Fertility and Pregnancy Outcome After Abdominal Irradiation That Included or Excluded the Pelvis in Childhood Tumor Survivors

Journal Article · Mon Mar 01 04:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.04.012· OSTI ID:21372113

Sudour, Helene ^[1]; Chastagner, Pascal ^[1]; Claude, Line ^[2]; Desandes, Emmanuel ^[3]; Klein, Marc ^[4]; Carrie, Christian ^[2]; Bernier, Valerie ^[5]

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1. Department of Paediatric Onco-Hematology, CHU Nancy, Vandoeuvre-les-Nancy (France)
2. Department of Radiotherapy, Centre Leon Berard, Lyon (France)
3. Department of Statistics, Centre Alexis Vautrin, Vandoeuvre-les-Nancy (France)
4. Department of Endocrinology, CHU Nancy, Vandoeuvre-les-Nancy (France)
5. Department of Radiotherapy, Centre Alexis Vautrin, Vandoeuvre-les-Nancy (France)

Purpose: To evaluate fertility after abdominal and/or pelvic irradiation in long-term female survivors. Methods and Materials: Puberty and pregnancy outcome were analyzed in female survivors of childhood cancer (aged <18 years) treated with abdominal and/or pelvic radiotherapy (RT) at one of two French centers (Nancy and Lyon) between 1975 and 2004. Data were obtained from medical records and questionnaires sent to the women. Results: A total of 84 patients who had received abdominal and/or pelvic RT during childhood and were alive and aged more than 18 years at the time of the study made up the study population. Of the 57 female survivors treated with abdominal RT that excluded the pelvis, 52 (91%) progressed normally through puberty and 23 (40%) had at least one recorded pregnancy. Of the 27 patients treated with pelvic RT, only 10 (37%) progressed normally through puberty and 5 (19%) had at least one recorded pregnancy. Twenty-two women (seventeen of whom were treated with pelvic RT) had certain subfertility. A total of 50 births occurred in 28 women, with one baby dying at birth; one miscarriage also occurred. There was a high prevalence of prematurity and low birth weight but not of congenital malformations. Conclusions: Fertility can be preserved in patients who undergo abdominal RT that excludes the pelvis, taking into account the other treatments (e.g., chemotherapy with alkylating agents) are taken into account. When RT includes the pelvis, fertility is frequently impaired and women can have difficulty conceiving. Nevertheless, pregnancies can occur in some of these women. The most important factor that endangers a successful pregnancy after RT is the total dose received by the ovaries and uterus. This radiation dose has to be systematically recorded to improve our ability to follow up patients.

• OSTI ID: 21372113
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 76; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ABDOMEN
ANIMALS
BODY
DISEASES
DOSES
FEMALE GENITALS
FEMALES
FERTILITY
GONADS
MAMMALS
MAN
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
OVARIES
PELVIS
PREGNANCY
PRIMATES
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
THERAPY
UTERUS
VERTEBRATES
WOMEN