Is motherhood still possible after pelvic carbon ion radiotherapy? A promising combined fertility-preservation approach

Author:

Barcellini Amelia12ORCID,Cassani Chiara34ORCID,Orlandi Ester13ORCID,Nappi Rossella E.35,Broglia Federica6,Delmonte Maria Paola6,Molinelli Silvia7,Vai Alessandro7ORCID,Vitolo Viviana1,Gronchi Alessandro8ORCID,D’Ambrosio Gioacchino9,Cobianchi Lorenzo31011,Fiore Maria Rosaria1

Affiliation:

1. Radiation Oncology Unit, Clinical Department, CNAO National Center for Oncological Hadrontherapy, Pavia, Italy

2. Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy

3. Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy

4. Unit of Obstetrics and Gynecology, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy

5. Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy

6. Department of Anesthesia and Intensive Care, Unit of Obstetric Anesthesia, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy

7. Medical Physics Unit, CNAO National Center for Oncological Hadrontherapy, Pavia, Italy

8. Department of Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

9. Department of Molecular Medicine, Anatomic Pathology Unit, University of Pavia and Foundation IRCCS Polyclinic San Matteo, Pavia, Italy

10. Department of General Surgery, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy

11. ITIR-Institute for Transformative Innovation Research, University of Pavia, Pavia, Italy

Abstract

Introduction: Preserving the endocrine and reproductive function in young female cancer patients undergoing pelvic radiation is a significant challenge. While the photon beam radiation's adverse effects on the uterus and ovaries are well established, the impact of pelvic carbon ion radiotherapy on women's reproductive function is largely unexplored. Strategies such as oocyte cryopreservation and ovarian transposition are commonly recommended for safeguarding future fertility. Methods: This study presents a pioneering case of successful pregnancy after carbon ion radiotherapy for locally advanced sacral chondrosarcoma. Results: A multidisciplinary approach facilitated the displacement of ovaries and uterus before carbon ion radiotherapy, resulting in the preservation of endocrine and reproductive function. Conclusion: The patient achieved optimal oncological response and delivered a healthy infant following the completion of cancer treatment.

Publisher

SAGE Publications

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