When women of reproductive age receive radiation therapy treatment, efforts should be made to avoid the ovaries, according to a new study published in the International Journal of Radiation Oncology, Biology, Physics.
Radiation therapy to the pelvic region can cause ovarian failure or result in damage that makes the uterus unable to accommodate the growth of a fetus, according to the study by researchers from the Harvard Radiation Oncology Program and the Dana-Farber Cancer Institute, both located in Boston. The study was published in the April 2009 issue of the journal (Int J Radiat Oncol Biol Phys, Vol. 73:5, pp. 1304-1312).
The study sought to review the impact of fertility, pregnancy, and neonatal outcomes among female cancer patients and to evaluate the effectiveness of ovarian transposition, or moving the ovaries out of the field of radiation as a means of preserving fertility.
Trial results reporting outcomes of patients who received craniospinal, abdominal, and pelvic radiation were reviewed. The researchers determined that craniospinal irradiation caused hormonal changes that affected a woman's ability to become pregnant later in life. Abdominal and pelvic radiation both increased the risk of uterine dysfunction that could lead to miscarriage, preterm labor, low birth weight, and placental abnormalities. Women who receive low doses of ovarian radiation can also suffer early menopause.
Ovarian transposition is an effective method of reducing the rates of ovarian dysfunction, the researchers said. However, scatter dose can cause significant damage even if the ovaries are outside the field of radiation.
Patients of reproductive age needing radiation therapy should be treated by a multidisciplinary team of caregivers, including a radiation oncologist, pediatric oncologist, medical oncologist, maternal fetal medicine specialist, and reproductive endocrinologist or gynecologist to receive optimal care, according to senior author and radiation oncologist Dr. Akila Viswanathan.
Related Reading
New location recommended for ovarian shielding in girls, March 2, 2009
Guidelines urge doctors to discuss fertility preservation with cancer patients early, May 3, 2006
Model reliably predicts age of ovarian failure after radiotherapy, July 12, 2005
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