Der Gynäkologe

, Volume 45, Issue 12, pp 933–938 | Cite as

Chemotherapie in der Schwangerschaft

Beispiel Mammakarzinom
Leitthema

Zusammenfassung

Bei den meisten Patientinnen mit in der Schwangerschaft aufgetretenem Mammakarzinom ergibt sich die Indikation zu einer adjuvanten/neoadjuvanten Chemotherapie. Allerdings sollte erst nach Abschluss von Fertilisation, Implantation und Organogenese ab der 14. SSW mit der Verabreichung dieser zytostatischen Therapie begonnen werden. Ein früherer Beginn geht mit einem deutlich erhöhten Risiko für Aborte und Fehlbildungen einher. Anthrazykline und Taxane gehören zu den Substanzen, die im zweiten und dritten Trimenon verabreicht werden dürfen. Zwar deuten Daten auf eine sichere Applikation der in utero applizierten Chemotherapie mit diesen Substanzen hin, doch Langzeitfolgen für die Kinder, wie Kardiotoxizität, erhöhtes Auftreten von malignen Erkrankungen oder eingeschränkte Fertilität, sind noch detaillierter zu erfassen. Derzeit gibt es keine Empfehlung zur Verabreichung einer zielgerichteten Therapie in der Schwangerschaft.

Schlüsselwörter

Zytostatika Zielgerichtete Therapie Kortikosteroide Trastuzumab Supportive Therapie 

Chemotherapy in pregnancy

Example breast cancer

Abstract

In the majority of women diagnosed with breast cancer in pregnancy adjuvant or neoadjuvant chemotherapy is indicated. Administration of chemotherapy should not start before 14 weeks of gestation when fertilization, implantation and organogenesis have been completed. An earlier start with cytotoxic drugs results in a higher rate of miscarriage, fetal death and major malformations. The use of anthracyclines and taxanes is possible in the second and third trimester. These substances seem to have a good safety profile but there is a need for more data about the long-term outcome in children with prenatal exposure to chemotherapy, particularly about a higher risk for malignancies, sterility and cardiotoxicity. Trastuzumab is currently not recommended in any trimester during pregnancy.

Keywords

Cytostatic agents Targeted therapy Corticosteroids Trastuzmab Supportive treatment 

Notes

Interessenkonflikt

Keine Angaben

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Universitätsfrauenklinik UlmUlmDeutschland
  2. 2.FrauenklinikHeinrich-Heine-Universität DüsseldorfDüsseldorfDeutschland

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