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为需要进行全脑全脊髓照射的青春期女孩和年轻女性保留生育能力:一例病例报告及治疗前需考虑的方案探讨

Preserving Fertility in Adolescent Girls and Young Women Requiring Craniospinal Irradiation: A Case Report and Discussion of Options to Be Considered Prior to Treatment.

作者信息

Lester-Coll Nataniel H, Morse Christopher B, Zhai Huifang A, Both Stefan, Ginsberg Jill P, Gracia Clarisa R, Lustig Robert A, Tochner Zelig, Hill-Kayser Christine E

机构信息

Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.

Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.

出版信息

J Adolesc Young Adult Oncol. 2014 Jun 1;3(2):96-99. doi: 10.1089/jayao.2013.0038.

DOI:10.1089/jayao.2013.0038
PMID:24940532
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4048972/
Abstract

Craniospinal irradiation (CSI) is associated with infertility risk for adolescent/young adult women. We explore two methods of reducing ovarian exposure: oophoropexy (surgical removal of the ovaries from the path of the X-ray beam) and proton therapy (to allow the beam to stop without exposing the ovaries/uterus). In the case discussed, oophoropexy followed by X-ray CSI reduced ovarian dose to that at which 50% of oocytes are expected to survive, and the patient appears to have viable oocytes; this technique did not reduce uterine dose. Proton therapy would have eliminated the ovarian and uterine dose and the need for oophoropexy.

摘要

全脑脊髓放疗(CSI)与青春期/年轻成年女性的不孕风险相关。我们探索了两种减少卵巢受照的方法:卵巢移位术(通过手术将卵巢移出X射线束的路径)和质子治疗(使射线束在不照射卵巢/子宫的情况下停止)。在讨论的病例中,卵巢移位术后进行X射线CSI可将卵巢剂量降低至预计50%卵母细胞存活的剂量,且该患者似乎有存活的卵母细胞;但这种技术并未降低子宫剂量。质子治疗本可消除卵巢和子宫的剂量,也无需进行卵巢移位术。

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本文引用的文献

1
Breast cancer screening for childhood cancer survivors after craniospinal irradiation with protons versus x-rays: a dosimetric analysis and review of the literature.质子与X射线颅脊髓照射后儿童癌症幸存者的乳腺癌筛查:剂量学分析及文献综述
J Pediatr Hematol Oncol. 2013 Aug;35(6):462-7. doi: 10.1097/MPH.0b013e31829bcdf8.
2
Discussing fertility preservation at the time of cancer diagnosis: dissatisfaction of young females.在癌症诊断时讨论生育力保存问题:年轻女性的不满。
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The predicted relative risk of premature ovarian failure for three radiotherapy modalities in a girl receiving craniospinal irradiation.在接受颅脊髓照射的女孩中,三种放疗方式导致卵巢早衰的预测相对风险。
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Optimizing fertility preservation practices for adolescent and young adult cancer patients.优化青少年和青年癌症患者的生育力保存实践。
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Comparison of therapeutic dosimetric data from passively scattered proton and photon craniospinal irradiations for medulloblastoma.比较被动散射质子和光子颅脊髓照射治疗剂量学数据在髓母细胞瘤中的应用。
Radiat Oncol. 2012 Jul 24;7:116. doi: 10.1186/1748-717X-7-116.
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