Female childhood cancer survivors and the impact of flank, abdominal or pelvic radiotherapy on live birth
: A systematic review and meta-analysis

  • Angela Louise Polanco

    Student thesis: Master's ThesisMaster of Science by Research


    Background: Due to increased rates of survival for children with cancer*, many now maintain their fertility into adulthood. Long-term chronic conditions of female childhood cancer survivors (CCS), coupled with physiological pressures of pregnancy and birth warrants further investigation by health care providers.

    Objectives: To investigate the impact upon live birth outcome for female CCS who received radiotherapy to the flank, abdomen or pelvic areas. A Patient and public involvement and engagement (PPIE) survey was used to align the review outcomes to patient need and results were presented.

    Data sources: A search of MEDLINE, PUBMED, CINAHL, Google Scholar, TRIP, SCOPUS and ProQuest databases was undertaken until 30th September 2017.

    Study criteria and participants:

    •Female CCS treated with radiotherapy to the flank, abdomen or pelvis

    •English language publications

    •Population data from a recognised data registry and from UK, USA, Canada, Australia or EU

    •Quantitative methodology

    Appraisal and synthesis: Data were extracted, and meta-analysis performed with EPPI Reviewer4 software. The Newcastle Ottawa scale was used for risk of bias assessment.

    Results: A statistically significant effect upon the odds of a premature birth (odds ratio 3.27, 95% CI 2.71-3.96) and stillbirth (odds ratio 1.62, 95% CI1.10-2.40) was noted. There was no statistically significant effect on live birth outcome or additional adverse pregnancy outcomes. The PPIE survey demonstrated that ‘maternal complications in pregnancy and birth’ was the primary concern of CCS with a call for more communication of likelihood of long-term complications related to cancer treatments.

    Limitations: Limitations were noted with software, heterogeneity of outcomes, lack of evidence and a reliance on self-reported data.

    Conclusions: Female CCS treated with radiotherapy to the flank, abdomen or pelvis need high risk antenatal care referral and surveillance due to increased odds of premature birth and stillbirth.

    Text BoxRegistration: PROSPERO ID- CRD42017054533
    Date of AwardDec 2018
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SupervisorJane Coad (Supervisor) & Elizabeth Bailey (Supervisor)

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