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CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(06): 573-577
DOI: 10.1055/s-0042-1746199
Original Article
Gynecological Endocrinology

Practical Prediction Model for Ovarian Insufficiency after Radiation

Modelo prático de predição para insuficiência ovariana após radiação
Gabriel Oliveira Bernardes Gil 
1   Radiotherapy Department, Hospital Mater Dei, Belo Horizonte, MG, Brazil
2   Gynecology Department, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP, Brazil
,
Cassiano Asano 
1   Radiotherapy Department, Hospital Mater Dei, Belo Horizonte, MG, Brazil
,
Warne Pedro de Andrade 
2   Gynecology Department, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP, Brazil
3   Oncology Department, Grupo Oncoclínicas, Belo Horizonte, MG, Brazil
,
Maria Luísa Braga Vieira Gil 
1   Radiotherapy Department, Hospital Mater Dei, Belo Horizonte, MG, Brazil
,
Eduardo Batista Cândido 
4   Gynecology Department, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
,
Marcos Regalin 
5   Radiotherapy Department, Hospital da Baleia, Belo Horizonte, MG, Brazil
,
Izabella Nobre Queiroz 
5   Radiotherapy Department, Hospital da Baleia, Belo Horizonte, MG, Brazil
,
Farley Soares Cantídio 
5   Radiotherapy Department, Hospital da Baleia, Belo Horizonte, MG, Brazil
,
Darly Gomes Soares Delfino 
6   Faculty of Medicine, Faculdade de Minas, Belo Horizonte, MG, Brazil
,
Agnaldo Lopes Silva-Filho 
2   Gynecology Department, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, SP, Brazil
3   Oncology Department, Grupo Oncoclínicas, Belo Horizonte, MG, Brazil
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Abstract

Objective The present study aimed to develop a useful mathematical model that predicts the age at which premature ovarian insufficiency might occur after teletherapy radiation. A diagnosis of premature or early menopause has physical and psychological consequences, so women may need support and long-term medical follow-up.

Methods To correlate ovarian radiation dose with ovarian function, we used the formula described by Wallace et al.: √g(z) = 10(2-0,15z), where “g(z)” and “z” represent oocyte survival rate and the radiation dose (in Gray), respectively. By simulating different ages and doses, we observed a pattern that could be used to simplify the relationship between radiation dose and remaining time of ovarian function.

Results We obtained a linear function between ovarian radiation dose and loss of ovarian function (LOF) that is the percentage of decrease in the time to the ovarian failure compared with the time expected for a woman at the same age without irradiation exposition. For patients < 40 years old and with ovarian radiation doses < 5 Gy, the equation LOF = 2.70 + (11.08 x Dose) can be applied to estimate the decrease in time to premature ovarian insufficiency.

Conclusion The present study reports a practicable theoretical method to estimate the loss of ovarian function. These findings can potentially improve the management and counseling of young women patients submitted to radiotherapy during their reproductive years.

Resumo

Objetivo O presente estudo teve como objetivo desenvolver um modelo matemático útil que prediz a idade na qual a insuficiência ovariana prematura pode ocorrer após a radioterapia externa (teleterapia). O diagnóstico de menopausa prematura ou precoce tem consequências físicas e psicológicas; portanto, as mulheres podem precisar de apoio e acompanhamento médico de longo prazo.

Métodos Para correlacionar a dose de radiação ovariana com a função ovariana, foi usada a fórmula descrita por Wallace et al.: √g(z) = 10(2-0,15z), na qual “g(z)” e “z” representam a taxa de sobrevivência do oócito e a dose de radiação (em Gray), respectivamente. Ao simular diferentes idades e doses, observamos um padrão que poderia ser usado para simplificar a relação entre a dose de radiação e o tempo restante da função ovariana.

Resultados Obtivemos uma função linear entre a dose de radiação ovariana e a perda da função ovariana (LOF, na sigla em inglês) que é a porcentagem de diminuição no tempo até a falência ovariana em relação ao tempo esperado para uma mulher da mesma idade sem exposição à radiação. Para pacientes < 40 anos de idade e com doses de radiação ovariana < 5 Gy, a equação LOF = 2,70 + (11,08 x Dose) pode ser aplicada para estimar a redução no tempo até a insuficiência ovariana.

Conclusão O presente estudo relata um método teórico viável para estimar a perda da função ovariana. Estes achados podem melhorar potencialmente o manejo e o aconselhamento de pacientes jovens submetidas à radioterapia durante seus anos reprodutivos.

Keywords

radiotherapy - ovarian insufficiency - ovarian function - ovarian radiation

Palavras-chave

radioterapia - insuficiência ovariana - função ovariana - radiação ovariana


Publication History

Received: 25 April 2021

Accepted: 14 February 2022

Article published online:
26 May 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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