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Childhood Radiation May Hurt Later Offspring

July 26, 2010
Written by: , Filed in: Abdominal Imaging, Pediatric Radiology
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Women who undergo radiation therapy for cancer as children run a greatly increased risk that their own children will be stillborn or die shortly after birth, according to a report in the journal The Lancet.

John D. Boice Jr., ScD, and Lisa B. Signorello, ScD, both of the International Epidemiology Institute in Rockville, Maryland, and the Division of Epidemiology at Vanderbilt University Medical Center in Nashville, led a team that gathered data from the Childhood Cancer Survivor Study (CCSS), covering people who were treated at 25 U.S. institutions and 1 Canadian institution.

All of the CCSS patients were younger than 21 when diagnosed with cancer and all had survived at least five years. The study encompassed 1,148 men and 1.657 women. The pregnancies among this group (including men who had impregnated their partners) totaled 4,946.

The researchers found that women who had undergone irradiation of the uterus or ovaries had an increase of up to twelvefold in the risk of stillbirth or neonatal death among their children.

“High-dose pelvic irradiation can permanently impair growth and blood flow to the uterus and results in a reduced uterine volume,” the study authors wrote, “and these effects of radiation are likely to be dependent on age. Whether these types of effects on the uterus increase the risk of placental or umbilical-cord anomalies or other factors already linked to stillbirth, or whether they operate through different mechanisms needs clarification.”

The study found no increased risk of stillbirth or neonatal death related to irradiation of the testes among men or the pituitary gland among women, or to use of alkylating chemotherapy drugs among either sex. The authors did note that people who are exposed to radiation on the job or in other nontreatment settings might also be prone to increased risk that their children might be stillborn or die shortly after birth. The researchers concluded:

Careful management is warranted of pregnancies in women given high doses of pelvic irradiation before puberty.

Related seminar: Pediatric Radiology Review


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