Department of Clinical Physiology and Nuclear Medicine, Hvidovre Hospital, Hvidovre, Denmark.
Clin Colorectal Cancer. 2011 Dec;10(4):348-52. doi: 10.1016/j.clcc.2011.06.003. Epub 2011 Jul 30.
There is limited experience in treating advanced colorectal cancer diagnosed during pregnancy because it is a rare occurrence; however, the incidence of colorectal cancer complicating pregnancy is expected to increase in the future. The combination of cancer and pregnancy is complicated and causes many dilemmas and concerns for the physician and patient. A delay in treatment may compromise maternal survival; however, therapy for the cancer may be harmful to the fetus. We present a case of a 26-year-old woman pregnant with twins who was diagnosed with metastatic colon cancer and treated with 5-fluorouracil, leukovorin, and oxaliplatin (FOLFOX) from 13 weeks gestational age to birth. The patient gave birth to healthy twins without malformations at 33 weeks gestational age. At follow-up examination, the 2-year-old twins are developing normally. The patient herself died 1 year after the initial cancer diagnosis. This shows a case in which the administration of FOLFOX during the second and third trimester of pregnancy caused no fetal harm. These findings are similar to those of previous studies in which systemic chemotherapy administered during the second and third trimester was relatively safe. However, we know that chemotherapy should be avoided during the first trimester.
在怀孕期间诊断出的晚期结直肠癌的治疗经验有限，因为这种情况很少见；然而，未来怀孕期间并发结直肠癌的发病率预计会增加。癌症和怀孕的结合是复杂的，会给医生和患者带来许多困境和担忧。治疗的延迟可能危及母亲的生存；然而，癌症的治疗可能对胎儿有害。我们报告了一例 26 岁的怀双胞胎的妇女，她被诊断患有转移性结肠癌，并从妊娠 13 周开始接受氟尿嘧啶、亚叶酸钙和奥沙利铂（FOLFOX）治疗至分娩。患者在妊娠 33 周时分娩出无畸形的健康双胞胎。在随访检查时，2 岁的双胞胎发育正常。患者本人在首次癌症诊断后 1 年死亡。这表明在妊娠第二和第三阶段使用 FOLFOX 不会对胎儿造成伤害。这些发现与之前的研究结果相似，即在妊娠第二和第三阶段给予全身化疗相对安全。然而，我们知道应该避免在妊娠第一阶段使用化疗。
