{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:12:03Z","timestamp":1788999123969,"version":"build-2803163510"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2011,11,1]],"date-time":"2011-11-01T00:00:00Z","timestamp":1320105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,11,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Eighty percent of all male rectal cancer patients are sexually active at the time of diagnosis. Because of modern multimodal therapy many can expect long-term survival. The testes can be exposed to scattered or direct radiation during radiotherapy, depending on their position in relation to the targeted volume.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This review analyzes the current literature providing data on testicular exposure to radiation during radiotherapy for rectal cancer and the consequences on testicular function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search was conducted in PubMed, Embase, and Cochrane. Ten original articles providing data on testicular exposure to radiation and testicular function in men with primary rectal cancer were included for qualitative synthesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Data on testicular exposure to radiation and testosterone levels in men with rectal cancer are reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>On average, the testes were exposed to 0.24\u20138.4\u2003Gy during long-course radiotherapy for rectal cancer. Testosterone levels after radiation were significantly lower compared with pretreatment levels or compared with patients treated with surgery alone. After radiotherapy, the absolute risk increase was 0.17\u20130.30 for posttreatment testosterone levels below 8\u2003nmol\/L. In the largest study, the relative risk was 2.7 for testosterone levels below 8\u2003nmol\/L for men treated with radiotherapy compared with men treated with surgery alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Current data generate three hypotheses: (i) during long-course radiotherapy for rectal cancer, the testes can be exposed to direct and\/or scattered radiation; (ii) men treated with radiotherapy seem at risk to develop testicular dysfunction with decreased serum testosterone levels compared with both pretreatment values and men treated with surgery alone; and (iii) a decrease in testosterone levels (&amp;lt;8\u2003nmol\/L) may precipitate specific symptoms caused by testosterone deficiency such as impaired physical, psychological, and sexual function after treatment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1743-6109.2011.02455.x","type":"journal-article","created":{"date-parts":[[2011,9,27]],"date-time":"2011-09-27T19:52:58Z","timestamp":1317153178000},"page":"3220-3226","source":"Crossref","is-referenced-by-count":31,"title":["Testicular Function After Radiotherapy for Rectal Cancer\u2014A Review"],"prefix":"10.1093","volume":"8","author":[{"given":"Christian","family":"Buchli","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Martling","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Arver","sequence":"additional","affiliation":[{"name":"Center for Andrology and Sexual Medicine, Karolinska Institutet , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torbj\u00f6rn","family":"Holm","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital , Stockholm , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2011,11,1]]},"reference":[{"key":"2023010704073644600_bb0010","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1200\/JCO.2005.05.256","article-title":"Impact of short-term preoperative radiotherapy on health-related quality of life and sexual functioning in primary rectal cancer: Report of a multicenter randomized trial","volume":"23","author":"Marijnen","year":"2005","journal-title":"J Clin Oncol"},{"key":"2023010704073644600_bb0015","doi-asserted-by":"crossref","first-page":"2269","DOI":"10.1002\/1097-0142(19950501)75:9<2269::AID-CNCR2820750913>3.0.CO;2-I","article-title":"The Stockholm I trial of preoperative short term radiotherapy in operable rectal carcinoma. 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