Department of Radiation Oncology, University of California-San Francisco, San Francisco, CA 94143-1708, USA.
Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S130-4. doi: 10.1016/j.ijrobp.2009.04.094.
The dose, volume, and clinical outcome data for penile bulb are reviewed for patients treated with external-beam radiotherapy. Most, but not all, studies find an association between impotence and dosimetric parameters (e.g., threshold doses) and clinical factors (e.g., age, comorbid diseases). According to the data available, it is prudent to keep the mean dose to 95% of the penile bulb volume to <50 Gy. It may also be prudent to limit the D70 and D90 to 70 Gy and 50 Gy, respectively, but coverage of the planning target volume should not be compromised. It is acknowledged that the penile bulb may not be the critical component of the erectile apparatus, but it seems to be a surrogate for yet to be determined structure(s) critical for erectile function for at least some techniques.
我们回顾了接受外照射放射治疗的患者的阴茎球部剂量、体积和临床结果数据。大多数(但并非全部)研究发现,勃起功能障碍与剂量学参数(如阈值剂量)和临床因素(如年龄、合并症)之间存在关联。根据现有数据,谨慎的做法是将 95%的阴茎球部体积的平均剂量保持在<50Gy。将 D70 和 D90 分别限制在 70Gy 和 50Gy 可能也是谨慎的做法,但不应影响计划靶区的覆盖范围。虽然承认阴茎球部可能不是勃起装置的关键组成部分,但对于至少某些技术来说,它似乎是决定勃起功能的未知结构的替代物。