Dosimetric Evaluation of the Uterus in Patients Receiving Total Body Irradiation with Ovarian Shielding.
Dosimetric Evaluation of the Uterus in Patients Receiving Total Body Irradiation with Ovarian Shielding.
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DOI：
10.1159/000526536
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发表时间：
2022-09
影响因子：
0.8
通讯作者：
Shirai, Katsuyuki
中科院分区：
文献类型：
--
作者：
Akahane, Keiko;Kako, Shinichi;Suzuki, Masato;Takahashi, Yuta;Hatanaka, Shogo;Kawahara, Masahiro;Nakada, Yukari;Ogawa, Kazunari;Takahashi, Satoru;Fukuda, Yukiko;Endo, Masashi;Oyama-Manabe, Noriko;Kanda, Yoshinobu;Shirai, Katsuyuki
不孕症是接受造血干细胞移植（HSCT）的患者中众所周知的晚期并发症。我们之前报道过，卵巢屏蔽全身照射（TBI）可将卵巢的辐射剂量降低至2.4戈伊（剂量为传统TBI的五分之一），并在不增加复发风险的情况下保留生育能力。据报道，暴露于子宫和卵巢会影响怀孕和分娩。然而，导致不孕症的子宫剂量限制仍然未知。在此，我们报告了2例在TBI合并卵巢屏蔽后分娩的患者的妊娠和分娩结局，并使用剂量-体积直方图评估了子宫剂量。病例1涉及一名患有急性髓性白血病的30岁女性，她在21岁时接受了HSCT，子宫平均剂量（Dmean）为7.0戈伊。由于妊娠期高血压疾病，她在妊娠38周时进行了自然妊娠和择期剖宫产。她生下了一个正常体重的婴儿。病例2涉及一名患有T细胞急性淋巴细胞白血病的32岁女性，她在30岁时接受了HSCT，子宫Dmean为7.6戈伊。她的孩子足月分娩，出生体重正常。这些结果表明，子宫Dmean在7.0和7.6戈伊之间对妊娠和分娩没有显著影响，对于青春期后接受卵巢屏蔽TBI的患者，卵巢功能得到保留。
Infertility is a well-known late complication in patients receiving hematopoietic stem cell transplantation (HSCT). We previously reported that total body irradiation (TBI) with ovarian shielding reduces the radiation dose to the ovaries to 2.4 Gy − one-fifth of the dose compared to conventional TBI − and preserves fertility without increasing the risk of relapse. Exposure to the uterus and ovaries can reportedly affect pregnancy and childbirth. However, the dose constraint of the uterus that causes infertility remains unknown. Herein, we report the pregnancy and birth outcomes of 2 patients who gave birth following TBI with ovarian shielding and evaluated the dose to the uterus using a dose-volume histogram. Case 1 involved a 30-year-old woman with acute myeloid leukemia who underwent HSCT at 21 years of age with a uterus mean dose (Dmean) of 7.0 Gy. She had a natural pregnancy and elective cesarean section at 38 weeks of gestation due to hypertensive disorders of pregnancy. She gave birth to a normal-birthweight infant. Case 2 involved a 32-year-old woman with T-cell acute lymphoblastic leukemia who underwent HSCT at 30 years of age with a uterus Dmean of 7.6 Gy. Her baby was delivered at full term with normal birthweight. These results indicate that a uterus Dmean between 7.0 and 7.6 Gy does not have a significant impact on pregnancy and delivery with the ovarian function being preserved for patients who received TBI with ovarian shielding after puberty.
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DOI：
10.1016/j.ijrobp.2009.04.012
发表时间：
2010-03-01
影响因子：
7
作者：
Sudour, Helene;Chastagner, Pascal;Bernier, Valerie
通讯作者：
Bernier, Valerie
影响因子：
168.9
作者：
Signore, Lisa B.;Mulvihill, John J.;Green, Daniel M.;Munro, Heather M.;Stovall, Marilyn;Weathers, Rita E.;Mertens, Ann C.;Whitton, John A.;Robison, Leslie L.;Boice, John D., Jr.
通讯作者：
Boice, John D., Jr.
通过使用螺旋形式疗法来进行非态度的适应症，可以进行性腺的总体照射。
DOI：
10.5603/rpor.a2021.0006
发表时间：
2021
期刊：
Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology
影响因子：
--
作者：
Dibs K;Sim AJ;Peñagaricano JA;Latifi K;Garcia GA;Peters JA;Nieder ML;Kim S;Robinson TJ
通讯作者：
Robinson TJ
影响因子：
20.3
作者：
Sanders, JE;Hawley, J;Appelbaum, FR
通讯作者：
Appelbaum, FR
影响因子：
3.5
作者：
Marklund, Anna;Nasiell, Josefine;Rodriguez-Wallberg, Kenny A.
通讯作者：
Rodriguez-Wallberg, Kenny A.