https://doi.org/10.1140/epjs/s11734-025-01643-7
Regular Article
Ovarian transposition to preserve ovarian function in young patients with cervical cancer undergoing postoperative intensity-modulated radiotherapy: a case series
1
Faculty of Medical Sciences, Department of Clinical Oncology, University of Kragujevac, Kragujevac, Serbia
2
Center for Radiation Oncology, University Clinical Center Kragujevac, Kragujevac, Serbia
3
Department of Medical Studies, Academy of Applied Preschool Teaching and Health Studies, Ćuprija, Serbia
4
Clinic for Obstetrics and Gynecology, Department of Gynecology and Obstetrics, University Clinical Centre Kragujevac, Kragujevac, Serbia
5
Faculty of Medical Sciences, Department of Gynecology and Obstetrics, University of Kragujevac, Kragujevac, Serbia
a
makizivkovicmarija@gmail.com
Received:
7
July
2024
Accepted:
23
April
2025
Published online:
9
May
2025
Total hysterectomy with bilateral adnexectomy and lymphadenectomy is the primary treatment of early cervical cancer. In recent years, the incidence has been increasing in women under 40 years of age, and there is a trend of increasing ovarian transpositions. The aim is to evaluate the dose distribution and functionality, in relation to the planning target volume (PTV) and transposed ovaries position in patients with adjuvant radiotherapy. In this study, a series of cervical cancer patients underwent total hysterectomy with bilateral salpingectomy and ovarian transposition, who were prescribed adjuvant radiotherapy. The ovarian function was monitored 1 year after treatment based on the values of luteinizing and follicle-stimulating hormone at 3-month controls. The research was conducted at the Center for Radiation Oncology, University Clinical Centre Kragujevac from May 2021 to January 2024. Six cervical cancer patients FIGO stage I and II (2018), with an average age of 34.33 years, underwent postoperative intensity-modulated radiotherapy (IMRT) (average TD 40.83 Gy) with delineation and preservation of 9 ovaries and brachytherapy with 3 applications of 600 cGy. Total 9 ovaries’ Dmean dose was an average of 12.15 Gy. Hormonal function was maintained in three patients, which were transposed at least 5 cm above the iliac crest, i.e., PTV whose Dmean dose was 2.49 Gy. Preservation of ovarian function is related to the dose contribution and their distance from the PTV. Before ovarian transposition, it is necessary to consult a radiation oncologist regarding the target volumes’ position, because the decision on adjuvant radiotherapy is usually made after surgery.
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© The Author(s), under exclusive licence to EDP Sciences, Springer-Verlag GmbH Germany, part of Springer Nature 2025
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
