Fertilité Après Radiothérapie Abdomino-Pelvienne Dans l'Enfance
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Puberté et grossesses ont été analysées chez des femmes traitées dans l'enfance par irradiation abdominale et/ou pelvienne dans deux centres français (Nancy et Lyon)entre 1975 et 2004. L'analyse a été faite à l'aide des dossiers médicaux et de questionnaires. 84 patientes ont reçu une radiothérapie abdominale pelvienne, sont vivantes, âgées de plus de 18 ans au moment de l'étude. Chez 22femmes(17après RT pelvienne)a été constatée une hypofertilité.Un total de 50 naissances pour 28 femmes ont été enregistrés.Il a été relevé une prévalence élevée de prématurité et petit poids de naissance, mais pas de malformation congénitale.La fécondité peut ètre préservée après RT abdominale excluant le bassin, sous réserve des autres traitements(chimiothérapie par alkylants).Lorsque la RT inclus le bassin, la fécondité est souvent altérée. Néanmoins, certaines grossesses sont observées. Le facteur le plus important après RT, empèchant d'obtenir et de mener une grossesse avec succès est la dose totale reçue par les ovaires et l'utérus. Cette dose doit ètre systématiquement enregistrée de façon à améliorer le suivi des patients.
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