PMID- 15050311
OWN - NLM
STAT- MEDLINE
DCOM- 20040427
LR  - 20161019
IS  - 0360-3016 (Print)
IS  - 0360-3016 (Linking)
VI  - 58
IP  - 5
DP  - 2004 Apr 1
TI  - Pregnancy outcomes after abdominal irradiation that included or excluded the 
      pelvis in childhood Wilms tumor survivors: a report from the National Wilms Tumor 
      Study.
PG  - 1364-8
AB  - PURPOSE: This report describes the pregnancy outcomes among 7 survivors of 
      childhood Wilms tumor, who were treated on one of the National Wilms Tumor 
      Studies (NWTS) with radiation therapy (RT) portals that extended beyond the 
      flank. METHODS AND MATERIALS: Pregnancy outcomes among female survivors of 
      childhood Wilms tumor treated with abdominal irradiation in NWTS 1-4 were 
      analyzed as part of the long-term follow-up study. Medical records and maternal 
      questionnaires were used to gather information on pregnancy outcomes. RESULTS: A 
      total of 130 patients received abdominal RT and survived to at least 15 years of 
      age. Seven patients (5.4%) had at least 1 recorded pregnancy. The extent of RT 
      fields was ascertained in 126 patients. For 4 patients, the extent of RT fields 
      could not be determined. Twelve girls received RT using portals that included the 
      upper abdomen but not the entire pelvis. Ten pregnancies were recorded in 5 of 
      these patients; 9 resulted in live births, and 1 resulted in a miscarriage. One 
      hundred fourteen girls received RT using portals that included the entire abdomen 
      and pelvis. The abdominal RT dose distribution among these 114 patients was as 
      follows: 9 received 0-10.49 Gy, 22 patients received 10.5-14.99 Gy, and 83 
      patients received 15+ Gy. Four pregnancies were recorded in 2 of these patients. 
      After 21 Gy to the abdomen and pelvis in 1 patient, all 3 pregnancies resulted in 
      miscarriages and fetal deaths. However, after 10.5 Gy, a normal live birth was 
      reported in the other patient. Pregnancy-related complications were also more 
      common if the RT portals included the pelvis. CONCLUSIONS: Fertility can be 
      preserved in children with Wilms tumor after upper abdominal RT (10-20 Gy) that 
      does not include the entire pelvis. In rare instances, fertility can be preserved 
      after low-dose whole-abdominal RT (10.5 Gy). The indications and dosages for RT 
      currently used have been greatly refined compared to NWTS-1 and NWTS-2. Childhood 
      Wilms tumor survivors should be considered to be at a high risk for infertility 
      and pregnancy-related complications during their reproductive years. Prompt 
      obstetric evaluation is indicated for optimal prenatal, antenatal, and postnatal 
      care.
FAU - Kalapurakal, John A
AU  - Kalapurakal JA
AD  - Department of Radiation Oncology, Northwestern University, Chicago, IL, USA. 
      j-kalapurakal@northwestern.edu
FAU - Peterson, Susan
AU  - Peterson S
FAU - Peabody, Eve M
AU  - Peabody EM
FAU - Thomas, Patrick R M
AU  - Thomas PR
FAU - Green, Daniel M
AU  - Green DM
FAU - D'angio, Giulio J
AU  - D'angio GJ
FAU - Breslow, Norman E
AU  - Breslow NE
LA  - eng
GR  - R01 CA054498/CA/NCI NIH HHS/United States
GR  - R01 CA 54498/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Int J Radiat Oncol Biol Phys
JT  - International journal of radiation oncology, biology, physics
JID - 7603616
SB  - IM
CIN - J Urol. 2005 Aug;174(2):719-20. PMID: 16006959
MH  - Abortion, Spontaneous
MH  - Adult
MH  - Birth Weight
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Fetal Death
MH  - Humans
MH  - Infant
MH  - Kidney Neoplasms/*radiotherapy
MH  - Pelvis
MH  - Poisson Distribution
MH  - Pregnancy
MH  - *Pregnancy Outcome
MH  - Radiotherapy Dosage
MH  - *Survivors
MH  - Wilms Tumor/*radiotherapy
EDAT- 2004/03/31 05:00
MHDA- 2004/04/28 05:00
CRDT- 2004/03/31 05:00
PHST- 2003/05/08 00:00 [received]
PHST- 2003/08/20 00:00 [revised]
PHST- 2003/08/25 00:00 [accepted]
PHST- 2004/03/31 05:00 [pubmed]
PHST- 2004/04/28 05:00 [medline]
PHST- 2004/03/31 05:00 [entrez]
AID - S036030160301811X [pii]
AID - 10.1016/j.ijrobp.2003.08.031 [doi]
PST - ppublish
SO  - Int J Radiat Oncol Biol Phys. 2004 Apr 1;58(5):1364-8. doi: 
      10.1016/j.ijrobp.2003.08.031.