{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T08:42:47Z","timestamp":1776328967252,"version":"3.50.1"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T00:00:00Z","timestamp":1628121600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,13]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Total body irradiation (TBI) with ovarian shielding is expected to preserve fertility among hematopoietic stem cell transplant (HSCT) patients with myeloablative TBI-based regimens. However, the radiation dose to the ovaries that preserves ovarian function in TBI remains poorly understood. Furthermore, it is uncertain whether the dose to the shielded organs is associated with relapse risk. Here, we retrospectively evaluated the relationship between fertility and the dose to the ovaries, and between relapse risk and the dose to the pelvic bones. A total of 20 patients (median age, 23 years) with standard-risk hematologic diseases were included. Median follow-up duration was 31.9 months. The TBI prescribed dose was 12 Gy in six fractions for three days. Patients\u2019 ovaries were shielded with cylinder-type lead blocks. The dose\u2013volume parameters (D98% and Dmean) in the ovaries and the pelvic bones were extracted from the dose\u2013volume histogram (DVH). The mean ovary Dmean for all patients was 2.4 Gy, and 18 patients recovered menstruation (90%). The mean ovary Dmean for patients with menstrual recovery and without recovery were 2.4 Gy and 2.4 Gy, respectively, with no significant difference (P = 0.998). Hematological relapse was observed in five patients. The mean pelvis Dmean and pelvis D98% for relapse and non-relapse patients were 11.6 Gy and 11.7 Gy and 5.6 Gy and 5.3 Gy, respectively. Both parameters showed no significant difference (P = 0.827, 0.807). In conclusion, TBI with ovarian shielding reduced the radiation dose to the ovaries to 2.4 Gy, and preserved fertility without increasing the risk of relapse.<\/jats:p>","DOI":"10.1093\/jrr\/rrab066","type":"journal-article","created":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T19:11:01Z","timestamp":1626462661000},"page":"918-925","source":"Crossref","is-referenced-by-count":10,"title":["Dosimetric evaluation of ovaries and pelvic bones associated with clinical outcomes in patients receiving total body irradiation with ovarian shielding"],"prefix":"10.1093","volume":"62","author":[{"given":"Keiko","family":"Akahane","sequence":"first","affiliation":[{"name":"Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuyuki","family":"Shirai","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan"},{"name":"Department of Radiology, Jichi Medical University, Tochigi 329-0498, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaru","family":"Wakatsuki","sequence":"additional","affiliation":[{"name":"QST Hospital, National Institutes for Quantum and Radiological Science and Technology, Chiba 263-8555, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masato","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shogo","family":"Hatanaka","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunari","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jichi Medical University, Tochigi 329-0498, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jichi Medical University, Tochigi 329-0498, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriko","family":"Oyama-Manabe","sequence":"additional","affiliation":[{"name":"Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Ashizawa","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi 350-8550, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun-ichi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinichi","family":"Kako","sequence":"additional","affiliation":[{"name":"Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinobu","family":"Kanda","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi 350-8550, Japan"},{"name":"Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama 330-8503, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"key":"2021091406113276600_ref1","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1056\/NEJMra052638","article-title":"Hematopoietic stem-cell transplantation","volume":"354","author":"Copelan","year":"2006","journal-title":"N Engl J Med"},{"key":"2021091406113276600_ref2","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1530\/EJE-13-0694","article-title":"Ovarian function after allogeneic hematopoietic stem cell transplantation in childhood and adolescence","volume":"170","author":"Vatanen","year":"2013","journal-title":"Eur J Endocrinol"},{"key":"2021091406113276600_ref3","doi-asserted-by":"crossref","first-page":"3373","DOI":"10.1182\/blood-2002-07-2231","article-title":"Nonmalignant late effects after allogeneic stem cell transplantation","volume":"101","author":"Soci\u00e9","year":"2003","journal-title":"Blood"},{"key":"2021091406113276600_ref4","doi-asserted-by":"crossref","first-page":"3045","DOI":"10.1182\/blood.V87.7.3045.bloodjournal8773045","article-title":"Pregnancies following high-dose cyclophosphamide with or without high-dose busulfan or total-body irradiation and bone marrow transplantation","volume":"87","author":"Sanders","year":"1996","journal-title":"Blood"},{"key":"2021091406113276600_ref5","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1182\/asheducation-2015.1.138","article-title":"Fertility issues in patients with hematologic malignancies","volume":"2015","author":"Loren","year":"2015","journal-title":"Hematology Am Soc Hematol Educ Program"},{"key":"2021091406113276600_ref6","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1038\/bmt.2009.313","article-title":"Tumor cell contamination in ovarian tissue cryopreserved before gonadotoxic treatment: should we systematically exclude ovarian autograft in a cancer survivor?","volume":"45","author":"Courbiere","year":"2010","journal-title":"Bone Marrow Transplant"},{"key":"2021091406113276600_ref7","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1007\/s10815-012-9786-y","article-title":"Recommendations for fertility preservation in patients with lymphoma, leukemia, and breast cancer","volume":"29","author":"ISFP Practice Committee","year":"2012","journal-title":"J Assist Reprod Genet"},{"key":"2021091406113276600_ref8","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s00277-013-1852-8","article-title":"Protection of ovarian function by two distinct methods of ovarian shielding for young female patients who receive total body irradiation","volume":"93","author":"Kanda","year":"2014","journal-title":"Ann Hematol"},{"key":"2021091406113276600_ref9","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1038\/bmt.2008.234","article-title":"Ovarian shielding allows 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