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Artificial radiation menopause: where are the ovaries?
R Counsell1, G Bain, M V Williams
1Addenbrooke's Hospital, Cambridge, UK.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|January 1, 1996
Summary
Radiotherapy for ovarian ablation requires large pelvic fields due to uncertain ovarian positions. This study suggests optimizing treatment volumes based on ovarian location to improve accuracy in inducing artificial menopause.
Area of Science:
- Radiotherapy
- Gynecologic Oncology
- Pelvic Anatomy
Background:
- Ovarian ablation via radiotherapy often uses large pelvic fields due to uncertain ovarian localization.
- Accurate ovarian positioning is crucial for effective radiotherapy in inducing artificial menopause.
Purpose of the Study:
- To assess the positional variation of ovaries in women under 50 years using computed tomography (CT).
- To inform optimal treatment volume definitions for pelvic radiotherapy aimed at ovarian ablation.
Main Methods:
- Retrospective review of 81 pelvic CT scans from women under 50.
- Exclusion of patients with pelvic malignancy or prior pelvic surgery, resulting in 30 eligible participants.
- Analysis of ovarian location relative to pelvic bony landmarks.
Main Results:
- Ovaries were clearly identified in 23 patients (77%).
- In 83% of identified cases, ovaries were in the upper two-thirds of a defined pelvic ring.
- Ovarian position was not significantly influenced by parity, uterine position, or rectal/bladder filling.
Conclusions:
- Current treatment volumes for radiotherapy-induced menopause may exclude the upper pelvis where ovaries are often located.
- Recommended treatment volume: inferior border of L5 vertebra to the middle of femoral heads, 1 cm lateral to pelvic walls.
- This refined volume definition may enhance radiotherapy precision for ovarian ablation.