Radiotherapy Appears Safe, But Caution Is Urged

In the second study, Dr. Amant’s team investigated 16 children (median age, 6 years) and 10 adults (median age, 33 years) who had neonatal exposure to radiotherapy. The estimated fetal irradiation was 91 mGy (range, 0-1,690).

Clinical neurological examination and cognitive tests showed that neuropsychological and behavioral measures were within normal ranges for both groups. Echocardiography demonstrated that cardiac function was comparable with that of an age- and gender-matched control group.2


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One child had severe cognitive delay, however, the prenatal dose of radiotherapy was relatively low and there were confounding factors to the pregnancy, including intravenous maternal nutrition and preterm delivery.2

RELATED: Cancer During Pregnancy: Rare, But Increasingly Common

“Pregnancy, particularly advanced pregnancy, has been traditionally considered a contra-indication to radiotherapy,” said Dr. Peccatori. “New radiation techniques and more sophisticated simulations of the received fetal dose may change this scenario, but caution remains mandatory when giving radiotherapy to a pregnant woman, particularly in the third trimester.”

Have the Talk on Contraception

In the third study, researchers from Dr. Amant’s group found that 29 of 897 (3.23%) patients in the database of the International Network for Cancer Infertility and Pregnancy became pregnant after cancer diagnosis or during treatment. Twelve of the 29 women were not using contraception, contraception failed in 7, and contraceptive use was unknown in 10.3

 “The core message from our results is that it is vital for doctors and patients to discuss contraception during cancer diagnosis and cancer treatment,” said Dr. Amant. “Although we know it’s possible to treat patients with chemotherapy/radiotherapy during pregnancy when necessary, it’s still better to avoid this situation, if possible.”

References

  1. Amant, F, Vandenbroucke T, Verheecke M, et al. Cancer during pregnancy: a case-control analysis of mental development and cardiac functioning of 38 children prenatally exposed to chemotherapy. In: Proceedings of the ESMO 2014 Congress; September 26-30, 2014; Madrid, Spain. Abstract 267PD_PR.
  2. Amant, F, Vandenbroucke T, Verheecke M, et al. Long-term neuropsychological and cardiac follow-up of children and adults who were antenatal exposed to radiotherapy. In: Proceedings of the ESMO 2014 Congress; September 26-30, 2014; Madrid, Spain. Abstract LBA49_PR.
  3. Amant F, Uzan C, Han S, et al. Matched cohort study on patients with cervical cancer diagnosed during pregnancy. In: Proceedings of the ESMO 2014 Congress; September 26-30, 2014; Madrid, Spain. Abstract 925P.