Chemotherapy during pregnancy
Affiliation and adress for correspondence

Klinika Ginekologii i Ginekologii Onkologicznej, Gdański Uniwersytet Medyczny. Kierownik Kliniki: dr hab. n. med. Dariusz Wydra
Correspondence to: Jacek J. Sznurkowski, Klinika Ginekologii i Ginekologii Onkologicznej, Gdański Uniwersytet Medyczny, ul. Kliniczna 1 A,80-401 Gdańsk,
tel.: 583 493 436, e-mail: jacek.sznurkowski@amg.gda.pl
Source of financing: Department own sources

CURR. GYNECOL. ONCOL. 2010, 8 (2), p. 123-131
ABSTRACT

Chemotherapy in the treatment of malignant tumors in pregnant women potentially threatens life and development of the fetus. Aim of paper: The purpose of this paper was to update current knowledge concerning the role of chemotherapy in combination therapy of gynecologic malignancies complicating pregnancy and to review available literature focusing on potential sequels of administration of chemotherapeutics at different time-points in pregnancy, with particular emphasis on fetal development, course of pregnancy and future lot of the child. Method: The PubMed database was searched using the following key words: methotrexate; 5-fluorouracil; aminopterin; thioguanine; mercaptopurine; cyclophosphamide; busulfan; ifosfamide; chlorambucil; dacarbazine; doxorubicin; daunorubicin; adriamycin; idarubicin; epirubicin; dactinomycin; bleomycin; mitoxantrone; vincristine; vinblastine; vinorelbine; paclitaxel; docetaxel; cisplatin; carboplatin; prednisone; tamoxifen; etoposide; teniposide; allopurinol; malformation; IUGR; chemotherapy; pregnancy. Search criteria were fulfilled by 33 papers (selected chemotherapeutic agent/pregnancy/malformation), which subsequently underwent content-related analysis. Conclusions: A decision on the use of chemotherapy during pregnancy should be made depending on type and stage of malignancy. It at all possible, administration of cytostatics should be delayed until the end of first trimester. If the patient requires multidrug therapy in the first trimester, she should receive anthracycline-derived antibiotics combined with Vinca alkaloids or should be placed on monotherapy and after 12 weeks shift to a multidrug regimen. Delivery should be planned for the 35th gestational week and 2-3 weeks after termination of chemotherapy in order to allow recovery of bone-marrow function.

Keywords: chemotherapy, pregnancy breast cancer, leukemia, cervical cancer