放射治疗和怀孕:2025年更新
Anna Gueiderikh1, Morgan Michalet2, Catherine Dejean3
1Hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France.
概括
怀孕期间的放射治疗是罕见的,但对胎儿有风险,这取决于妊娠年龄. 超膜辐射可能是安全的,但亚膜辐射可以终止怀孕,而剂量监测至关重要.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 怀孕期间的癌症很少发生,约在1000例怀孕中发生1例.
- 辐射对胎儿的风险取决于妊娠年龄,包括发育不良,小头症和潜在的辐射诱导癌症.
- 现有的指导方针需要更新,以管理怀孕患者的放射治疗.
研究的目的:
- 介绍法国放射瘤学会 (SFRO) 关于在怀孕期间使用放射治疗的最新建议.
- 概述基于辐射位置和妊娠年龄的风险分层和管理策略.
- 强调剂量监测和首选的放射治疗技术.
主要方法:
- 审查和综合当前证据和关于放射治疗和怀孕的专家共识.
- 基于胚胎/胎儿暴露水平和妊娠年龄的风险评估.
- 评估不同的放射治疗技术,包括形状和强度调节的放射治疗.
主要成果:
- 超膜照射可以在孕妇中进行,胎儿风险最小.
- 腹膜下辐射需要提出治疗性终止怀孕,因为有很大的胎儿风险.
- 在进行放射治疗时,建议对幻影剂量进行估计和体内测量.
- 对于较低的胎儿剂量,通常优先选择符合性放射治疗,但特定瘤部位除外.
结论:
- 更新的SFRO建议为孕妇患者的放射治疗管理提供了一个框架.
- 风险与益处的评估至关重要,指导治疗延续或终止的决定.
- 精确的剂量监测和技术选择至关重要,以尽量减少胎儿暴露.
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