An evaluation of lateral and medial transposition of the ovaries out of radiation fields

Abstract

Background. Transposition of the ovaries is practiced in young women before possible radiation to the pelvic fields. In patients with carcinoma of the uterine cervix (Ca cervix), the ovaries are transposed laterally (LOT), whereas in patients with Hodgkin's disease (HD), they are usually transposed medially (MOT). Nevertheless, not all transposed ovaries are successfully protected. Methods. Computed tomography was performed in 16 patients (7 Ca cervix and 9 HD) after ovarian transposition. The location of all identified ovaries was depicted on diagrams of the respective radiation fields for evaluation of the efficacy of LOT or MOT in relocating the ovaries out of these fields. Results: All 13 ovaries transposed laterally were easily identified by CT, as compared with only 13 of 18 ovaries transposed medially (P = 0.2). Eleven of the 13 ovaries that underwent lateral transposition (6 of 7 patients) were located outside the radiation field. In contrast, only 3 of 13 identified ovaries in the medially transposed group were completely outside the radiation field (P = 0.005). Of the remainder, six were completely within the radiation field, and four were at least partially within the radiation field. Conclusions. Although LOT achieves its purpose in patients with Ca cervix, the use of MOT in patients with HD should be revised to achieve better protection of the ovaries from the effects of radiation. The authors suggest that LOT is preferred over MOT also in patients with HD if radiation of the pelvic lymph nodes is planned. Cancer 1994; 74: 774‐9.

Radiation dose to laterally transposed ovaries during external beam radiotherapy for cervical cancer

“…For each Rando section, a single point located 4.5 cm deep from the anterior phantom surface and 9 cm from the midline of the phantom may correspond to the ovarian position. However, the distance between the ovary and the patient midline may vary considerably among individuals [6]. To obtain a reliable ovarian dose mapping, the sections 25 and 26 were replaced by two 2.5 cm thick sections constructed from Lucite.…”

Fertility Preservation for Pre-Pubertal Girls and Young Female Cancer Patients

“…An way to prevent damage to the ovaries caused by ionizing radiation therapy applied to the pelvic region, is to surgically move the ovary temporarily to a location outside the field of radiation (Hadar et al, 1994;Howard, 1997). This procedure, referred to as oophoropexy, can be performed laparoscopically.…”

Kinderwunsch und Krebs – mit großen Schritten in die Zukunft

“…Später wurde die alternative Methode der kraniolateralen Transposition propagiert, die nach Freipräparati-on des Infundibulumstiels, eine Verlagerung der Ovarien nach kranial bis unter die Zwerchfellkuppeln erlaubt und somit zu einer erheblichen Reduktion der effektiven Strahlendosis am Eierstock führen kann [9]. In einer Analyse von Hadar et al [10] [13]. Eine Retransplantation kann nach abgeschlossener onkologischer Therapie bei Kinderwunsch heterotop in örtlicher Narkose oder orthotop intraabdominell erfolgen.…”