[Testes doses and sex hormone changes using different radiotherapy machines to treat rectal cancer]

Complications of pelvic irradiation have gained more attention because of increased survival of patients. CO-60 Teletherapy has wide penumbra in comparison with linear accelerator that can cause testes irradiation during radiotherapy in vicinity of lower border of pelvic portal when treated for rectal cancer. In this study we compared testicular doses of testes when pelvis is irradiated for rectal cancer and its effect on sex hormone levels. In a cohort study, rectal cancer patients treated by pelvic irradiation concomitant with chemotherapy in two group. A group treated by Co-60 Teletherapy and another group by Linear Accelerator [LINAC]. Sex hormones serum levels were measured immediately before and 3 to 6 weeks after finishing irradiation. Testicular doses were measured by TLD [LiF], 3 times during whole course of irradiation in 5 patients of each group. T test and Mann-Whitney were used to compare data. 28 patients entered in study but 2 patients died early in course of radiotherapy [1 in each group], and one patient excluded because testes was inside of treatment portals. Patients and disease characteristics were similar between groups. Testes doses in patients treated by LINAC [55 +/- 24.7 mGy] was significantly lower than Co-60 [120 +/- 23 mGy] [p <0.001]. FSH and LH serumic level increased after irradiation in both groups and there is not a relation between FSH and LH levels with treatment machine [p<0.2] for LINAC and p<0.6 for Co-60. Decrease in serumic levels of testosterone was significant in patients treated by CO-60 [p<0.05], but was not significant in LINAC group [p<0.3]. It seems using LINAC in treating patient with rectal cancer can decrease testes doses but can not prevent hormonal changes. We suggest extra shield to decrease testes doses below the toxic dose

Clinical manifestations and treatment results of patients with cervical cancer: a report from Iran

Cervical cancer is one of the major causes of cancer and death among women aged 40 to 60 in developing countries. There is some difference, however, in the incidence of this cancer in Iranian women compared to women living in western and south-east Asian countries. We aimed at investigating the epidemiologic aspects and treatment results of cervical cancer among Iranian patients. Medical records of patients with cervical cancer who were referred to Mortazavi Radiation Oncology Center [Imam Hossein Hospital] between 2000 and 2004 were evaluated retrospectively. Clinical data such as stage of the disease, type pf chemotherapy, radiation technique and sequence of treatment was recorded. A total of 220 patients with a median age of 55 years [range: 28 to 89] were studied. The majority of them [37.3%] were referred with stage IIB of the disease. Other stages, in order of frequency, were IIA, IIIA and IB. Most of the patients [74%] were treated with two opposed field radiotherapy with a dose of 50 Gy or less [64%]. Disease recurred in 46 patients [21%], 153 patients [74%] received two opposed field radiotherapy and 54 [36%] patients were treated with four fields. On the other hand, 113 patients [55%] did not receive brachytherapy, 36 [18%] only received ovoid brachytherapy and 56 [27%] were treated with ovoid and tandem brachytherapy. Recurrence was more prevalent if the radiotherapy dose was less than 50 Gy and also in patients treated with four-field box technique. The most frequent site of recurrence was pelvic area [71%]. Our report revealed that most of the patients in Iran are diagnosed in advanced stages, a finding that can influence treatment results. Also, using external beam radiotherapy techniques, accessibility to brachytherapy devices and better patient support may improve treatment results