Subject(s)
Education, Nursing , Curriculum , Education, Nursing/standards , Evaluation Studies as Topic , Humans , PolandABSTRACT
In 22 patients with stage I cervical cancer, 23-37 years of age, Wertheim-Meigs radical hysterectomy was performed with preservation of one or both ovaries transposed outside the pelvis. In 17 of these patients post-operative radiotherapy was applied: 5 cases were treated by brachytherapy only and 12 cases by brachy- plus teletherapy. For evaluation of the post-treatment hormonal function of gonads, serum FSH, LH, estradiol and progesterone levels were assayed. It was found that gonad transposition without subsequent radiotherapy, as well as post-operative brachytherapy, induced no damage to hormonal function of ovaries during follow-up lasting 2-23 months. On the other hand, the castration syndrome occurred in 7 of 12 patients treated - apart from brachytherapy - also by teletherapy. An analysis of location of the transposed ovaries in relation to the external irradiation fields suggests that for preservation of the hormonal function the transposed ovary must be situated at a distance of at least several cms from the irradiated-field border. This distance can be obtained either surgically ("high" transposition) or by modification of the irradiation procedure: namely, in case of lateral transposition the anteroposterior pelvic field technique is recommended; in individual cases either additional shielding of ovary or lowering of the upper border of the irradiated fields may be applied.
