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.
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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