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BACKGROUND Ovarian failure has been reported to occur in female cancer survivors who had received spinal radiation as children. We aimed to determine whether laparoscopic unilateral oophoropexy prior to radiotherapy effectively preserves ovarian function. METHODS In a retrospective analysis, the study group comprised girls, aged 18 and younger, who received spinal irradiation for a brain tumor. Ovarian dysfunction, the primary endpoint, was defined as an elevated follicle-stimulating hormone level or persistent amenorrhea. RESULTS After applying exclusion criteria, 15 patients comprised the group that had undergone laparoscopic oophoropexy, and 11 patients comprised the comparison group that did not have oophoropexy. Mean age at diagnosis, length of follow-up, proportion of high-risk tumors and doses and duration of chemotherapy and radiation were not different between the two groups. Two of 15 patients (13%, 95% CI 0.2–40%) with oophoropexy had ovarian dysfunction compared with five of 11 (45%, 95% CI 17–77%) in the comparison group (P = 0.09). CONCLUSIONS Oophoropexy may protect against radiation-induced ovarian failure in girls receiving spinal radiation. A high risk of ovarian dysfunction was seen in patients who did not undergo oophoropexy. In girls who underwent oophoropexy, a lower rate of ovarian dysfunction was seen. [ABSTRACT FROM AUTHOR]