Document Detail


Pregnancy outcome after treatment for Wilms tumor: a report from the national Wilms tumor long-term follow-up study.
MedLine Citation:
PMID:  20458053     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study was undertaken to evaluate the effect of prior treatment with radiation therapy or chemotherapy for unilateral Wilms tumor (WT) diagnosed during childhood on pregnancy complications, birth weight, and the frequency of congenital malformations in live-born offspring.
PATIENTS AND METHODS: We reviewed pregnancy outcomes among female survivors and partners of male survivors of WT treated on National Wilms Tumor Studies 1, 2, 3, and 4 by using a maternal questionnaire and a review of both maternal and offspring medical records.
RESULTS: We received reports of 1,021 pregnancies with duration of 20 weeks or longer, including 955 live-born singletons, for whom 700 sets of maternal and offspring medical records were reviewed. Rates of hypertension complicating pregnancy (International Classification of Diseases [ICD] code 642), early or threatened labor (ICD-644) and malposition of the fetus (ICD-652) increased with increasing radiation dose in female patients. The percentages of offspring weighing less than 2,500 g at birth and of those having less than 37 weeks of gestation also increased with dose. There was no significant trend with radiation dose in the number of congenital anomalies recorded in offspring of female patients.
CONCLUSION: Women who receive flank radiation therapy as part of the treatment for unilateral WT are at increased risk of hypertension complicating pregnancy, fetal malposition, and premature labor. The offspring of these women are at risk for low birth weight and premature (ie, < 37 weeks gestation) birth. These risks must be considered in the obstetrical management of female survivors of WT.
Authors:
Daniel M Green; Jane M Lange; Eve M Peabody; Natalia N Grigorieva; Susan M Peterson; John A Kalapurakal; Norman E Breslow
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-05-10
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  28     ISSN:  1527-7755     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-10     Completed Date:  2010-09-08     Revised Date:  2011-07-29    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2824-30     Citation Subset:  IM    
Affiliation:
Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, 262 Danny Thomas Way, Mail Stop 735, Memphis, TN 38105-2794, USA. Daniel.green@stjude.org
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MeSH Terms
Descriptor/Qualifier:
Female
Follow-Up Studies
Humans
Hypertension, Pregnancy-Induced / etiology
Male
Pregnancy
Pregnancy Complications, Neoplastic / etiology*
Pregnancy Outcome
Radiation Injuries / etiology
Survivors
Wilms Tumor / drug therapy*,  radiotherapy*
Grant Support
ID/Acronym/Agency:
CA-21765/CA/NCI NIH HHS; CA-42326/CA/NCI NIH HHS; CA-54498/CA/NCI NIH HHS; CA-55727/CA/NCI NIH HHS; R01 CA054498-20/CA/NCI NIH HHS
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