FRIDAY, July 23 (HealthDay News) -- Female survivors of childhood cancer treated with pelvic radiation have a much higher risk of stillbirth and neonatal death in their offspring than do females who did not get radiation, but there is no increased risk for male survivors who received gonadal radiation, according to research published online July 23 in the The Lancet.
Lisa B. Signorello, of the International Epidemiology
Institute in Rockville, Md., and colleagues conducted a retrospective cohort analysis of stillbirth and neonatal death among offspring of pediatric cancer survivors. The amount of radiation to a survivor's pituitary gland, testes, or ovaries and uterus were noted, as well as any history of having received alkylating drugs. The purpose of the study was to indirectly assess the transmission risk of germline damage in offspring of both male and female pediatric cancer survivors by measuring rates of stillbirth and neonatal death in their offspring.
The researchers found that radiation of the testes, radiation of the pituitary, and receipt of alkylating drugs did not increase the risk of stillbirth or neonatal death in offspring. Radiation of the uterus or ovaries at doses of at least 10 Gy was associated with an adjusted relative risk of stillbirth or neonatal death of 9.1. When girls received ovarian radiation before menarche, the risk of these adverse outcomes was significantly elevated (adjusted relative risk, 4.7) with exposures as low as 1.0 to 2.49 Gy.
"In conclusion, for men exposed to gonadal irradiation, there does not seem to be an increased risk of stillbirth or neonatal death among their offspring, which is reassuring not only for male survivors of childhood cancer but also for men exposed to ionizing radiation in occupational or other settings. For women, however, high-dose uterine or ovarian radiation does seem to have important adverse effects, which are most likely to be attributable to uterine damage. Therefore, careful management is warranted for pregnant women treated with high doses of pelvic irradiation before they have reached puberty," the authors write.
Abstract
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