Lawrenz Barbara, Henes Melanie, Neunhoeffer Eva, Fehm Tanja, Huebner Stephanie, Kanz Lothar, Marini Patricia, Mayer Frank
University Women's Hospital, Tuebingen, Tuebingen, Germany.
Onkologie. 2012;35(3):128-32. doi: 10.1159/000336830. Epub 2012 Feb 21.
Over the last decade, advances in oncology led to improved treatment results and increasing numbers of long-term cancer survivors. Fulfilling the desire to have children is important for many patients after cancer treatment. Consequently, oncologists, gynecologists and obstetricians are seeing more patients who wish to conceive after treatment. The necessary prerequisites that should be considered when supporting a planned pregnancy after cancer treatment are discussed in this article. The possible consequences of chemotherapy and radiotherapy on the course of pregnancy and the health of the offspring, as well as the interactions between cancer and pregnancy, are reviewed with the focus on childhood cancer, malignant lymphomas, and breast cancer. Despite chemo- or radiotherapy, neither the teratogenic risk nor the risk of adventitious cancers appears to be increased for the offspring of cancer survivors. However, there is a slightly higher risk of miscarriage after chemotherapy. In case of radiation to the uterus, there is a higher risk of premature birth, intrauterine growth retardation, and increased perinatal mortality. The effect is more pronounced after prepubertal radiation than for postpubertal radiation. The former cancer patient's desire to conceive can nevertheless be supported, given that pregnancy and birth are closely monitored.
在过去十年中，肿瘤学的进展带来了更好的治疗效果，长期癌症幸存者的数量也在增加。对许多癌症治疗后的患者来说，实现生育愿望很重要。因此，肿瘤学家、妇科医生和产科医生接待了越来越多希望在治疗后怀孕的患者。本文讨论了支持癌症治疗后计划怀孕时应考虑的必要前提条件。重点围绕儿童癌症、恶性淋巴瘤和乳腺癌，回顾了化疗和放疗对妊娠过程及后代健康可能产生的影响，以及癌症与妊娠之间的相互作用。尽管接受了化疗或放疗，但癌症幸存者的后代出现致畸风险或患偶发性癌症的风险似乎并未增加。然而，化疗后流产的风险略高。如果子宫受到辐射，早产、宫内生长受限和围产期死亡率增加的风险更高。青春期前辐射后的影响比青春期后辐射更为明显。不过，鉴于对妊娠和分娩进行密切监测， former cancer patient's desire to conceive can nevertheless be supported可译为“仍可支持 former cancer patient's desire to conceive” （原句此处表述不太清晰准确）以前癌症患者的生育愿望。
