radiotherapy
of prostate cancer for men desiring continued fertility.
Keywords
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Article info
Publication history
Published online: March 12, 2022
Accepted:
February 10,
2022
Received in revised form:
January 12,
2022
Received:
November 19,
2021
Identification
Copyright
© 2022 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.
