接受 22-27 Gy 下丘脑/垂体照射的女性儿童癌症幸存者生育力下降：来自儿童癌症幸存者研究的报告。
Decreased fertility among female childhood cancer survivors who received 22-27 Gy hypothalamic/pituitary irradiation: a report from the Childhood Cancer Survivor Study.
机构信息
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA.
出版信息
Fertil Steril. 2011 May;95(6):1922-7, 1927.e1. doi: 10.1016/j.fertnstert.2011.02.002. Epub 2011 Mar 3.
OBJECTIVE
To evaluate the effect of hypothalamic/pituitary radiation (HPT RT) dose on the occurrence of first pregnancy.
DESIGN
Retrospective cohort study of childhood cancer 5-year survivors (CCS) diagnosed between 1970 and 1986 before 21 years of age at one of 26 North American pediatric cancer treatment centers.
SETTING
Self-administered questionnaire.
PATIENT(S): A total of 3,619 female CCS who participated in the Childhood Cancer Survivor Study and received no or scatter (≤0.1 Gy) radiation to the ovaries and 2,081 female siblings (Sibs) of the participants.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Self-reported pregnancy events.
RESULT(S): As a group, CCS were as likely to report being pregnant as Sibs (hazard ratio 1.07, 95% confidence interval 0.97-1.19). Multivariable models showed a significant decrease in the risk of pregnancy with HPT RT doses≥22 Gy compared with those CCS receiving no HPT RT.
CONCLUSION(S): These results support the hypothesis that exposures of 22-27 Gy HPT RT may be a contributing factor to infertility among female CCS.
目的
评估下丘脑/垂体放疗（HPT RT）剂量对首次妊娠发生的影响。
设计
对 26 个北美儿科癌症治疗中心之一的 21 岁以下于 1970 年至 1986 年期间诊断为儿童癌症的 5 年幸存者（CCS）的回顾性队列研究。
地点
自我管理问卷。
患者
共有 3619 名女性 CCS 参加了儿童癌症幸存者研究，未接受卵巢或散射（≤0.1 Gy）照射，2081 名参与者的女性同胞（Sibs）。
干预措施
无。
主要观察指标
自我报告的妊娠事件。
结果
作为一个群体，CCS 报告怀孕的可能性与 Sibs 一样（风险比 1.07，95%置信区间 0.97-1.19）。多变量模型显示，与未接受 HPT RT 的 CCS 相比，HPT RT 剂量≥22 Gy 的妊娠风险显著降低。
结论
这些结果支持以下假设：22-27 Gy HPT RT 暴露可能是女性 CCS 不孕的一个因素。
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