Researchers conducted a small, early-stage trial to see if a surgical procedure could protect the ovaries in young women undergoing pelvic radiation for cervical cancer. The procedure involved taking a small piece of a woman's own ovarian tissue and grafting it under the skin of her abdomen before she started radiation treatment. The idea was to move hormone-producing tissue away from the radiation field to keep it safe. The study included 22 women aged 35 or younger with locally advanced cervical cancer. They were randomly assigned to either receive the ovarian graft or not before their standard radiation treatment. The main goal was to see if the graft could preserve the body's natural estrogen production and prevent menopausal symptoms caused by ovarian damage from radiation. After six months, the results showed a notable difference. In the group that received the graft, 85% of patients had hormone levels consistent with preserved ovarian function and were free of menopausal symptoms. In the group that did not receive the graft, all patients showed hormone profiles compatible with early menopause, known as premature ovarian insufficiency. The procedure was reported to be technically safe and feasible in this small group, though three patients assigned to the graft group were excluded before the procedure due to other clinical conditions. It is very important to view these results cautiously. This was an exploratory Phase II trial, which means it is one of the first tests of this approach in this specific group of patients. The study was small, conducted at a single center in Brazil, and the median follow-up time was less than two years. Doctors and patients were aware of who received the graft, which can influence how symptoms are reported. We do not know the long-term effectiveness of the graft for preserving fertility or hormone function for many years, or if there are any rare side effects. For now, this study suggests a potential new option that deserves further research in larger, longer trials to confirm its safety and benefits.
Autologous ovarian grafting may preserve ovarian function in young cervical cancer patients undergoing pelvic radiotherapySmall trial tests ovarian tissue graft to protect hormone function during cervical cancer radiation
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Key Takeaway
Consider autologous ovarian grafting for ovarian preservation in young cervical cancer patients undergoing pelvic radiotherapy, but recognize evidence is from a small exploratory trial.
This exploratory phase II randomized trial evaluated autologous fresh ovarian tissue grafting into subcutaneous tissue prior to pelvic radiotherapy for preventing hypoestrogenism in young women with cervical cancer. The study included 22 women aged ≤35 years with locally advanced cervical cancer (FIGO 2018 stages IB3-IVA) and preserved ovarian function at a single center in Brazil. Patients were randomized to receive the grafting procedure or to not undergo grafting, with a median follow-up of 18.9 months.
At six months, 85% of patients in the intervention group had hormonal profiles consistent with preserved ovarian function and were free of climacteric symptoms. In contrast, all patients in the control group exhibited hormonal profiles compatible with premature ovarian insufficiency at the same time point. The study did not report specific absolute numbers, effect sizes, or p-values for these outcomes.
Regarding safety, the procedure was reported as technically safe, with no adverse events or serious adverse events reported. However, three patients were excluded from the intervention group due to clinical conditions, and tolerability details beyond technical safety were not provided. The study had several limitations, including its single-center design, nonblinded nature, exploratory phase II status, and short-term follow-up period.
While the findings suggest that fresh autologous subcutaneous ovarian grafting may be a feasible and effective approach for preventing hypoestrogenism in this specific patient population during short-term follow-up, clinicians should interpret these results cautiously. The evidence comes from a small, exploratory trial with methodological limitations, and long-term efficacy and generalizability beyond the study population and setting remain uncertain.
What this means for you:
Early, small study finds ovarian tissue graft may protect hormone function during radiation; more research is needed to confirm. More on Cancer
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View Original Abstract ↓
OBJECTIVE: To evaluate the short-term feasibility and efficacy of fresh autologous ovarian tissue grafting into the subcutaneous tissue for the prevention of hypoestrogenism in young women with cervical cancer undergoing pelvic radiotherapy.
DESIGN: Single center, nonblinded, exploratory phase II randomized trial conducted at Instituto do Câncer do Estado de São Paulo, Brazil, from June 2022 to April 2025.
SUBJECTS: Women aged ≤35 years with locally advanced cervical cancer (FIGO 2018 stages IB3-IVA), preserved ovarian function, and histologic subtypes of squamous cell carcinoma or usual adenocarcinoma, eligible for definitive pelvic radiotherapy.
INTERVENTION: Participants were randomized 1:1 to an intervention group (n = 12) with underwent autologous fresh ovarian tissue grafting into the subcutaneous tissue prior to pelvic radiotherapy, or to a control group (n = 10), with did not undergo grafting.
MAIN OUTCOME MEASURES: Hormonal ovarian function assessed by serum estradiol and follicle-stimulating hormone (FSH) levels.
RESULTS: A total of 22 patients were enrolled, with three excluded from the intervention group due to clinical conditions. The median follow-up was 18.9 months. At six months, 85% of patients in the intervention group maintained hormonal profiles consistent with preserved ovarian function and were free of climacteric symptoms, whereas all controls exhibited profiles compatible with premature ovarian insufficiency. Baseline assessments confirmed normal ovarian function in all participants.
CONCLUSION: Fresh autologous subcutaneous ovarian grafting was technically safe, feasible and effective in preventing hypoestrogenism and climacteric symptoms during short-term follow-up in young women undergoing pelvic radiotherapy for cervical cancer.
Adjuvant radiotherapy improves recurrence-free survival for intermediate-risk cervical cancer patients after surgery
Adjuvant radiotherapy improves recurrence-free survival for early-stage cervical cancer patients
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