Radiotherapy and pregnancy

We present the updated recommendations of the French society for radiation oncology on radiotherapy and pregnancy. The occurrence of cancer during pregnancy is a rare event (approximately 1 in 1000 pregnancies). The risks for the embryo or the foetus depend on the gestational age at the time of irradiation. The main risks are malformations with microcephaly and mental retardation. There is also a risk of radiation-induced cancer in the unborn child. In the case of only supradiaphragmatic irradiation, radiotherapy can be performed most often in pregnant women without risk to the foetus. On the other hand, in the case of an indication for subdiaphragmatic irradiation, therapeutic termination of the pregnancy should be proposed. In all cases, when radiotherapy is chosen, a phantom estimation of the dose delivered to the foetus, confirmed by in vivo measurement, is recommended. Conformational radiotherapy is the preferred technique because of the lower dose delivered to the foetus (except in tumour locations where other techniques such as IMRT are recommended). (C) 2021 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.

Automated summary

This article presents the updated recommendations of the French society for radiation oncology on radiotherapy and pregnancy. Cancer during pregnancy is rare and the risks for the embryo or fetus depend on the gestational age at the time of irradiation. Radiation-induced malformations and cancer are the main risks. Supradiaphragmatic irradiation can usually be performed without risk to the fetus, but subdiaphragmatic irradiation may require termination of the pregnancy. Phantom estimation and in vivo measurement of fetal dose are recommended when choosing radiotherapy. Conformational radiotherapy is the preferred technique, except for certain tumor locations that may require other techniques such as IMRT.