Docetaxel, gemcitabine, and cisplatin administered for non-small cell lung cancer during the first and second trimester of an unrecognized pregnancy.
Although several chemotherapeutic agents have been proven to be safe for the fetus after the organogenesis period, there is limited information on their use during the first trimester of pregnancy. We here report the first case of a patient with lung cancer who was treated with platinum-based chemotherapy from the first trimester of an unrecognized pregnancy. A 35-year-old woman was diagnosed with stage IV non-small cell lung cancer with brain metastasis. Since she recalled the date of her last menstrual period at about 20 days prior to consult, we did not consider the possibility of conception at the time of diagnosis. With an object of controlling the increased intracranial pressure, we initially performed a craniotomy with tumor removal, followed by whole brain irradiation. Without our knowledge of her pregnancy, she received a palliative chemotherapy with docetaxel and cisplatin followed by gemcitabine and cisplatin as the second-line chemotherapeutic agents between weeks 9 and 22 of gestation. Follow-up computed tomographic scans performed 2 months after the last chemotherapy showed a fetus in the patient's abdomen. Cesarean section was performed at 33 weeks of gestation, delivering a 1490 g female newborn with no evidence of congenital malformations.
Kim
Jung Han
JH
Division of Hematology and Oncology, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Republic of Korea. harricil@hotmail.com
Kim
Hyeong Su
HS
Sung
Chong Won
CW
Kim
Keong Ju
KJ
Kim
Chang Hyun
CH
Lee
Keun Young
KY
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000628:therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000188:drug therapy*; D002945:Cisplatin / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D000077143:Docetaxel; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000628:therapy*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011838:Radiation-Sensitizing Agents; D012264:Ribonucleotide Reductases / Q000037:antagonists & inhibitors; D043823:Taxoids / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D000093542:Gemcitabine
D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents; D011838:Radiation-Sensitizing Agents; D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D012264:Ribonucleotide Reductases; D002945:Cisplatin; D000093542:Gemcitabine