Department of Medical Oncology, Dr Lutfi KNrdar Kartal Education and Research Hospital, Istanbul, Turkey.
Int J Gynecol Cancer. 2010 Jul;20(5):698-703. doi: 10.1111/igc.0b013e3181daaf3e.
Cancer is the second leading cause of death in women of reproductive age. The most common tumors diagnosed during pregnancy are breast and cervix cancer, Hodgkin lymphoma and non-Hodgkin lymphoma, leukemias, and malignant melanoma. The aim of therapy in pregnancy is to give optimal treatment to the mother without harm to the fetus. In the first trimester, organogenesis continues, so chemotherapy should not be given because of increasing risk of spontaneous abortion, fetal malformation, and mortality. We evaluated mostly seen tumors during pregnancy and assessed treatment type and outcome of pregnancy after chemotherapy in our population.
We retrospectively analyzed 27 patients who have been treated during pregnancy or after the delivery because of several malignancies.
The tumors associated with pregnancy were breast cancer, hematologic malignancies,gynecologic malignancies, sarcomas, and others. The chemotherapy regimens were given in 17 of 27 patients in the second or third trimester of pregnancy. Four of the patients were diagnosed with cervical cancer, hemangiopericytoma, chronic myeloid leukemia,and breast cancer during the first trimester, so their pregnancies were ended by therapeutic abortion. Although 1 of the 3 fetuses who were exposed to chemotherapy in utero at the second or third trimester was born prematurely and low birth weight was diagnosed in the other 2 fetuses, fetal malformation was not seen in any of them. There were 7 normal and 9 cesarean deliveries. Twenty-three healthy babies survived from 27 pregnancies, of whom 17 babies were exposed to chemotherapeutic agents.
We reported herein 27 patients with malignancies diagnosed during pregnancy; 17 patients received chemotherapy during the gestational period without any fetal or maternal abnormalities. Because of the low incidence of malignancy during pregnancy, our report is noteworthy.
癌症是生育年龄女性的第二大死亡原因。怀孕期间最常见的诊断肿瘤是乳腺癌和宫颈癌、霍奇金淋巴瘤和非霍奇金淋巴瘤、白血病和恶性黑素瘤。治疗的目的是在不伤害胎儿的情况下为母亲提供最佳治疗。在妊娠早期，器官发生继续，因此不应给予化疗，因为自然流产、胎儿畸形和死亡率的风险增加。我们评估了妊娠期间最常见的肿瘤，并评估了我们人群中化疗后妊娠的治疗类型和结局。
我们回顾性分析了 27 名因多种恶性肿瘤在妊娠期间或分娩后接受治疗的患者。
与妊娠相关的肿瘤有乳腺癌、血液系统恶性肿瘤、妇科恶性肿瘤、肉瘤和其他肿瘤。在妊娠的第二或第三孕期，27 例患者中有 17 例接受了化疗。4 例患者在妊娠早期被诊断为宫颈癌、血管外皮细胞瘤、慢性髓性白血病和乳腺癌，因此通过治疗性流产结束了妊娠。尽管有 3 例胎儿在妊娠中期暴露于化疗，但其中 1 例早产，另外 2 例胎儿体重低，但他们均未出现胎儿畸形。其中 7 例为正常分娩，9 例为剖宫产。27 例妊娠中有 23 例健康婴儿存活，其中 17 例婴儿接触了化疗药物。
我们在此报告了 27 例妊娠期间诊断为恶性肿瘤的患者；17 例患者在妊娠期接受化疗，无任何胎儿或母体异常。由于妊娠期间恶性肿瘤的发病率低，因此我们的报告值得关注。
