[Normal tissue tolerance to external beam radiation therapy: ovaries]

Area of Science:

• Radiation oncology
• Reproductive endocrinology
• Surgical oncology

Context:

• Ovarian irradiation during cancer treatment can lead to premature menopause or infertility.
• Ovaries are highly sensitive to radiation, with dose and patient age being critical factors.
• Protecting ovarian function is crucial for fertility preservation in patients of reproductive age.

Purpose:

• To describe the technique and rationale for ovarian transposition in patients undergoing pelvic irradiation.
• To minimize radiation dose to the ovaries, thereby reducing the risk of castration.
• To integrate ovarian transposition into fertility-sparing strategies for cancer patients.

Summary:

• Ovarian transposition involves surgically moving ovaries outside the radiation field before pelvic irradiation.
• The goal is to exclude ovaries from doses of 5 Gy and ideally 2 Gy to prevent radiation-induced castration.
• This procedure is part of a multidisciplinary approach to fertility preservation alongside cytotoxic therapies.

Impact:

• Preserves ovarian function and fertility in patients undergoing potentially sterilizing radiation therapy.
• Reduces the incidence of premature menopause and associated long-term health consequences.
• Enhances the quality of life for cancer survivors by maintaining reproductive potential.