Jiménez-Gordo A M, de las Heras B, Zamora P, Espinosa E, González-Barón M
Medical Oncology Department, University Hospital La Paz, Madrid, 28046, Spain.
Gynecol Oncol. 2000 Jan;76(1):126-7. doi: 10.1006/gyno.1999.5641.
We hereby report on two patients receiving goserelin due to breast cancer in whom a failure in ovarian ablation was detected. A review of the hormonal effects of LHRH analogues is performed.
CASE 1: A 36-year-old female was diagnosed with breast carcinoma and treated with surgery, chemotherapy, radiotherapy, and goserelin. A 16-week gestation was detected after 17 months of uninterrumpted hormonal therapy at ablative doses. CASE 2: A 41-year-old female was diagnosed with breast carcinoma and treated with surgery, chemotherapy, radiotherapy, and tamoxifen. Goserelin was substituted for tamoxifen due to bone metastases and, 2 years later, a failure in ovarian ablation was confirmed after the reappearance of the patient's menses.
Goserelin-induced ovarian ablation may fail after the use of appropriate doses of this drug. We suggest a possible mechanism of hormone resistance induced by the long-term administration of LHRH analogues. No fetal damage was detected after goserelin exposure in the first 4 months of gestation.
我们在此报告两例因乳腺癌接受戈舍瑞林治疗但出现卵巢去势失败的患者。并对促性腺激素释放激素（LHRH）类似物的激素作用进行综述。
病例1：一名36岁女性被诊断为乳腺癌，接受了手术、化疗、放疗及戈舍瑞林治疗。在以消融剂量进行17个月不间断激素治疗后，检测到妊娠16周。病例2：一名41岁女性被诊断为乳腺癌，接受了手术、化疗、放疗及他莫昔芬治疗。因骨转移，他莫昔芬被戈舍瑞林替代，两年后，患者月经再次出现，证实卵巢去势失败。
使用适当剂量的戈舍瑞林后，其诱导的卵巢去势可能失败。我们提出了长期使用LHRH类似物诱导激素抵抗的一种可能机制。妊娠前4个月接触戈舍瑞林后未检测到胎儿损伤。
