Longhi Alessandra, Pignotti Elettra, Versari Michela, Asta Susanna, Bacci Gaetano
Chemotherapy Service, Rizzoli Orthopaedic Institute, Bologna, Italy.
Oncol Rep. 2003 Jan-Feb;10(1):151-5.
We compared the residual ovarian function and the fertility of two groups of female patients treated at different times at the authors' institution by neoadjuvant chemotherapy for localized osteosarcoma of the extremities. From 1997 to 2000, one group of 31 females received neoadjuvant treatment according to the IOR 6 protocol, which included high-dose ifosfamide, high-dose methotrexate, adryamycin, and cis-platinum. In this group of patients an oral contraceptive (OC) was given in an attempt to prevent post-chemotherapy ovarian failure. Another group of 90 patients was treated between 1974 to 1995 with the same antiblastic drugs according to similar protocols (IOR 1-IOR 5). These patients did not receive OC or other treatment to protect ovarian function. There were no significant differences between the two groups of patients. Early chemotherapy-induced menopause occurred in 3 out of 19 postpubertal patients who received the OC and in 3 out of 71 postpubertal patients in the control group. In the OC group there were 2 cases of thrombophlebitis. No delay in menarche was seen in prepubertal patients. From statistical evaluation we underline that age and alkylant doses are the most important predictive factors for early menopause and that oral contraceptives during chemotherapy do not protect ovarian function in patients receiving high-dose alkylant based chemotherapy.
我们比较了在作者所在机构于不同时间接受新辅助化疗治疗四肢局限性骨肉瘤的两组女性患者的残余卵巢功能和生育能力。1997年至2000年，一组31名女性根据IOR 6方案接受新辅助治疗，该方案包括高剂量异环磷酰胺、高剂量甲氨蝶呤、阿霉素和顺铂。在这组患者中，给予口服避孕药（OC）以试图预防化疗后卵巢功能衰竭。另一组90名患者在1974年至1995年间根据类似方案（IOR 1 - IOR 5）使用相同的抗增殖药物进行治疗。这些患者未接受OC或其他保护卵巢功能的治疗。两组患者之间无显著差异。接受OC的19名青春期后患者中有3例出现早期化疗诱导的绝经，对照组71名青春期后患者中有3例出现。OC组有2例血栓性静脉炎。青春期前患者未见月经初潮延迟。通过统计学评估我们强调，年龄和烷化剂剂量是早期绝经最重要的预测因素，并且在接受基于高剂量烷化剂化疗的患者中，化疗期间口服避孕药并不能保护卵巢功能。
