|Titre :||Female childhood cancer survivors and the impact of flank, abdominal or pelvic radiotherapy on live birth rates: a systematic review and meta-analysis (2021)|
|Auteurs :||Angela Polanco ; Jane Coad ; Bob Phillips ; Nicolas Aldridge ; Elizabeth Bailey|
|Type de document :||Article : texte imprimé|
|Dans :||Midirs. Midwifery Digest (Vol. 31, n° 4, December 2021)|
|Article en page(s) :||p. 523-536|
Paramédical (MeSH)Chimioradiothérapie ; Évaluation des risques ; Fécondité ; Grossesse ; Grossesse non désirée ; Médecine factuelle ; Survie sans rechute ; Survivants du cancer ; Tumeurs
Population: Adult female survivors of childhood, adolescent, and young adult cancers (childhood cancer survivors (CCS)) have a survival rate of up to 84 per cent, with many now able to maintain fertility into adulthood.
Intervention: This review critically appraised and synthesised evidence for live birth rates and adverse pregnancy outcomes of female CCS (aged 0-24 at diagnosis), treated with radiotherapy to the abdomen, flank, or pelvis. MEDLINE, PUBMED, CINAHL, Google Scholar, TRIP, SCOPUS, and ProQuest were searched on 30th of September 2017 and on the 11th of June 2020. Studies were subjected to inclusion and exclusion criteria with secondary independent review. Public and Patient Involvement and Engagement (PPIE) was used to assist in the selection of outcomes. Data were analysed using EPPI Reviewer. Risk of bias was assessed using The Newcastle Ottawa scale (NOS). Meta-analysis used a random effects model (DerSimonian and Laird) with parameters of heterogeneity set at I² of > 50% and a chisquared p value of Comparator: Sibling control groups and/or general population controls with no history of treatment for childhood cancer where available.
Outcomes: The database search yielded 1495 studies; 1289 screened for title and abstract; 26 screened as full text, eight used for meta-analysis. Upon aggregation (11th of June 2020), one study was added and used in the meta-analysis (total n=9 used for metaanalysis). Female CCS who received radiotherapy to the flank, abdomen or pelvis had an
increased odds of premature birth ( to CCS that had not had radiotherapy. CCS exposed to radiotherapy had increased odds of stillbirth (OR 1.72 [1.08, 2.74] p= 0.02) when compared to non-CCS controls.
Data for live birth rates were not analysed due to heterogeneity and control group variance. Female CCS warrant high-risk antenatal care and ongoing surveillance throughout
pregnancy. Further research investigating toxic thresholds of the uterus is recommended. Female CCS require detailed communication of future pregnancy risk before pregnancy occurs.
|Localisation||Section||Support||Cote de rangement||Statut||Disponibilité|
|Bibliothèque Paramédicale||Périodiques||Périodique||MID.DIG. 21-4||Empruntable||Disponible|