Women who were treated with radiation to cure Wilms tumor as a child appear to have preserved fertility with the ability to have normal infants as long as their entire pelvis was not irradiated, according to an article in the April issue of the International Journal of Radiation Oncology Biology Physics.

Although earlier studies have highlighted the adverse impact radiation therapy can have upon the fertility of female survivors of Wilms tumor and other childhood cancers, the earlier research did not include detailed analyses of survivors’ pregnancies in relation to the location of the radiation field.

In the current study, American researchers analyzed pregnancy outcomes among female survivors of childhood Wilms tumor treated with abdominal irradiation in the National Wilms Tumor Studies as part of a long-term follow-up study. A total of 130 patients were identified who survived at least to age 15 years, and radiation fields were determined for 126 of them.

Of 12 survivors who received radiation therapy with portals including the upper abdomen but not the entire pelvis, there were 10 recorded pregnancies in 5 women resulting in 9 live births and a miscarriage. A total of 114 women had received radiation in a field that included the entire abdomen and pelvis. There were 4 pregnancies recorded for 2 patients. A woman who had received 21 Gy total to abdomen and pelvis had 3 pregnancies, none carried to a live birth. However, a second woman who had received a total of only 10.5 Gy had a normal live birth for her pregnancy.

The results indicate that female survivors can have healthy children as long as their entire pelvis is not treated with radiation therapy. Fertility may also be preserved after lower-dose full abdomen-pelvis radiation.

“The good news is that this study shows it is possible for women who received radiation therapy to the abdomen to treat Wilms tumor as a child can go on to have healthy babies,” said John A. Kalapurakal, M.D., the lead author of the study. “To minimize any complications from the cancer treatment, we encourage these survivors to be regularly evaluated by their obstetrician before, during, and after pregnancy to ensure that the child and the mother receive adequate care.”