Radiotherapy During Pregnancy: Literature Review

الملخص

The diagnosis of cancer during pregnancy is a sensitive and uncommon situation, occurring in approximately 1 out of every 1000 pregnancies. Due to the high vulnerability of the developing embryo and fetus to ionizing radiations, careful consideration should be given to the treatment of these tumors. In this article, we provide a review of existing literature and offer recommendations regarding the use of radiotherapy during pregnancy. The risks associated with radiation exposure depend on the stage of pregnancy at the time of irradiation. The primary risks involve the possibility of malformations, such as microcephaly and mental retardation, in the offspring. There is also a potential risk of radiation-induced cancer in the unborn child. If the irradiation is limited to areas above the diaphragm, radiotherapy can often be administered to pregnant women without posing a risk to the fetus. However, if irradiation below the diaphragm is required, therapeutic termination of the pregnancy may be recommended. In all cases, when radiotherapy is proposed, it is important to estimate the dose delivered to the fetus using a phantom method, which should be confirmed by in vivo measurements. Conformational radiotherapy is the preferred technique because it delivers a lower dose to the fetus, except in tumor locations where other techniques such as intensity modulated radiotherapy treatment are recommended.