Medical Radiology and Radiation Safety. 2013. Vol. 58. No. 1. P. 43–49
RADIATION THERAPY
E.A. Dunaeva, E.A. Kadieva, L.V. Demidova, A.V. Boyko, S.A. Kozhevnikova, T.A. Teleous, O.B. Dubovetskaya, R.N. Plavnik, E.S. Tsvetaeva, N.I. Khramtsova
Methodic of Conformal Radiation Therapy of Cervical Cancer with Ovarian Transposition
Herzen Moscow Research Oncological Institute, Moscow, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
Abstract
Purpose: To study optimal methods of conformal external beam radiation with 3D planning of cervical cancer in women with ovarian transposition for ovary care.
Material and methods: 44 young women with cervical cancer (T1b1,2 2a,b, N0–1 M0) treated at Herzen Moscow Research Oncological Institute in period from 2009 to 2011. The patients were treated with combined method included ovarian transposition. First group included 26 cervical cancer patients, with laparoscopic ovarian transposition, preoperative radiochemotherapy (5-FU 2000–2500 mg, cisplatin 90 mg, external beam radiation after 30 Gy + 2 fractions of brachytherapy 10 Gy) and panhysterectomy. Second group included 18 cervical cancer patients with panhysterectomy and ovarian transposition, postoperative external beam radiation after 42.5–47.5 Gy and brachytherapy after 20–25Gy to vagina. Further evaluation included CT scan and dosimetry. We use 6 treatment fields with gantry angles 0, 55, 100, 180, 260 and 350 degrees in localization ovaries upper than superior limb of target. In cases of low ovaries transposition the whole target treated twofields method with gantry 0 and 180 degrees.
Results: Mean ovary dose of laparoscopic ovarian transposition was 0.53 Gy (from 0.13 to 3.5 Gy).Mean ovary dose of laparotomic ovarian transposition was 1.31 Gy (from 0.34 to 4.14 Gy).
Conclusion: Our methods of conformal radiation therapy with new technique give a possibility to avoid irradiation of transpositional ovaries in young women with cervical cancer.
Key words: cervical cancer, ovarian transposition, conformal external beam radiation