Management of glioblastoma multiforme in pregnancy

Abstract

Glioblastoma multiforme presenting during pregnancy presents unique challenges to the clinician. In planning treatment, potential benefits to the mother must be balanced against the risks to the fetus. In addition, evidence relating to timing of surgery and the use of radiotherapy and chemotherapy in pregnancy is limited. Management of peritumoral edema and seizures in pregnancy is also complicated by the potential for drug-related teratogenic effects and adverse neonatal outcomes on the fetus. The general anesthetic used for surgery must factor obstetric and neurosurgical considerations. In this review article, the authors seek to examine the role, safety, and timing of therapies for glioblastoma in the context of pregnancy. This covers the use of radiotherapy and chemotherapy, timing of surgery, postoperative care, anesthetic considerations, and use of anticonvulsant medications and steroids. The authors hope that this will provide a framework for clinicians treating pregnant patients with glioblastomas.

Management strategies for neoplastic and vascular brain lesions presenting during pregnancy: A series of 29 patients

“…[76323940] Different histological types of brain tumors associated with pregnancy were described. [612132026293036373940] In this series as well as in others,[61220323739] the gliomas were the most prevalent histological type; the meningiomas were the second more frequent. In our material, four cases of astrocytomas were detected.…”

“…In addition to putting at risk the lives of both the mother and infant, this association represents a real therapeutic challenge. [612132032383940] It is, therefore, fundamental that a multidisciplinary care team approach be established. [76323940] Different histological types of brain tumors associated with pregnancy were described.…”

“…There are few data on the risks of pregnancy in women with these diseases and no clear guidelines regarding its management during pregnancy, delivery, and puerperium. [612132032383940] This study aims at identifying the best medical and surgical procedures to be followed for a pregnant patient harboring a brain tumor or an intracranial vascular lesion.…”

Effect of marital status on survival in glioblastoma multiforme by demographics, education, economic factors, and insurance status

“…Second, males tend to have more bad habits such as smoking and drinking than females have, meaning that males benefit more than females from the lifestyle change caused by marriage. In addition, in married female patients, pregnancy accelerates the progression of astrocytoma 30, 31, 32…”

Recurrent Gliosarcoma in Pregnancy

“…In most of these reports, glial tumors were low-grade according to WHO classification. However, cases with glioblastoma multiforme in pregnancy were reported [16, 17]. But to the best of our knowledge, the literature does not contain a gliosarcoma case diagnosed and managed during pregnancy.…”