首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Seminoma of the testis: is scrotal shielding necessary when radiotherapy is limited to the para-aortic nodes?
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Seminoma of the testis: is scrotal shielding necessary when radiotherapy is limited to the para-aortic nodes?

机译:睾丸精原细胞瘤:当放疗仅限于主动脉旁淋巴结时,是否必须进行阴囊屏蔽?

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摘要

PURPOSE: To evaluate the influence of different shielding conditions and field geometry on the scatter dose to the remaining testicle during postoperative radiotherapy (RT) in seminoma. MATERIALS AND METHODS: Testicular dose measurements were made with LiF thermoluminescent dosimeters (TLD) in 29 patients with stage I and IIA seminoma. The target volume consisted of para-aortic (PA) and para-aortic and homolateral iliac (PAI) lymph nodes in 14 and 15 patients, respectively. All patients had a scrotal shield as well as an additional block extending 7 cm inferiorly from the caudal field edge to shield the testicle from external scatter and collimator leakage. Doses with and without testicular blocks were measured for all patients. In seven patients treated exclusively to the PA region the gonadal dose was assessed according to four different shielding conditions: without any protection, with a gonadal shield alone, with the addition of an inferior field border block to the gonadal shield, and with the field border block alone. RESULTS: For patients treated with PAI fields the mean testicular doses per fraction were 3.89 cGy (S.D. +/- 1.44) and 1.48 cGy (S.D. +/- 0.51) without and with gonadal shielding, respectively (P-value < 0.001); the corresponding values for PA fields were 1.86 cGy (S.D. +/- 0.86) and 0.65 cGy (S.D. +/- 0.35). For the patients treated to the PA region and assessed according to the four different shielding conditions, the additional external block to the testicular shield did not reduce significantly the measured dose on the testis. CONCLUSIONS: These results suggest a benefit of gonadal shielding even in seminoma patients undergoing radiotherapy limited to the para-aortic region.
机译:目的:评估精原细胞瘤术后放疗期间不同屏蔽条件和场几何形状对剩余睾丸散射剂量的影响。材料与方法:用LiF热发光剂量计(TLD)对29例I期和IIA期精原细胞瘤患者进行了睾丸剂量测量。目标体积分别由14位和15位患者的主动脉旁(PA)以及主动脉旁和homo侧(PAI)淋巴结组成。所有患者均具有阴囊保护罩以及从尾视野边缘下方延伸7 cm的另一块屏障,以保护睾丸免受外部散射和准直仪渗漏。对所有患者均测量有无睾丸阻滞的剂量。在仅对PA区进行治疗的7名患者中,根据四种不同的屏蔽条件评估了性腺剂量:无任何保护,仅使用性腺屏蔽,在性腺屏蔽中添加下场边界块,并使用场边界单独封锁。结果:对于接受PAI领域治疗的患者,每级的平均睾丸剂量分别为3.89 cGy(S.D. +/- 1.44)和1.48 cGy(S.D. +/- 0.51),没有和有性腺屏蔽(P值<0.001); PA场的相应值为1.86 cGy(标准偏差+/- 0.86)和0.65 cGy(标准偏差+/- 0.35)。对于接受PA区域治疗并根据四种不同的屏蔽条件进行评估的患者,睾丸屏蔽的附加外部阻滞并未显着减少睾丸上的测量剂量。结论:这些结果表明,即使在接受限于主动脉旁区域放疗的精原细胞瘤患者中,性腺屏蔽也有益处。

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