title: Primary brain tumours, meningiomas and brain metastases in pregnancy: report on 27 cases and review of literature.
abstract: BACKGROUND
  The concurrence of intracranial tumours with pregnancy is rare. The purpose of this study was to describe all reported patients registered in the international Cancer in Pregnancy registration study (CIP study; http://www.cancerinpregnancy.org), and to review the literature in order to obtain better insight into outcome and possibilities of treatment in pregnancy.
  
  
  METHODS
  We collected all intracranial tumours (primary brain tumour, cerebral metastasis, or meningioma) diagnosed during pregnancy, registered prospectively and retrospectively by international collaboration since 1973. Patients diagnosed postpartum were excluded. We summarised the demographic features, treatment decisions, obstetrical and neonatal outcomes.
  
  
  RESULTS
  The mean age of the 27 eligible patients was 31years (range 23-41years), of which 13 and 12 patients were diagnosed in the second and third trimesters, respectively. Eight patients (30%) underwent brain surgery, seven patients (26%) had radiotherapy and in three patients (11%) chemotherapy was administered during gestation. Two patients died during pregnancy and four pregnancies were terminated. In 16 (59%) patients elective caesarean section was performed of which 14 (52%) were still preterm (range 30-36weeks, mean 33weeks). Five patients had a vaginal delivery (range 36-40weeks). Of the 21 ongoing pregnancies all children were born alive without visible congenital malformations and the available long-term follow-up data (range 2-25years) of six children were reassuring.
  
  
  CONCLUSIONS
  Adherence to standard protocol for the treatment of brain tumours during pregnancy appears to allow a term delivery and a higher probability of a vaginal delivery.
authors.affiliation: Gynecologic Oncology, University Hospitals Leuven, Herestraat, 49, 3000 Leuven, Belgium; Division of Oncology, KULeuven, Herestraat, 49, 3000 Leuven, Belgium.
authors.forename: Magali
authors.initials: M
authors.lastname: Verheecke
authors.affiliation: Department of Obstetrics and Gynecology, 2nd Medical Faculty, Charles University, Ovocný trh, 5, 11636 Prague, Czech Republic.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Halaska
authors.affiliation: Department of Gynecologic Oncology, Center Gynecologic Oncology, Plesmanlaan, 121, 1066 CX Amsterdam, The Netherlands.
authors.forename: Christianne A
authors.initials: CA
authors.lastname: Lok
authors.affiliation: Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid, 10, 6525 GA Nijmegen, The Netherlands.
authors.forename: Petronella B
authors.initials: PB
authors.lastname: Ottevanger
authors.affiliation: Division of Obstetrics and Gynecology, San Gerardo Hospital, University of Milan-Bicocca, Via Pergolesi, 33, 20900 Monza, Italy.
authors.forename: Robert
authors.initials: R
authors.lastname: Fruscio
authors.affiliation: Department of Radiotherapy and Clinical Oncology, Vejle Hospital, Brummersvej, 1, DK-7100 Vejle, Denmark.
authors.forename: Karina
authors.initials: K
authors.lastname: Dahl-Steffensen
authors.affiliation: University Hospital of Krakow (Jagiellonian University), Department of Gynecology and Oncology, Gołębia, 24, Kraków, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kolawa
authors.affiliation: Gynecologic Oncology, University Hospitals Leuven, Herestraat, 49, 3000 Leuven, Belgium; Division of Oncology, KULeuven, Herestraat, 49, 3000 Leuven, Belgium.
authors.forename: Mina Mhallem
authors.initials: MM
authors.lastname: Gziri
authors.affiliation: Gynecologic Oncology, University Hospitals Leuven, Herestraat, 49, 3000 Leuven, Belgium; Division of Oncology, KULeuven, Herestraat, 49, 3000 Leuven, Belgium.
authors.forename: Sileny Naeyu
authors.initials: SN
authors.lastname: Han
authors.affiliation: Gynecologic Oncology, University Hospitals Leuven, Herestraat, 49, 3000 Leuven, Belgium; Division of Oncology, KULeuven, Herestraat, 49, 3000 Leuven, Belgium.
authors.forename: Kristel
authors.initials: K
authors.lastname: Van Calsteren
authors.affiliation: Physics Department in Radiation-Oncology, University Hospitals Leuven, Herestraat, 49, 3000 Leuven, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Van den Heuvel
authors.affiliation: Neurosurgery, University Hospitals Leuven, Herestraat, 49, 3000 Leuven, Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: De Vleeschouwer
authors.affiliation: Division of Oncology, KULeuven, Herestraat, 49, 3000 Leuven, Belgium; General Medical Oncology, University Hospitals Leuven, Herestraat, 49, 3000 Leuven, Belgium.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Clement
authors.affiliation: Radiation-Oncology, University Hospitals Leuven, Herestraat, 49, 3000 Leuven, Belgium.
authors.forename: Johannes
authors.initials: J
authors.lastname: Menten
authors.affiliation: Gynecologic Oncology, University Hospitals Leuven, Herestraat, 49, 3000 Leuven, Belgium; Division of Oncology, KULeuven, Herestraat, 49, 3000 Leuven, Belgium. Electronic address: frederic.amant@uzleuven.be.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Amant
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology* / Q000556:secondary / Q000628:therapy; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000628:therapy; D008579:Meningioma / Q000473:pathology* / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D011256:Pregnancy Outcome; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Brain tumour; Chemotherapy; Pregnancy; Radiotherapy; Surgery