{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T17:55:46Z","timestamp":1764784546110,"version":"3.40.5"},"reference-count":50,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract:<\/jats:title><jats:sec id=\"S0317167120002541_as1\"><jats:title>Objective:<\/jats:title><jats:p>Patients with pregnancy-associated secondary brain tumors (PASBT) are challenging to manage. Because no guidelines for the management of such patients currently exist, we performed a systematic review of the literature using PRISMA guidelines with a discussion of management from a neurosurgeon\u2019s perspective.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167120002541_as2\"><jats:title>Method:<\/jats:title><jats:p>Systematic review of the literature using PRISMA guidelines from 1999 to 2018.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167120002541_as3\"><jats:title>Results:<\/jats:title><jats:p>We identified 301 studies of which 16 publications (22 patients reporting 25 pregnancies, 20 deliveries, 5 early terminations) were suitable for final analysis. The most frequent primary cancers were breast (8\/22, 36.36%), skin (6\/22, 27.27%), and lung (5\/22, 22.73%). Four patients (18.18%) had neurosurgical procedures during their pregnancies. Five patients (22.73%) received neurosurgical resection after their pregnancies. Nine patients (40.91%) received radiation therapy and seven patients (31.82%) received chemotherapy during pregnancy while seven patients (31.82%) received chemotherapy and radiation after pregnancy. There was 1 fetal death (5%) out of 20 healthy deliveries. Five pregnancies (20%) were terminated in the first trimester due to a need for urgent neurosurgical intervention.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167120002541_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>Management of PASBT remains a challenging issue. Maternal and fetal risks associated with surgical resection and teratogenicity due to adjuvant therapy should be discussed in the context of a multidisciplinary team. Timing of surgery and the use of systemic chemoradiation depends on the gestational age (GA) of the fetus, extent, and control of the mother\u2019s primary and metastatic disease. Guidelines need to be established to help neuro-oncology teams safely and effectively manage this group of patients.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cjn.2020.254","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T08:09:25Z","timestamp":1605859765000},"page":"698-707","source":"Crossref","is-referenced-by-count":8,"title":["A Review of the Neurosurgical Management of Brain Metastases During Pregnancy"],"prefix":"10.1017","volume":"48","author":[{"given":"Phileas J.","family":"Proskynitopoulos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9801-5037","authenticated-orcid":false,"given":"Fred C.","family":"Lam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunjay","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett C.","family":"Young","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosef","family":"Laviv","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekkehard M.","family":"Kasper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,11,20]]},"reference":[{"volume-title":"Obstetric anesthesia","year":"1993","author":"Morris","key":"S0317167120002541_ref28"},{"key":"S0317167120002541_ref29","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyy542"},{"key":"S0317167120002541_ref23","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.74.883.740638"},{"key":"S0317167120002541_ref38","first-page":"e1527","article-title":"Patient-specific fetal dose determination for multi-target gamma knife radiosurgery: computational model and case report","volume":"9","author":"Paulsson","year":"2017","journal-title":"Cureus"},{"key":"S0317167120002541_ref14","first-page":"633","article-title":"Radiation therapy in pregnancy: risk calculation and risk minimization","volume":"27","author":"Greskovich","year":"2000","journal-title":"Semin Oncol"},{"key":"S0317167120002541_ref18","first-page":"16-0100","article-title":"A \u2018silent\u2019 skull metastatic follicular thyroid carcinoma mimicking as a benign scalp tumor in a pregnant woman","author":"Huang","year":"2017","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"S0317167120002541_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-015-0726-6"},{"key":"S0317167120002541_ref37","doi-asserted-by":"crossref","first-page":"40A","DOI":"10.37549\/ARO1062","article-title":"Whole-brain radiation therapy in pregnant patients with brain metastases: risks of ionizing radiation exposure to the fetus","author":"Parsai","year":"2015","journal-title":"Appl Rad Oncol"},{"key":"S0317167120002541_ref49","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000008790"},{"key":"S0317167120002541_ref50","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000048479.23069.24"},{"key":"S0317167120002541_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(17)30441-2"},{"key":"S0317167120002541_ref24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2011.01314.x"},{"key":"S0317167120002541_ref12","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.12780"},{"key":"S0317167120002541_ref47","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2014.02.018"},{"key":"S0317167120002541_ref4","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-90752-9_5"},{"key":"S0317167120002541_ref2","unstructured":"2. 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