Mir Olivier, Berveiller Paul, Ropert Stanislas, Goffinet François, Goldwasser François
Department of Medical Oncology, Assistance Publique-Hôpitaux de Paris, Faculty of Medicine, Cochin Teaching Hospital, Paris Descartes University, Paris, France.
Cancer. 2008 Dec 1;113(11):3069-74. doi: 10.1002/cncr.23935.
The incidence of cancer during pregnancy is increasing given the trend for women to postpone childbearing. Knowledge of the potential toxicity and teratogenicity of chemotherapy agents is crucial for patient counseling. Platinum derivatives are active against various malignancies that occur more frequently during pregnancy: melanoma, cervical and ovarian cancers, and lung cancer. The authors of this article performed a systematic review of reports documenting the use of platinum derivatives during pregnancy in the English literature from 1977 through January 2008. Forty-three pregnancies were described: 36 patients received cisplatin, 6 patients received carboplatin, and 1 patient received both drugs. Two fetal malformations occurred after in utero exposure to cisplatin, but the causative link between cisplatin administration and these malformations remains speculative. However, either detectable cisplatin levels or platinum-DNA adducts were observed in neonates who were exposed to platinum derivatives during the third trimester, providing evidence for a late-onset transplacental transfer of these drugs. The administration of platinum derivatives, although feasible during the second and third trimesters of pregnancy, raises concern regarding the transplacental transfer of these drugs in late pregnancy and has unknown short- and long-term effects.
鉴于女性推迟生育的趋势，孕期癌症的发病率正在上升。了解化疗药物的潜在毒性和致畸性对于患者咨询至关重要。铂类衍生物对孕期更常见的各种恶性肿瘤有效：黑色素瘤、宫颈癌、卵巢癌和肺癌。本文作者对1977年至2008年1月期间英文文献中记录孕期使用铂类衍生物的报告进行了系统综述。共描述了43例妊娠情况：36例患者接受顺铂治疗，6例患者接受卡铂治疗，1例患者同时接受了两种药物治疗。子宫内接触顺铂后出现了两例胎儿畸形，但顺铂给药与这些畸形之间的因果关系仍属推测。然而，在妊娠晚期接触铂类衍生物的新生儿中观察到了可检测到的顺铂水平或铂-DNA加合物，这为这些药物的晚期经胎盘转移提供了证据。铂类衍生物的给药虽然在妊娠中期和晚期可行，但引发了对这些药物在妊娠晚期经胎盘转移的担忧，并且其短期和长期影响尚不清楚。
