PDF(Pubmed)
Abstract：
Colorectal cancer (CRC) in pregnancy is rare and often presents at a late stage due to the masking of signs by pregnancy. A typical chemotherapeutic regimen for stage III and IV CRC comprised 5-Fluorouracil (5-FU) and oxaliplatin. The treatment of CRC during pregnancy is complicated owing to the potential risk of teratogenicity with chemotherapy, especially in the first trimester. Data suggest that the administration of chemotherapy beyond the first trimester may be relatively safe. Previous reports have shown success with the use of FOLFOX (folinic acid, 5-FU, oxaliplatin) and FOLFIRI (folinic acid, 5-FU, irinotecan) during pregnancy. Moreover, neoadjuvant FOLFOXIRI (folinic acid, 5-FU, oxaliplatin, irinotecan) resulted in improved outcomes when compared to standard preoperative chemoradiotherapy in the treatment of locally advanced and metastatic CRC. The use of FOLFOXIRI in pregnancy is not currently documented, and therefore, the outcomes of using this chemotherapeutic regimen are unclear. The aim of this case report was to demonstrate the use of FOLFOXIRI in pregnancy. A retrospective chart review was performed to assess the clinical course and fetal outcome of 2 patients presented in this case report. FOLFOXIRI was initiated in two pregnant women with nonmetastatic and metastatic CRC, resulting in successful delivery of healthy infants. FOLFOXIRI is an effective chemotherapy regimen for the treatment of advanced CRC and may be used during the second and third trimesters of pregnancy.
摘要：
妊娠结直肠癌（CRC）很少见，并且由于妊娠掩盖了体征，通常在晚期出现。III期和IV期CRC的典型化疗方案包括5-氟尿嘧啶(5-FU)和奥沙利铂。妊娠期间CRC的治疗是复杂的，因为化疗有致畸的潜在风险。尤其是在孕早期.数据表明，超过前三个月的化疗可能相对安全。以前的报告显示，使用FOLFOX（亚叶酸，5-FU,奥沙利铂)和FOLFIRI(亚叶酸，5-FU,伊立替康）在怀孕期间。此外，新辅助FOLFOXIRI（亚叶酸，5-FU,奥沙利铂,与标准术前放化疗治疗局部晚期和转移性CRC相比，伊立替康）改善了预后。目前没有记录在怀孕期间使用FOLFOXIRI，因此,使用这种化疗方案的结果尚不清楚.该病例报告的目的是证明FOLFOXIRI在怀孕期间的使用。进行了回顾性图表审查，以评估本病例报告中2例患者的临床病程和胎儿结局。FOLFOXIRI在两名患有非转移性和转移性CRC的孕妇中开始，导致健康婴儿的成功分娩。FOLFOXIRI是治疗晚期CRC的有效化疗方案，可在妊娠中期和晚期使用。
