# Gonad Dose Assessment of Patients Undergoing Pelvic Radiotherapy
## 3 Results  
Of the 70 patients studied aged 45 years or younger who underwent pelvic radiotherapy between 2014 and 2023, 12 were male patients with rectal tumors, 18 were female patients with rectal tumors, and 40 were female patients with gynecological tumors. The average age of all study patients was 38.76 years, with a standard deviation of 6. The average number of children before treatment was 1.25 and the standard deviation was 1.40. Of these 70 patients, 58.6% of patients were treated with the VMAT technique. Since 2020, all patients in the study were treated with the VMAT technique. Despite this, only 18.6% of patients met the maximum dose limits and 22.9% met the mean dose limits for the testicles and ovaries. Across the entire sample, only 5 female patients underwent ovarian transposition. The results are presented separately for male patients, female patients with rectal tumors, and female patients with gynecological tumors. The characteristics of the male patients with rectal tumors are summarized in Table 2. All patients received 50.40 Gy in 28 fractions in the prone position. Of these, 4 patients were treated using the 3 DCRT technique and 8 were treated with the VMAT technique. The average age of the patients was 38.75 years, with a standard deviation of 5. The average number of children before treatment was 0.56, with a standard deviation of 0.88. Table 3 summarizes the irradiation technique as well as the maximum and mean doses delivered to each patient's right and left testicles. According to the CORSAIR project, only 50% of patients complied with the maximum dose limit for the testicles (<6 Gy), with one patient meeting the limit solely for the left testicle. When evaluating the mean dose, 66.70% of patients met the dose limit for both testicles, while one patient met the limit only for the left testicle. No statistically significant differences were observed between the doses delivered to the left and right testicles (\(p\) > 0.05). However, significant differences were detected between the maximum and mean doses (\(p\) < 0.05), with the maximum dose being significantly higher, as expected. Furthermore, no statistically significant differences were observed between the VMAT and 3 DCRT techniques in terms of the maximum and mean doses delivered to either the left or right testicles (\(p\) > 0.05). \begin{table}
\begin{tabular}{c c c} \hline \hline
**Dose Limits** & **Maximum Dose** & **Mean Dose** \\ \hline Testicles & \textless{6 Gy} & \textless{5 Gy} \\ Ovaries & \textless{V}_{7.5\,\textless{Gy}}\textless{26\%} * & \textless{8.8 Gy} \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Dose constraints from the CORSAIR project [25]. \begin{table}
\begin{tabular}{c c c c c c c c} \hline \hline
**Total** & **Average** & **Minimum** & **Maximum** & **Average** & **Position** & **3 DCRT** & **VMAT** \\
**Patients** & **Age** & **Age** & **Age** & **Children** & & **Does** & **Position** & **3 DCRT** & **VMAT** \\ \hline
12 & 38.75 & 32 & 45 & 0.56 & 50.40 Gy & Prone & 4 & 8 \\ \hline \hline \end{tabular}
\end{table} 
Table 2: Characterization of the sample males with rectal tumors. It should be noted that no distinction was made between high, medium, or low rectal cancer, although the position of the treatment volume relative to the testicles could influence proximity and thus the likelihood of meeting the dose limit. The distance from the position of the tumor to the testicles was measured in the same way for each patient, in the sagittal plane. No differences of more than 2 cm were observed, so this difference had no statistically significant impact on the dose administered to the testicles. Female patients with rectal tumors  
All patients were treated with 50.40 Gy in 28 fractions in the prone position, except for one patient who was treated in the dorsal position due to uterine invasion, receiving 25 Gy in 5 fractions, as detailed in Table 4. The 3 DCRT technique was used in 12 patients, while VMAT was employed for 6 patients.