From the Comprehensive Cancer Center Vienna, Department of Medicine I/Division of Oncology, Medical School, University of Vienna, Vienna, Austria; and the 1st Propaedeutic Surgical Department, Hippocrateio Hospital, Medical School, University of Athens, Athens, Greece.
Obstet Gynecol. 2013 Feb;121(2 Pt 1):337-343. doi: 10.1097/AOG.0b013e31827c5822.
Cervical cancer is the most common solid carcinoma diagnosed during pregnancy; obviously, pregnancy adds complexity to treatment recommendations. We synthesized all available data and evaluated the efficacy and safety of the administration of platinum derivatives during pregnancy in cervical cancer.
Eligible articles were identified by a search of MEDLINE and ClinicalTrials.gov databases for the period up to September 7, 2012; the algorithm comprised a predefined combination of the terms "cervical," "cancer," "cisplatin," carboplatin," and "pregnancy."
Two investigators, working independently, searched the literature and extracted data from all studies that examined the efficacy and safety of platinum derivatives administered during pregnancy in cervical cancer. All cases in which therapeutic abortion was scheduled were excluded. Moreover, quantitative synthesis of the published articles was performed.
TABULATION, INTEGRATION, AND RESULTS: Overall, 24 studies (48 pregnancies, 48 newborns [one twin pregnancy and one miscarriage]) were eligible. In relation to cisplatin, 47 pregnancies were identified, whereas regarding carboplatin administration, only one pregnancy was retrieved. Cisplatin was administered either as monotherapy or combined with bleomycin, 5-fluorouracil, paclitaxel, vincristine, and bleomycin, whereas carboplatin was given in combination with paclitaxel. In most cases (67.4%), a completely healthy neonate was born; all children were healthy with a median follow-up of 12.5 months. The mean delivery weight of newborns was 2,213 g. Complete and partial response was achieved in 10% and 63.4% of patients with cervical cancer, respectively, whereas stabilization and progression of the disease occurred in 23.3% and 3.3% of women in the case group. In the majority of women in the case group, chemotherapy was well tolerated. The median progression-free survival was 48.5 months.
Cisplatin may play a significant role in the management of patients with cervical cancer during the second and third trimesters.
宫颈癌是孕期最常见的实体癌；显然，妊娠给治疗建议增加了复杂性。我们综合了所有可用数据，并评估了妊娠期间给予铂类衍生物治疗宫颈癌的疗效和安全性。
通过搜索 MEDLINE 和 ClinicalTrials.gov 数据库，确定截至 2012 年 9 月 7 日的合格文章；算法包括“宫颈”、“癌症”、“顺铂”、“卡铂”和“妊娠”等术语的预定义组合。
两名独立的研究人员搜索文献，并从所有研究中提取关于妊娠期间给予铂类衍生物治疗宫颈癌的疗效和安全性的数据。所有计划进行治疗性流产的病例均被排除。此外，还对已发表的文章进行了定量综合分析。
列表、综合和结果：共有 24 项研究（48 例妊娠，48 例新生儿[1 例双胞胎妊娠和 1 例流产]）符合条件。与顺铂相关的有 47 例妊娠，而卡铂治疗的仅 1 例妊娠。顺铂单独使用或联合博来霉素、5-氟尿嘧啶、紫杉醇、长春新碱和博来霉素使用，而卡铂与紫杉醇联合使用。在大多数情况下（67.4%），新生儿完全健康；所有儿童均健康，中位随访时间为 12.5 个月。新生儿的平均出生体重为 2213 克。宫颈癌患者的完全缓解和部分缓解率分别为 10%和 63.4%，而疾病稳定和进展的发生率分别为 23.3%和 3.3%。在病例组的大多数女性中，化疗耐受性良好。无进展生存期的中位数为 48.5 个月。
顺铂可能在妊娠第二和第三阶段宫颈癌患者的治疗中发挥重要作用。
