Zaki Peter, Zhu Junjia, Mackley Heath B, Rosenberg Jennifer C
Department of Radiation Oncology, Penn State Cancer Institute, 400 University Dr, Hershey, PA 17033, USA.
Department of Radiation Oncology, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA.
Ecancermedicalscience. 2021 Jan 13;15:1169. doi: 10.3332/ecancer.2021.1169. eCollection 2021.
The human embryo or foetus is susceptible to harmful effects of radiation, which include growth delay, malformations, impaired cognitive function, cancer and foetal demise. The purpose of this study is to describe pregnancy screening practices in radiation oncology, so that potential health effects may be avoided and areas of prevention may be identified.
An electronic survey was delivered to 6,304 members of the American Society for Radiation Oncology. The survey subjects were radiation oncologists who are currently practicing in the world. Chi-square tests and a multiple logistic regression model were used to analyse the data. All tests were two-sided and the statistical significance level used was 0.05. This study (STUDY00009765) was approved by an Institutional Review Board.
A total of 434 responses from practicing radiation oncologists were received. Of these respondents, 69.1% were practicing in the United States. Of all respondents, 19.8% reported treating paediatric patients and 93.6% reported treating premenopausal patients. Despite 84.8% of radiation oncologists saying they would 'strongly agree' or 'agree' that one should screen for pregnancy prior to radiation therapy, 29.7% of respondents reported their department has no screening policy and 7.1% of respondents reported they do not screen for pregnancy. Having a departmental policy was associated with screening for pregnancy (-value = 0.0005).Of all respondents, 93 reported treating a known pregnant patient. Of these 93 respondents, 76 reported intentionally treating and 17 reported accidentally treating a pregnant patient. Respondents who did not screen at time of simulation were significantly more likely to treat a pregnant patient than those who screened at time of simulation (-value = 0.0459).
Heterogeneity exists among practicing radiation oncologists regarding pregnancy screening. Institutional policies should be clear and consistent. All members of the radiation oncology team should make every effort to minimise unintended radiation exposure to the embryo or foetus.
人类胚胎或胎儿易受辐射的有害影响，这些影响包括生长发育迟缓、畸形、认知功能受损、癌症和胎儿死亡。本研究的目的是描述放射肿瘤学中的妊娠筛查实践，以便避免潜在的健康影响并确定预防领域。
向美国放射肿瘤学会的6304名成员进行了电子调查。调查对象为目前在世界各地执业的放射肿瘤学家。采用卡方检验和多元逻辑回归模型对数据进行分析。所有检验均为双侧检验，使用的统计显著性水平为0.05。本研究（研究编号：STUDY00009765）获得了机构审查委员会的批准。
共收到434名执业放射肿瘤学家的回复。在这些受访者中，69.1%在美国执业。在所有受访者中，19.8%报告治疗儿科患者，93.6%报告治疗绝经前患者。尽管84.8%的放射肿瘤学家表示他们会“强烈同意”或“同意”在放疗前应进行妊娠筛查，但29.7%的受访者报告其科室没有筛查政策，7.1%的受访者报告他们不进行妊娠筛查。有科室政策与进行妊娠筛查相关（P值 = 0.0005）。在所有受访者中，93人报告治疗过已知怀孕的患者。在这93名受访者中，76人报告是故意治疗，17人报告是意外治疗了怀孕患者。在模拟时未进行筛查的受访者比在模拟时进行筛查的受访者更有可能治疗怀孕患者（P值 = 0.0459）。
执业放射肿瘤学家在妊娠筛查方面存在异质性。机构政策应清晰且一致。放射肿瘤学团队的所有成员应尽一切努力将对胚胎或胎儿的意外辐射暴露降至最低。
