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AJOG：含铂药物可用于妊娠合并宫颈癌的治疗

2015-03-08 Mechront MedSci原创

妊娠合并宫颈癌化疗铂
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宫颈癌是妊娠期最常见的固体肿瘤之一，妊娠期其发生率约为0.1-12/10,000。对于妊娠期合并宫颈癌，其管理与癌症分期、妊娠孕周等密切相关。含铂化疗药物是目前临床上治疗宫颈癌的有效药物，对于妊娠期合并宫颈癌孕妇，临床上通常是孕中期和孕晚期使用新辅助化疗，以延缓或阻止宫颈癌进展，直到胎儿成熟娩出。但是治疗过程中有多少铂会由母体进入胎儿等关于胎盘转运铂的相关研究却非常少。因此Byrne J进行了一项研究以探究该问题，其研究成果发表在近期AJOG上。

该研究共纳入2008-05至2014-06月间，共21名与孕中期诊断为宫颈癌的孕妇。其孕期使用含铂药物的新辅助化疗，直到剖宫产终止妊娠。终止妊娠时，同时采母血、脐血和羊水样本，分析其铂含量。

该研究结果显示，纳入人群的平均宫颈癌诊断孕周为17周（13-23周），含铂药物的新辅助化疗平均使用了3个（2-4）疗程。研究对象与30.4-36.5周孕终止妊娠。22名新生儿肝肾功正常、听力筛查正常、血液系统无异常。分析样本铂含量得出，脐血和羊水铂含量分别为母血的23%-65%和11%-42%。

该研究结果表明，胎儿胎盘单位对铂有过滤阻挡机制，对孕中、晚期妊娠合并宫颈癌患者使用含铂药物的新辅助化疗是安全的。

原始出处：

Köhler C1, Oppelt P2, Favero G3, Morgenstern B4, Runnebaum I5, Tsunoda A6, Schmittel A7, Schneider A8, Mueller M9, Marnitz S10.How much platinum passes the placental barrier? Analysis of platinum applications in 21 patients with cervical cancer during pregnancy.Am J Obstet Gynecol. 2015 Feb 27. pii: S0002-9378(15)00158-1. doi: 10.1016/j.ajog.2015.02.022. [Epub ahead of print]

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1737476, encodeId=fe071e3747657, content=<a href='/topic/show?id=292f965e5b5' target=_blank style='color:#2F92EE;'>#铂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96575, encryptionId=292f965e5b5, topicName=铂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ca4034296500, createdName=ms3153534357578991, createdTime=Tue Jun 02 04:10:00 CST 2015, time=2015-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407945, encodeId=4f39140e94556, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Tue Mar 10 14:10:00 CST 2015, time=2015-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18031, encodeId=160d180314d, content=发现宫颈癌，还是引产吧…, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=117.136.30.**, createdTime=Mon Mar 09 18:57:00 CST 2015, time=2015-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18032, encodeId=3ce518032a1, content=发现宫颈癌，还是引产吧…, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=117.136.30.**, createdTime=Mon Mar 09 18:57:00 CST 2015, time=2015-03-09, status=1, ipAttribution=)]
    2015-06-02 ms3153534357578991

    #铂#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1737476, encodeId=fe071e3747657, content=<a href='/topic/show?id=292f965e5b5' target=_blank style='color:#2F92EE;'>#铂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96575, encryptionId=292f965e5b5, topicName=铂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ca4034296500, createdName=ms3153534357578991, createdTime=Tue Jun 02 04:10:00 CST 2015, time=2015-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407945, encodeId=4f39140e94556, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Tue Mar 10 14:10:00 CST 2015, time=2015-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18031, encodeId=160d180314d, content=发现宫颈癌，还是引产吧…, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=117.136.30.**, createdTime=Mon Mar 09 18:57:00 CST 2015, time=2015-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18032, encodeId=3ce518032a1, content=发现宫颈癌，还是引产吧…, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=117.136.30.**, createdTime=Mon Mar 09 18:57:00 CST 2015, time=2015-03-09, status=1, ipAttribution=)]
    2015-03-10 一闲

    #宫颈#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1737476, encodeId=fe071e3747657, content=<a href='/topic/show?id=292f965e5b5' target=_blank style='color:#2F92EE;'>#铂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96575, encryptionId=292f965e5b5, topicName=铂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ca4034296500, createdName=ms3153534357578991, createdTime=Tue Jun 02 04:10:00 CST 2015, time=2015-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407945, encodeId=4f39140e94556, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Tue Mar 10 14:10:00 CST 2015, time=2015-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18031, encodeId=160d180314d, content=发现宫颈癌，还是引产吧…, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=117.136.30.**, createdTime=Mon Mar 09 18:57:00 CST 2015, time=2015-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18032, encodeId=3ce518032a1, content=发现宫颈癌，还是引产吧…, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=117.136.30.**, createdTime=Mon Mar 09 18:57:00 CST 2015, time=2015-03-09, status=1, ipAttribution=)]
    2015-03-09 117.136.30.**

    发现宫颈癌，还是引产吧…

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1737476, encodeId=fe071e3747657, content=<a href='/topic/show?id=292f965e5b5' target=_blank style='color:#2F92EE;'>#铂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96575, encryptionId=292f965e5b5, topicName=铂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ca4034296500, createdName=ms3153534357578991, createdTime=Tue Jun 02 04:10:00 CST 2015, time=2015-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407945, encodeId=4f39140e94556, content=<a href='/topic/show?id=92194628826' target=_blank style='color:#2F92EE;'>#宫颈#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46288, encryptionId=92194628826, topicName=宫颈)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11102737131, createdName=一闲, createdTime=Tue Mar 10 14:10:00 CST 2015, time=2015-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18031, encodeId=160d180314d, content=发现宫颈癌，还是引产吧…, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=117.136.30.**, createdTime=Mon Mar 09 18:57:00 CST 2015, time=2015-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18032, encodeId=3ce518032a1, content=发现宫颈癌，还是引产吧…, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=117.136.30.**, createdTime=Mon Mar 09 18:57:00 CST 2015, time=2015-03-09, status=1, ipAttribution=)]
    2015-03-09 117.136.30.**

    发现宫颈癌，还是引产吧…

    0