title: Preserving Fertility in Adolescent Girls and Young Women Requiring Craniospinal Irradiation: A Case Report and Discussion of Options to Be Considered Prior to Treatment.
abstract: Craniospinal irradiation (CSI) is associated with infertility risk for adolescent/young adult women. We explore two methods of reducing ovarian exposure: oophoropexy (surgical removal of the ovaries from the path of the X-ray beam) and proton therapy (to allow the beam to stop without exposing the ovaries/uterus). In the case discussed, oophoropexy followed by X-ray CSI reduced ovarian dose to that at which 50% of oocytes are expected to survive, and the patient appears to have viable oocytes; this technique did not reduce uterine dose. Proton therapy would have eliminated the ovarian and uterine dose and the need for oophoropexy.
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Nataniel H
authors.initials: NH
authors.lastname: Lester-Coll
authors.affiliation: Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Morse
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Huifang A
authors.initials: HA
authors.lastname: Zhai
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Stefan
authors.initials: S
authors.lastname: Both
authors.affiliation: Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania. ; Department of Pediatrics, Division of Oncology, Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.
authors.forename: Jill P
authors.initials: JP
authors.lastname: Ginsberg
authors.affiliation: Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Lustig
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Zelig
authors.initials: Z
authors.lastname: Tochner
authors.affiliation: Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Christine E
authors.initials: CE
authors.lastname: Hill-Kayser
keywords: craniospinal irradiation; fertility after radiation; fertility preservation in cancer survivors; oophoropexy; proton therapy