12月12日，發(fā)表在的JCO雜志上一項(xiàng)最新研究"Congenital Anomalies in the Children of Cancer Survivors: A Report From the Childhood Cancer Survivor Study"顯示,，年輕癌癥患者接受放化療后,，不會(huì)增加今后孩子出生缺陷的風(fēng)險(xiǎn),。
研究者Lisa Signorello講到,，我們知道兒童接受的一些治療確實(shí)對(duì)生殖系統(tǒng)有損害,，很多孩子接受重度治療后會(huì)出現(xiàn)不孕,。我們現(xiàn)在知道主要取決于治療類(lèi)型，從而會(huì)出現(xiàn)高流產(chǎn)率或低出生體重率,。
對(duì)于兒童癌癥幸存者,，擔(dān)憂(yōu)會(huì)持續(xù)到他們的下一代。這項(xiàng)新研究中,，研究者隨訪(fǎng)了美國(guó)和加拿大的近2800名兒童期癌癥幸存者,，定期對(duì)他們調(diào)查包括詢(xún)問(wèn)懷孕和生育的問(wèn)題。
治療至少5年后,，幸存者生產(chǎn)的4700名嬰兒中,，129名（不到3%）有至少一個(gè)出生缺陷，包括唇腭裂,，21三體和心血管缺陷,。睪丸和卵巢區(qū)域接受過(guò)放療，或者服用過(guò)化療藥物的人群和那些沒(méi)有這些暴露的人群,，其出生缺陷率是相同的,。
對(duì)于女性幸存者的孩子，放化療后孩子出生缺陷率為3%,，沒(méi)有接受那些治療的母親為3.5%,，對(duì)于男性，分別為1.9%和1.7%,?；熀头暖煂?duì)于出生缺陷的風(fēng)險(xiǎn)沒(méi)有劑量反應(yīng)關(guān)系。
作者指出,，癌癥幸存者的結(jié)果中沒(méi)有包括那些和家族史相關(guān)的出生缺陷,，而且該研究沒(méi)有包括一個(gè)父母均無(wú)癌癥的對(duì)照組。
這樣的研究對(duì)為癌癥兒童和接受過(guò)治療的兒童提供咨詢(xún)上是非常重要的,，雖然以前也有研究發(fā)現(xiàn)癌癥治療不會(huì)造成額外的出生缺風(fēng)險(xiǎn),，但是本研究參考了癌癥治療的醫(yī)療記錄，結(jié)果更加可信,。（生物谷Bioon.com）
doi:10.1200/JCO.2011.37.2938
PMC:
PMID:
Congenital Anomalies in the Children of Cancer Survivors: A Report From the Childhood Cancer Survivor Study.
Signorello LB, Mulvihill JJ, Green DM, Munro HM, Stovall M, Weathers RE, Mertens AC, Whitton JA, Robison LL, Boice JD Jr.
PURPOSEChildren with cancer receive mutagenic treatments, which raises concern about the potential transmissibility of germline damage to their offspring. This question has been inadequately studied to date because of a lack of detailed individual treatment exposure assessment such as gonadal radiation doses. METHODSWithin the Childhood Cancer Survivor Study, we performed a retrospective cohort analysis of validated cases of congenital anomalies among 4,699 children of 1,128 male and 1,627 female childhood cancer survivors. We quantified chemotherapy with alkylating agents and radiotherapy doses to the testes and ovaries and related these exposures to risk of congenital anomalies using logistic regression.ResultsOne hundred twenty-nine children had at least one anomaly (prevalence = 2.7%). For children whose mothers were exposed to radiation or alkylating agents versus neither, the prevalence of anomalies was 3.0% versus 3.5% (P = .51); corresponding figures were 1.9% versus 1.7% (P = .79) for the children of male survivors. Neither ovarian radiation dose (mean, 1.19 Gy; odds ratio [OR] = 0.59; 95% CI, 0.20 to 1.75 for 2.50+ Gy) nor testicular radiation dose (mean, 0.48 Gy; OR = 1.01; 95% CI, 0.36 to 2.83 for 0.50+ Gy) was related to risk of congenital anomalies. Treatment with alkylating agents also was not significantly associated with anomalies in the children of male or female survivors. CONCLUSIONOur findings offer strong evidence that the children of cancer survivors are not at significantly increased risk for congenital anomalies stemming from their parent's exposure to mutagenic cancer treatments. This information is important for counseling cancer survivors planning to have children.
