Pregnancy and glial brain tumors
Pregnancy and glial brain tumors
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DOI：
10.1093/neuonc/nou019
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发表时间：
2014-09-01
期刊：
影响因子：
15.9
通讯作者：
Armstrong, Terri S.
中科院分区：
文献类型：
--
作者：
Yust-Katz, Shlomit;de Groot, John F.;Armstrong, Terri S.
背景脑肿瘤治疗的改进导致了现在考虑怀孕的脑肿瘤年轻女性数量的增加。本研究的目的是评估妊娠对脑肿瘤生物学的影响。在这项机构审查委员会批准的回顾性研究中，我们检索了该机构的数据库中诊断时怀孕或在疾病过程中怀孕的神经胶质脑肿瘤患者。我们确定了34例这样的患者，并审查了他们的图表，以确定每个患者的临床过程和妊娠结局。15例患者在妊娠期间被诊断为原发性脑肿瘤：3例为胶质母细胞瘤，6例为III级胶质瘤，6例为II级胶质瘤。这些患者中只有2例终止妊娠，其余患者分娩了健康婴儿。23例患者在诊断后妊娠（4例患者在诊断时妊娠，诊断后再次妊娠）。在诊断后怀孕的患者中，5例I级肿瘤患者在妊娠期间和妊娠后病情稳定。然而，在18例II级或III级胶质瘤患者中，8例（44%）在妊娠期间或分娩后8周内确认肿瘤进展。与I级胶质瘤相比，II级和III级胶质瘤的肿瘤生物学可能在妊娠期间发生改变，导致肿瘤进展的风险增加。这些发现支持需要增加肿瘤监测和患者咨询，并收集额外的数据以进一步完善这些结果。
Background. Improvements in brain tumor treatments have led to an increase in the number of young women with brain tumors who are now considering pregnancy. The aim of this study is to evaluate the influence of pregnancy on brain tumor biology.Methods. In this institutional review board-approved retrospective study, we searched the institution's database for patients with glial brain tumors who were pregnant at the time of diagnosis or became pregnant during the course of their illness. We identified 34 such patients and reviewed their charts to determine each patient's clinical course and pregnancy outcome.Results. Fifteen patients were diagnosed with a primary brain tumor during pregnancy: 3 with glioblastomas, 6 with grade III gliomas, and 6 with grade II gliomas. Pregnancy was terminated in only 2 of these patients, and the remainder delivered healthy babies. Twenty-three patients became pregnant after diagnosis (4 patients were pregnant at diagnosis and again after diagnosis). Of the patients who became pregnant after diagnosis, the 5 with grade I tumors had stable disease during and after pregnancy. However, of the 18 patients with grade II or III gliomas, 8 (44%) had confirmed tumor progression during pregnancy or within 8 weeks of delivery.Conclusions. In contrast to grade I gliomas, the tumor biology of grades II and III gliomas may be altered during pregnancy, leading to an increased risk of tumor progression. These findings support the need for increased tumor surveillance and patient counseling and for additional data collection to further refine these results.