放射療法是常見的癌癥治療方法，但一項(xiàng)最新研究顯示,，女孩如果在骨盆部位接受放療,，長大后生育時(shí)出現(xiàn)死產(chǎn)的風(fēng)險(xiǎn)增加，但男孩睪丸部位接受放療并不會(huì)影響其未來生育,。
新一期英國醫(yī)學(xué)期刊《柳葉刀》（The Lancet）發(fā)表研究報(bào)告說,，美國研究人員分析了2000多名年少時(shí)曾患癌癥男、女幸存者的數(shù)據(jù),，他們生育后代的死產(chǎn)率總體約為2%,，其中年少時(shí)曾在骨盆部位接受放療女性生育后代的死產(chǎn)率高達(dá)約18%。
研究人員分析說,，放療射線在殺死癌細(xì)胞的同時(shí)可能會(huì)影響癌變部位周圍的正常組織,，而年少時(shí)在骨盆部位接受放療女性的子宮和卵巢可能因此受到傷害，從而影響其生長發(fā)育,，并最終導(dǎo)致生育時(shí)死產(chǎn)率上升,。
這項(xiàng)研究還分析了男性年少時(shí)睪丸部位接受放療對生育的影響，但發(fā)現(xiàn)這并不會(huì)導(dǎo)致其后代死產(chǎn)率的上升。研究人員因此推測認(rèn)為,，放療只會(huì)影響器官組織,，而不會(huì)損害精子中所含有的DNA遺傳物質(zhì)。
這項(xiàng)研究還顯示,，單獨(dú)采用化學(xué)療法治療癌癥對男孩和女孩長大后的生育都沒有明顯影響,。(生物谷Bioon.com)
生物谷推薦原文出處：
The Lancet doi:10.1016/S0140-6736(10)60752-0
Stillbirth and neonatal death in relation to radiation exposure before conception: a retrospective cohort study
Dr Lisa B Signorello ScD a b , Prof John J Mulvihill MD c, Daniel M Green MD d, Heather M Munro MS a, Prof Marilyn Stovall PhD e, Rita E Weathers BS e, Prof Ann C Mertens PhD f, John A Whitton MS g, Leslie L Robison PhD d, Prof John D Boice ScD a b
Background
The reproductive implications of mutagenic treatments given to children with cancer are not clear. By studying the risk of untoward pregnancy outcomes, we indirectly assessed the risk of transmission of germline damage to the offspring of survivors of childhood cancer who were given radiotherapy and chemotherapy.
Methods
We did a retrospective cohort analysis, within the Childhood Cancer Survivor Study (CCSS), of the risk of stillbirth and neonatal death among the offspring of men and women who had survived childhood cancer. Patients in CCSS were younger than 21 years at initial diagnosis of an eligible cancer, were treated at 25 US institutions and one Canadian institution, and had survived for at least 5 years after diagnosis. We quantified the chemotherapy given to patients, and the preconception radiation doses to the testes, ovaries, uterus, and pituitary gland, and related these to the risk of stillbirth or neonatal death using Poisson regression analysis.
Findings
Among 1148 men and 1657 women who had survived childhood cancer, there were 4946 pregnancies. Irradiation of the testes (16 [1%] of 1270; adjusted relative risk 0·8 [95% CI 0·4—1·6]; mean dose 0·53 Gy [SD 1·40]) and pituitary gland (17 [3%] of 510, 1·1 [0·5—2·4] for more than 20·00 Gy; mean dose 10·20 Gy [13·0] for women), and chemotherapy with alkylating drugs (26 [2%] of 1195 women, 0·9 [0·5—1·5]; ten [1%] of 732 men, 1·2 [0·5—2·5]) were not associated with an increased risk of stillbirth or neonatal death. Uterine and ovarian irradiation significantly increased risk of stillbirth and neonatal death at doses greater than 10·00 Gy (five [18%] of 28, 9·1 [3·4—24·6]). For girls treated before menarche, irradiation of the uterus and ovaries at doses as low as 1·00—2·49 Gy significantly increased the risk of stillbirth or neonatal death (three [4%] of 69, 4·7 [1·2—19·0]).
Interpretation
Our findings do not support concern about heritable genetic changes affecting the risk of stillbirth and neonatal death in the offspring of men exposed to gonadal irradiation. However, uterine and ovarian irradiation had serious adverse effects on the offspring that were probably related to uterine damage. Careful management is warranted of pregnancies in women given high doses of pelvic irradiation before puberty.
Funding
Westlakes Research Institute, National Cancer Institute, and Children's Cancer Research Fund.
