Dosimetric evaluation of ovaries and pelvic bones associated with clinical outcomes in patients receiving total body irradiation with ovarian shielding

Autor: Yuta Takahashi, Shinichi Kako, Masahiro Ashizawa, Yoshinobu Kanda, Shun-ichi Kimura, Noriko Oyama-Manabe, Keiko Akahane, Masahiro Kawahara, Satoru Takahashi, Shogo Hatanaka, Katsuyuki Shirai, Masaru Wakatsuki, Kazunari Ogawa, Masato Suzuki
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Adult
Organs at Risk
medicine.medical_specialty
Transplantation Conditioning
Adolescent
Health
Toxicology and Mutagenesis
Urology
Ovary
total body irradiation (TBI)
Oncology/Medicine
Young Adult
Ovarian function
Radiation Protection
ovarian shielding
Recurrence
medicine
Humans
Radiology
Nuclear Medicine and imaging
In patient
Relapse risk
Pelvic Bones
Radiation Injuries
Pelvis
Retrospective Studies
relapse
fertility
Radiation
Leukemia
business.industry
Significant difference
Radiation dose
Hematopoietic Stem Cell Transplantation
Anemia
Aplastic
Fertility Preservation
Recovery of Function
Total body irradiation
Myeloablative Agonists
Menstruation
medicine.anatomical_structure
Treatment Outcome
Myelodysplastic Syndromes
AcademicSubjects/SCI00960
Female
AcademicSubjects/MED00870
business
Whole-Body Irradiation
Follow-Up Studies
Zdroj: Journal of Radiation Research
ISSN: 1349-9157
0449-3060
Popis: Total body irradiation (TBI) with ovarian shielding is expected to preserve fertility among hematopoietic stem cell transplant (HSCT) patients with myeloablative TBI-based regimens. However, the radiation dose to the ovaries that preserves ovarian function in TBI remains poorly understood. Furthermore, it is uncertain whether the dose to the shielded organs is associated with relapse risk. Here, we retrospectively evaluated the relationship between fertility and the dose to the ovaries, and between relapse risk and the dose to the pelvic bones. A total of 20 patients (median age, 23 years) with standard-risk hematologic diseases were included. Median follow-up duration was 31.9 months. The TBI prescribed dose was 12 Gy in six fractions for three days. Patients’ ovaries were shielded with cylinder-type lead blocks. The dose–volume parameters (D98% and Dmean) in the ovaries and the pelvic bones were extracted from the dose–volume histogram (DVH). The mean ovary Dmean for all patients was 2.4 Gy, and 18 patients recovered menstruation (90%). The mean ovary Dmean for patients with menstrual recovery and without recovery were 2.4 Gy and 2.4 Gy, respectively, with no significant difference (P = 0.998). Hematological relapse was observed in five patients. The mean pelvis Dmean and pelvis D98% for relapse and non-relapse patients were 11.6 Gy and 11.7 Gy and 5.6 Gy and 5.3 Gy, respectively. Both parameters showed no significant difference (P = 0.827, 0.807). In conclusion, TBI with ovarian shielding reduced the radiation dose to the ovaries to 2.4 Gy, and preserved fertility without increasing the risk of relapse.
Databáze: OpenAIRE
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