Codacci-Pisanelli Giovanni
Università degli Studi 'La Sapienza' di Roma, 00185 Rome, Italy.
Ecancermedicalscience. 2019 Dec 3;13:981. doi: 10.3332/ecancer.2019.981. eCollection 2019.
Although rare, the treatment of pregnant women with cancer remains a challenging situation that requires strict collaboration between different specialities and experts in different fields. Frequent lack of experience and knowledge about this condition could lead to late diagnosis, imprecise management, suboptimal treatment, and foetal and maternal harm. Until recently, the choice for a woman diagnosed with cancer during pregnancy was either to sacrifice the foetus by administering effective treatment to the mother or to risk potential harm to the mother by withholding chemotherapy. This conference report aims to summarise all different aspects of cancer and pregnancy discussed at this 2-day meeting. Data on the safety (for mother and child) of chemotherapy administered after the first trimester of pregnancy are accumulating together with the recommendation to bring pregnancy as close as possible to its natural duration. Several aspects such as the poor prognosis of breast cancer diagnosed in the year after delivery and the delayed growth of foetuses exposed to chemotherapy despite the quasi-normal duration of pregnancy require further investigation. In this apparently tragic situation, results are excellent and comforting data accumulate so that we can transmit an optimistic feeling to women facing cancer during pregnancy.
尽管罕见,但癌症孕妇的治疗仍然是一个具有挑战性的情况,需要不同专业和不同领域的专家之间密切协作。对此情况经验和知识的频繁缺乏可能导致诊断延迟、管理不精确、治疗不理想以及对胎儿和母亲造成伤害。直到最近,对于孕期被诊断出患有癌症的女性来说,选择要么是通过对母亲进行有效治疗来牺牲胎儿,要么是通过不进行化疗来冒对母亲造成潜在伤害的风险。本会议报告旨在总结在这次为期两天的会议上讨论的癌症与妊娠的所有不同方面。关于妊娠中期后进行化疗的安全性(对母亲和孩子而言)的数据正在积累,同时也有建议尽量让妊娠接近其自然时长。诸如产后一年内诊断出的乳腺癌预后不良以及尽管孕期时长基本正常但接触化疗的胎儿生长迟缓等几个方面需要进一步研究。在这种看似悲惨的情况下,出现了出色且令人欣慰的数据,因此我们能够向面临孕期癌症的女性传递一种乐观情绪。