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Aggressive therapy of childhood cancers has improved survival rates substantially, but the long-term effects of radiation and chemotherapy on reproductive capacity is incompletely understood.
Researchers analyzed risk for stillbirth or neonatal death in 4946 singleton pregnancies carried or fathered by 1657 women and 1148 men who had survived childhood cancer (diagnosed before age 21, from 1970 through 1986). Roughly 30% of survivors received both radiation and alkylating drugs, 35% underwent radiation alone, 15% received alkylating agents alone, and 20% had neither. Organ-specific (pituitary gland, testes, and uterus/ovaries) radiation exposure was estimated for each patient.
Irradiation of the testes or pituitary gland or exposure to alkyla…