Fenig E, Mishaeli M, Kalish Y, Lishner M
Institute of Oncology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
Cancer Treat Rev. 2001 Feb;27(1):1-7. doi: 10.1053/ctrv.2000.0193.
The risk of foetal irradiation during pregnancy is discussed. It seems that, due to the low level of X-ray exposure to the foetus, neither diagnostic radiography nor nuclear diagnostic examination justifies termination of pregnancy. Radiotherapy for breast cancer, Hodgkin's disease and cervical cancer in pregnant women is reviewed. Radiation therapy for breast cancer is not an absolute contraindication for pregnancy and the risk-benefit assessment should be discussed with the mother. The risk to the foetus during radiotherapy for supradiaphragmatic Hodgkin's disease appears to be minimal, provided special attention is paid to the treatment techniques and the foetus is adequately shielded. Radiotherapy for the treatment of cervical cancer may be necessary during pregnancy, but the timing should be adjusted taking into consideration gestational age. Offspring of cancer patients who were treated by radiotherapy appear to be at little risk of childhood cancer or birth defects. Cancer patients should not be discouraged from having children and can expect a good outcome of pregnancy. However, in the non-pregnant woman, to further reduce any risk it is advisable to delay pregnancy for 12 months following completion of radiation therapy.
讨论了孕期胎儿受辐射的风险。由于胎儿接受的X射线照射水平较低，诊断性放射摄影和核诊断检查似乎都不能成为终止妊娠的理由。对孕妇乳腺癌、霍奇金病和宫颈癌的放射治疗进行了综述。乳腺癌放射治疗并非妊娠的绝对禁忌证，应与母亲讨论风险效益评估。对于膈上霍奇金病放疗期间的胎儿，只要特别注意治疗技术并对胎儿进行充分屏蔽，风险似乎极小。宫颈癌放疗在孕期可能是必要的，但应根据孕周调整时间。接受放射治疗的癌症患者的后代患儿童癌症或出生缺陷的风险似乎很小。不应劝阻癌症患者生育，且可预期妊娠结局良好。然而，对于未怀孕的女性，为进一步降低任何风险，建议在放疗结束后延迟12个月再怀孕。
