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Radiotherapy and pregnancy.

M Michalet1, C Dejean2, U Schick3

  • 1Institut du cancer de Montpellier, 208, avenue des Apothicaires, 34298 Montpellier, France.

Cancer Radiotherapie : Journal De La Societe Francaise De Radiotherapie Oncologique
|December 26, 2021
PubMed
Summary
This summary is machine-generated.

Cancer during pregnancy is rare, but radiation therapy poses risks to the fetus. Supradiaphragmatic radiation may be safe, but subdiaphragmatic radiation often warrants pregnancy termination. Fetal dose estimation is crucial.

Keywords:
French society for radiation oncologyGrossesseGuidelinesPregnancyRadiation therapyRadiothérapieRecommandationsSociété française de radiothérapie oncologique

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Maternal-Fetal Medicine

Background:

  • Cancer complicates approximately 1 in 1000 pregnancies.
  • Fetal exposure to radiation carries risks including malformations and secondary cancers.
  • Gestational age at irradiation significantly influences embryo/fetal risk.

Purpose of the Study:

  • To update recommendations for radiotherapy in pregnant patients.
  • To outline risk stratification based on irradiation location and gestational age.
  • To provide guidance on fetal dose assessment and preferred techniques.

Main Methods:

  • Review of existing literature and clinical guidelines.
  • Risk assessment based on radiation physics and radiobiology.
  • Analysis of fetal dose reduction strategies.

Main Results:

  • Supradiaphragmatic radiotherapy may be performed with minimal fetal risk.
  • Subdiaphragmatic radiotherapy generally necessitates discussion of therapeutic termination.
  • Fetal dose estimation via phantom studies and in vivo measurement is recommended.
  • Conformational radiotherapy is preferred for dose reduction, with exceptions for techniques like IMRT.

Conclusions:

  • Radiotherapy decisions in pregnancy require careful risk-benefit analysis.
  • Fetal dose monitoring and minimization are paramount.
  • Technological advancements like IMRT may be indicated in specific tumor locations.