Herrmann T, Rupprecht E, Voigtmann L, Kuchheuser W
Bereich Strahlenbiologie der Strahlentherapieabteilung, Medizinischen Akademie Carl Gustav Carus, Dresden.
Strahlenther Onkol. 1988 Nov;164(11):629-37.
The results of a longterm study on 55 children are presented whose parents were treated by radiotherapy. Five or ten years after a first examination, these children were submitted to a check-up investigation of their physical and intellectual development. The group of twenty irradiated fathers received an average dose to the gonads of 0.55 Gy (0.01 to 6.4 Gy), the group of twenty irradiated mothers 0.72 Gy (0.01 to 8.0 Gy). In all parents the most frequent finding was Hodgkin's disease, which was diagnosed as a neoplasm in 23 cases. Chemotherapy was applied in two out of 40 patients. The proof of paternity was made with a 86% accuracy for ten out of twenty fathers by determination of HLA types. A conception was demonstrated beyond all doubt after a dose to the testicles of 1.2 Gy in the irradiated fathers and after a dose to the ovaries of 3.0 Gy in the irradiated mothers. The offspring of the F1 generation showed no modification in the sex ratio. In the primary examination, a rate of 5.5% of severe malformations was found (trisomy E, bradyacousia of the inner ear, cleft hands and feet). 24% of the children had malformations which needed a treatment (hernias, torticollis, hip dysplasia). 18 out of 55 children (33%) presented abnormalities in the widest sense of the word. Three children (5.5%) were premature infants, and there is a general tendency towards shortened pregnancy (-3.6 days). Hernias (7/55) are a frequent finding. In children of both sexes, carporadiography shows a delayed development which is not compensated in the check-up examinations at five or ten years, but does not cause an underdevelopment in body height as compared to great normal collectives. The results suggest a slightly increased malformation rate among children whose parents were treated by radiotherapy. Above all the connective and supporting tissue seems involved. Some proposals are made how to give a radiogenetic advice to tumor patients who want to have children.
本文呈现了一项针对55名儿童的长期研究结果,这些儿童的父母曾接受过放射治疗。在首次检查后的五年或十年,这些儿童接受了身体和智力发育的检查。20名接受照射的父亲性腺平均受照剂量为0.55 Gy(0.01至6.4 Gy),20名接受照射的母亲性腺平均受照剂量为0.72 Gy(0.01至8.0 Gy)。在所有父母中,最常见的诊断是霍奇金病,其中23例被诊断为肿瘤。40名患者中有2名接受了化疗。通过检测HLA类型,20名父亲中有10名的父系鉴定准确率达到86%。照射后的父亲睾丸受照剂量达到1.2 Gy以及母亲卵巢受照剂量达到3.0 Gy后,毫无疑问地证实了受孕情况。F1代后代的性别比例没有变化。在初次检查中,发现严重畸形率为5.5%(E三体、内耳听力减退、手足裂)。24%的儿童有需要治疗的畸形(疝气、斜颈、髋关节发育不良)。55名儿童中有18名(33%)在最宽泛的意义上存在异常。3名儿童(5.5%)为早产儿,并且普遍存在怀孕缩短的趋势(-3.6天)。疝气(7/55)是常见的发现。在男女儿童中,腕关节X线摄影显示发育延迟,在五年或十年后的检查中并未得到补偿,但与正常大群体相比,并未导致身高发育不足。结果表明,父母接受过放射治疗的儿童中畸形率略有增加。最重要的是,结缔组织和支持组织似乎受到影响。文中提出了一些建议,以便为想要孩子的肿瘤患者提供放射遗传学方面的建议。