Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

Gao, Wei; Liang, Jinxiao; Qiu, Yan

doi:10.1007/s10815-015-0490-6

Cited by 20 publications

(20 citation statements)

References 27 publications

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“…The FCR contains complete information on chemotherapy and radiotherapy given within 4 months of diagnosis. Previous studies, however, have not detected a significant dose‐response association between radiotherapy or alkylating agents and congenital anomalies . Studies have demonstrated neither genomic instability nor germline minisatellite mutation associated with radiotherapy .…”

Section: Discussionmentioning

confidence: 93%

“…However, this is a diagnostic group with a large variety of congenital anomalies and we had limited numbers of these Table 5. Prevalence ratios (PR) with 95% confidence intervals (CI) for association between the risk for any congenital anomaly and cancer of parent in young adulthood (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) 1 Observed number of offspring with any congenital anomaly. Only congenital anomalies in offspring recorded in the first 2 years of life were taken into account.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies, however, have not detected a significant doseresponse association between radiotherapy or alkylating agents and congenital anomalies. 8,9,25,26 Studies have demonstrated neither genomic instability nor germline minisatellite mutation associated with radiotherapy. [27][28][29] Being unable to directly examine effects of parental cancer therapies on congenital anomalies in offspring, we used diagnosis groups of cancers as a proxy for treatment as well as the initial information on radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Risk for congenital anomalies in offspring of childhood, adolescent and young adult cancer survivors

Seppänen

Artama

Malila

et al. 2016

Intl Journal of Cancer

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Offspring of cancer survivors (CS) may be at risk for congenital anomalies due to the mutagenic therapies received by their parents. Our population-based cohort study aimed to investigate the risk for congenital anomalies in offspring of CS compared to offspring of their siblings. Using the Finnish Cancer Registry, Central Population Register, and Hospital Discharge Register, we identified hospital contacts due to congenital anomalies in 6,862 offspring of CS (early-onset cancer between 1953 and 2004) and 35,690 offspring of siblings. Associations between congenital anomalies and cancer were evaluated using generalized linear regression modelling. The ratio of congenital anomalies in offspring of CS (3.2%) was slightly, but non-significantly, elevated compared to that in offspring of siblings (2.7%) [prevalence ratio (PR) 1.07, 95% confidence interval (CI) 0.91-1.25]. When offspring of childhood and adolescent survivors (0-19 years at cancer diagnosis) were compared to siblings' offspring, the risk for congenital anomalies was non-significantly increased (PR 1.17, 95% CI 0.92-1.49). No such increase existed for offspring of young adult survivors (20-34 years at cancer diagnosis) (PR 1.01, 95% CI 0.83-1.23). The risks for congenital anomalies were elevated among offspring of CS diagnosed with cancer in the earlier decades (1955-1964: PR 2.77, 95% C I 1.26-6.11; and 1965-1974: PR 1.55, 95% C I 0.94-2.56). In our study, we did not detect an overall elevated risk for congenital anomalies in offspring of survivors diagnosed in young adulthood. An association between cancer exposure of the parent and congenital anomalies in the offspring appeared only for those CS who were diagnosed in the earlier decades.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Risk for congenital anomalies in offspring of childhood, adolescent and young adult cancer survivors

Seppänen

Artama

Malila

et al. 2016

Intl Journal of Cancer

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“…As stated, the dose needed to destroy a half of the primordial follicles (LD 50 ) is estimated at below 2 Gy [48] 55-3.17), which evidences that radiotherapy during childhood exerts a negative effect on reproductive health in adulthood. The importance of the time elapsed, as well as individual differences for the effects of radiation observed, requires further studies [100].…”

Section: Transgenerational Transmission Of Genomic Instabilitymentioning

confidence: 99%

Effect of ionizing radiation on the female reproductive system

Skrzypek¹,

Wdowiak²,

Panasiuk³

et al. 2019

Ann Agric Environ Med.

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Introduction and objective. The tendency towards postponement of maternity implies a greater exposure of female germ cells to damaging environmental effects, including ionizing radiation (IR). Progress in paediatric oncology, based on the use of radiotherapy, also implies the occurrence of gonadal dysfunctions and subsequent female fertility disorders. Therefore, it seems justifiable to systematize the state of knowledge concerning the effect of IR on the female reproductive system. Brief description of the state of knowledge. A considerable part of studies concerning the effect of IR on female germ cells have been conducted on animals. Their extrapolation to humans is hindered because in animal studies high acute exposures are applied, which do not reflect human environmental exposures characterized by chronic low dose exposure. Studies on animals provide a heterogenous image, which hinders the formulation of unequivocal conclusions and indicates that radiosensitivity depends, i.a. on IR dose, stage of development of oocytes, the applied marker of the effects of IR, or on the species. LD50 of human oocytes is estimated to be below 2 Gy. The effect of IR depends, i.a. on the dose fractionation and the age (older women are more radiosensitive). In females, the effective sterilizing dose is: at birth 20.3 Gy, at 10 years 18.4 Gy, at 20 years 16.5 Gy, whereas at 30 years 14.3 Gy, which is associated with the available pool of ovarian follicles. Conclusions. Within the range of low doses received as a result of environmental exposure to IR, there is no evidence for the occurrence of either adverse pregnancy outcomes, nor fertility disorders in females. These effects may be related to the cancer radiotherapy, or exposure to high IR doses during nuclear accidents.

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“…Pelvic irradiation in childhood negatively affect uterus, increasing risk of spontaneous miscarriages, preterm labor, low-birth-weight infants, placental abnormalities [17]. These pregnancy-related complications are related with reduced uterine volume, damage of uterine vessels, myometrial fibrosis, endometrial injury.…”

Section: Impact Of Radiotherapymentioning

confidence: 99%

Reproductive health of female childhood cancer survivors

Žulpaitė

Bumbulienė

2018

Ginekol Pol

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Current treatment schemes of childhood cancer are usually effective enough to enable successful management of the disease. With the high rates of survival, another problem arises because patients often suffer much later from side effects of the toxic therapy. A common complication caused by cancer treatment is impairment of the female reproductive system including dysfunction of the hypothalamus and hypophysis, the killing of gonadal cells, and uterine injury. This may lead to altered pubertal timing, gonadotropin insufficiency or deficiency, acute ovarian failure, premature ovarian insufficiency, sexual dysfunction, and complicated pregnancy. The severity of these side effects depends a lot on the patient's age at treatment and the particularities of their chemo- and/or radiotherapy regimens. While some types of cancer require aggressive treatment, and therefore negative side effects cannot be avoided, strategies which preserve the patient's reproductive potential are essential. Such strategies are more established in the treatment of adult women, however there are also promising opportunities in the treatment of pediatric oncology patients. Ovar-ian transposition is already widely applied before pelvic radiotherapy. Cryopreservation of ovarian tissue, cryopreservation and in vitro maturation of immature oocytes, or cryopreservation of mature oocytes when the patient's age is appropriate, have also shown to have promising results in pediatric patients. Concurrent combinations of several techniques can also be successful. Counselling of pediatric patients and their families is challenging, and the urgent commencement of anticancer therapies often discourages attempts to preserve the girl's reproductive system. Given that successful methods of fertility preserva-tion are already accessible, it is crucial not to leave this topic aside at the time of diagnosis.

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Exposure to radiation therapy is associated with female reproductive health among childhood cancer survivors: a meta-analysis study

Cited by 20 publications

References 27 publications

Risk for congenital anomalies in offspring of childhood, adolescent and young adult cancer survivors

Risk for congenital anomalies in offspring of childhood, adolescent and young adult cancer survivors

Effect of ionizing radiation on the female reproductive system

Reproductive health of female childhood cancer survivors

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