Underuse of ovarian transposition in reproductive-aged cancer patients treated by primary or adjuvant pelvic irradiation
Underuse of ovarian transposition in reproductive-aged cancer patients treated by primary or adjuvant pelvic irradiation
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DOI：
10.1111/j.1447-0756.2010.01443.x
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发表时间：
2011-07-01
影响因子：
1.6
通讯作者：
Kang, Soon-Beom
中科院分区：
文献类型：
--
作者：
Han, Seung-Su;Kim, Yun Hwan;Kang, Soon-Beom
目的：探讨卵巢转位（OT）在接受放射治疗的育龄肿瘤患者中的应用现状。材料与方法：1999年11月至2008年12月，2524例患者在首尔国立大学医院接受盆腔照射。我们筛选了具有以下适应症的患者：(1)年龄在12至40岁之间，(2)接受初级或辅助盆腔放疗。241例患者年龄在12 - 40岁之间。在排除了133例转移性疾病或姑息性放射治疗的患者后，发现108例患者适合OT。分析这108例患者的OT应用现状、OT手术类型、肿瘤类型及放疗类型。结果：宫颈癌为主要适应症（n = 68, 62.9%）。另有37.1%的指征疾病由直肠癌（n = 19）、外阴-阴道癌（n = 4）、非霍奇金淋巴瘤（n = 3）和其他盆腔肿瘤（n = 14）组成。108例患者中，只有31例（28.7%）患者在盆腔放疗前接受过OT。大多数手术应用于宫颈癌患者（n = 29），直肠癌和子宫内膜癌分别只有2例手术。OT大多在剖腹手术期间进行。腹腔镜手术仅应用于1例晚期宫颈癌。结论：虽然OT可以预防放射治疗引起的卵巢早衰，但在我们的机构中，这一程序的使用相当不足。该方法应得到更广泛的应用，以保持生育能力，提高育龄癌症患者的生活质量。
Aim: To investigate the application status of ovarian transposition (OT) in reproductive-aged cancer patients undergoing radiation therapy.Material & Methods: Between November 1999 and December 2008, 2524 patients had received pelvic irradiation at Seoul National University Hospital. We filtered the patients with the indications of (i) within 12 to 40 years of age, and (ii) receiving primary or adjuvant pelvic irradiation. There were 241 patients within 12 to 40 years of age. After excluding 133 patients with metastatic disease or under palliative radiation treatment, 108 patients were discovered appropriate for OT. We analyzed the application status of OT, surgical types of OT, cancer types and radiation types in those 108 patients.Results: Cervical cancer was the major indication (n = 68, 62.9%). Another 37.1% of indicated disease were composed of rectal cancer (n = 19), vulvo-vaginal cancer (n = 4), non-Hodgkin's lymphoma (n = 3), and other pelvic tumors (n = 14). Among the 108 patients, only 31 (28.7%) patients had received OT before pelvic irradiation. Most of the operations were applied on cervical cancer patients (n = 29) and only two procedures on rectal and endometrial cancer, respectively. OT had been mostly performed during laparotomy. Laparoscopic procedure was applied in only one case with advanced cervical cancer.Conclusions: Although OT could be a preventive measure of premature ovarian failure from radiation therapy, this procedure has been considerably underused at our institution. This procedure should be applied more widely to preserve the fertility and improve the quality of life in reproductive-aged cancer patients.