Department of Obstetrics and Gynecology, Ningbo Huamei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China.
J Obstet Gynaecol Res. 2021 Oct;47(10):3425-3436. doi: 10.1111/jog.14957. Epub 2021 Aug 2.
This study aims to investigate the safety and efficacy of chemotherapy in ovarian cancer patients in pregnancy.
In this study, eligible studies were searched on PubMed, Embase, and Cochrane Library databases up to December 31, 2020. Data were calculated and presented by frequency and percentage, mean ± standard deviation (SD), and median (range), respectively. Kaplan-Meier survival analysis was performed to estimate overall survival (OS) and progression-free survival (PFS).
Finally, 34 studies including 40 ovarian cancer cases receiving chemotherapy during pregnancy were included. All 40 patients received chemotherapy during pregnancy. During the follow-up, seven of 37 (18.9%) women had a relapse and four of them (4/7, 57.1%) died of recurrence. Survival analysis failed to reach median OS and PFS within the follow-up (range 3-72 months). Better OS and PFS after chemotherapy in pregnancy were obtained in women with early-stage ovarian cancer (I) compared with those with advanced stage (III-IV). Neither OS nor FS differed between women treated with multi-drugs and those with monotherapy. Forty-one newborns were delivered from 40 pregnant women. Thirty-four (34/41, 82.9%) were completely healthy at birth and the end of follow-up (range 0.18-160 months). However, one newborn died 5 days after birth due to multiple congenital malformations, and another one developed Tourette's syndrome, aphasia, Asperger's syndrome as well as speech delay.
This meta-analysis first reveals the efficacy and safety of chemotherapy for ovarian cancer during pregnancy, especially for early-stage patients. Cisplatin or carboplatin is suggested to be used as monotherapy to reduce adverse effects.
本研究旨在探讨妊娠合并卵巢癌患者化疗的安全性和有效性。
本研究于 2020 年 12 月 31 日在 PubMed、Embase 和 Cochrane Library 数据库中检索符合条件的研究。数据分别通过频率和百分比、均值±标准差（SD）和中位数（范围）进行计算和呈现。采用 Kaplan-Meier 生存分析估计总生存期（OS）和无进展生存期（PFS）。
最终纳入 34 项研究，共包含 40 例接受化疗的妊娠合并卵巢癌患者。所有 40 例患者均在妊娠期间接受了化疗。在随访期间，37 例患者中有 7 例（18.9%）复发，其中 4 例（4/7，57.1%）死于复发。生存分析未能在随访期间达到中位 OS 和 PFS（范围 3-72 个月）。与晚期（III-IV 期）患者相比，早期（I 期）卵巢癌患者接受化疗后的 OS 和 PFS 更好。多药化疗与单药化疗患者的 OS 和 FS 无差异。40 例孕妇共分娩 41 例新生儿。34 例（34/41，82.9%）新生儿出生时及随访结束时（范围 0.18-160 个月）完全健康。然而，有 1 例新生儿出生后 5 天因多发先天性畸形死亡，另 1 例新生儿患有妥瑞氏症、失语症、阿斯伯格综合征和言语迟缓。
本荟萃分析首次揭示了妊娠合并卵巢癌化疗的疗效和安全性，特别是对早期患者。建议使用顺铂或卡铂单药治疗以减少不良反应。
