Abstract 300P
Background
Cervical cancer is the leading cause of death among gynecological cancers and ranks seventh among all types of cancer affecting women in Vietnam, with about 15.7% of cases occurring in women under 40 years old. Post-operative radiation therapy can cause ovarian dysfunction and related complications even in patients who had the ovaries transposed. This study aims to evaluate the extent of radiation exposure to the transposed ovaries and its impact on ovarian function in cervical cancer patients at the Ho Chi Minh City Oncology Hospital, who have undergone ovary transposition and received adjuvant radiation therapy.
Methods
We studied retrospectively radiation dosages and ovarian functions in cervix cancer patients who had ovarian transposition at our hospital from Jan 2020 to Dec 2021. We included patients under 45 years who completed at least 6 months of radiation therapy, and collected data on their medical records and radiotherapy planning software. Ovarian function was evaluated by FSH and estradiol levels before and after treatment. We used Epidata and Stata software to analyze the data and tested correlations using t-test pairing, Fisher test, and Spearman correlation.
Results
A total of 22 patients were included in the study. The mean radiation dose to the ovaries was positively correlated with PTV, ovarian position, stage and radiation technique. Of the 15 patients whose ovarian function was investigated after radiotherapy, 5 patients (33.33%) preserved ovarian function. The function preserved groups had lower ovarian radiation dosage. Table: 300P
| Mean ovarian dosage (Gy) +/- SD (n) | Range | p | |
| StageIB2IB3IIA1IIIC1p | 6,14 +/- 6,5 (16)14,26 +/- 12,14 (12)11,21 +/- 10,65 (4)15,86 +/- 15,29 (8) | 0,854-190.946-35,8670,963-21,130,885-45,562 | p=0,21 |
| Ovarian position:Inside pelvis outside pelvis | 20,63 +/- 11,92 (13)6,4 +/- 7,88 (27) | 3,532-42,560,85-29,57 | 0,008 |
| FunctionPreservedNot preserved | 1,29 +/- 2,13 (5)20,54 +/- 11,23 (10) | 1,09 -3,24,231-42,562 | 0,001 |
| Technique3D CRTIMRT | 6,46 +/- 9,89 (27)19,45 +/- 9,03 (13) | 42,58 -0,8535,87 -5,29 | 0,0001 |
Conclusions
Transposed ovary location and mean ovarian dose are important factors in determining ovarian function outcomes. 3D CRT was better than IMRT, possibly due to scatter doses and inadequate ovarian dose constraints during radiation therapy planning. Increasing sample size and establishing a consistent practice protocol could enhance the validity of this study.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Ho Chi Minh City University of Medicine and Pharmacy.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
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