LBA49_PRLONG-TERM NEUROPSYCHOLOGICAL AND CARDIAC FOLLOW-UP OF CHILDREN AND ADULTS WHO WERE ANTENATAL EXPOSED TO RADIOTHERAPY

• Published in: Annals of oncology Vol. 25; no. suppl_4
• Main Authors: Amant, F., Vandenbroucke, T., Verheecke, M., Gziri, M.M., Han, S.N., van den Heuvel, F., Lagae, L., Willemsen, M.A., Kapusta, L., Ottevanger, P.B., Mertens, L., Claes, L., van Calsteren, K.
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.09.2014
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdu438.61

Abstract Aim: The use of radiation in medical diagnostics and treatment is standard of care. Apart from deductions from atom bomb and nuclear plant disaster survivors, there are scarce data on the long-term outcome after antenatal exposure to medical radiation. We aimed to assess the general health, cardiac and neuropsychological outcome of children in utero exposed to radiotherapy. Methods: Women treated with radiotherapy during pregnancy were retro- and prospectively registered by the International Network on Cancer, Infertility and Pregnancy (INCIP). Children were assessed at 1.5, 3.0, 6.0 or 9.0 years of age, by echocardiography, a clinical neurological examination, cognitive tests and questionnaires regarding health and behavior. Adults were examined by echocardiography and questionnaires regarding health and behavior. Echocardiographic data were compared to an age- and gender-matched control group and neurocognitive data to test specific age-appropriate norms. Results: Sixteen children (median age: 6.0 years, range 1.5–9.6) and ten adults (median age: 33.0 years, range 22.0–49.0) antenatal exposed to radiotherapy from Belgium, The Netherlands and Italy were enrolled. Median maternal and estimated fetal irradiation were 48 Gy (range, 12–70) and 91 mGy (range, 0–1690), respectively. Conventional and advanced cardiac function measurements were normal. Overall neuropsychological, behavioral and general health outcomes were within normal ranges. No linear relationship was found between fetal dose of radiation and cognitive outcome. One child revealed a severe cognitive delay, however this child was exposed to a relatively low dose of radiotherapy (34 mGy) in addition to other confounding pregnancy complications. The mother suffered from an aggressive non-hodgkin tumor of the brain with impact on her general state (maternal somnolence, hemiplegia and intravenous nutrition) followed by preterm delivery. Conclusions: The overall long-term cardiac, neuropsychological, behavioral and general health outcomes after prenatal exposure to radiotherapy appear to be within normal ranges. Larger series are needed to strengthen these findings. Disclosure: All authors have declared no conflicts of interest.