Radiotherapy for metastatic melanoma presenting in pregnancy

Abstract

We describe the study of a patient with metastatic melanoma to axillary nodes presenting during pregnancy. The factors considered in her management are discussed, including issues related to staging, the decision not to terminate the pregnancy and the relative efficacy and fetal toxicity of the available treatment options. An overview of the known effects of radiotherapy on the fetus is presented and the technical alterations that were used to decrease the toxicity of radiotherapy are discussed.

Pregnancy and radiotherapy: Management options for minimising risk, case series and comprehensive literature review

“…In the cases where radiotherapy was commenced at less than 10 weeks gestation, spontaneous abortion and sensory loss because of inner ear defect occurred, which are consistent with the expected risks published by the AAPM given the gestational age 1 . There were two malformations occurring in the 10‐ to 27‐week group, which was again consistent with the expected risk 33 . There was a case of spontaneous abortion occurring with radiotherapy at 10 weeks gestation, 19 and a child with learning difficulties and scoliosis at 28 weeks gestation: 19 these risks are more in keeping with the less than 10 weeks and 10‐ to 27‐week groups, respectively and hence consistent with the risks documented by the AAPM 1 .…”

Melanom und Schwangerschaft

“…Auch die Strahlendosis für den Fötus während einer Thoraxröntgenuntersuchung liegt mit Werten unter 0,1 Milligray (mGy) weit unter den empfohlenen Grenzwerten [2]. CTUntersuchungen mit einer deutlich hö-heren Strahlenbelastung sollten nur bei entsprechender Indikation wie Verdacht auf Fernmetastasierung durchgeführt werden [5]. [26] zeigten sich keine schwerwiegenden Nebenwirkungen, v. a. nicht für den Fötus.…”