Women treated with radiation therapy to cure Wilms tumor can have healthy babies if entire pelvis was not irradiated

Women who were treated with radiation therapy to cure Wilms tumor as a child can go on to have healthy babies so long as their entire pelvis was not irradiated, according to a new study in the April 2004 issue of the International Journal of Radiation Oncology-Biology-Physics, the official journal of ASTRO, the American Society for Therapeutic Radiology and Oncology.

Radiation to the abdomen of a young girl can often impair her long-term fertility because of its effects on the ovaries, uterus, and musculoskeletal system of the abdomen, spine and pelvis. While earlier studies have highlighted the adverse impact radiation therapy can have upon the fertility of female survivors of Wilms tumor and other childhood cancers, the earlier research did not include detailed analyses of the survivors’ pregnancies in relation to where they received the radiation therapy.

This study analyzed the pregnancy outcomes among female survivors of childhood Wilms tumor treated with abdominal irradiation in the National Wilms Tumor Studies (NWTS) 1-4 as part of a long-term follow-up study. The report described the pregnancy outcomes among seven survivors of childhood Wilms tumor who were treated on one of the NWTS with radiation therapy portals that extended beyond the flank.

Results of the study showed that female survivors of Wilms tumor can go on to have healthy children so long as their entire pelvis is not treated with radiation therapy to cure their cancer. The study also showed that, on rare occasions, girls treated with low-dose whole-abdominal radiation therapy also can go on to have a healthy baby.

“The good news is that this study shows it is possible for women who received radiation therapy to the abdomen to treat Wilms tumor as a child can go on to have healthy babies,” said John A. Kalapurakal, M.D., the lead author of the study and a member of the department of radiation oncology at Northwestern Memorial Hospital in Chicago. “To minimize any complications from the cancer treatment, we encourage these survivors to be regularly evaluated by their obstetrician before, during and after pregnancy to ensure that the child and the mother receives adequate care.”

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