Falkson C I, Falkson H C, Falkson G
Department of Medical Oncology, University of Pretoria, South Africa.
Eur J Cancer. 1991;27(10):1208-11. doi: 10.1016/0277-5379(91)90082-o.
Serial determinations of serum oestradiol (E2), follicle-stimulating hormone (FSH) and luteinising hormone (LH) were done to assess the effect of chemotherapy, with or without a gonadotropin-releasing hormone analogue, buserelin, on ovarian function in 147 premenopausal women treated for breast cancer. Cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) plus buserelin was given to 81 women with metastatic disease, and 66 women were randomised to adjuvant cyclophosphamide, methotrexate and 5-fluorouracil (CMF) with buserelin or CMF alone. Baseline mean E2 of patients treated with cytostatics plus buserelin fell from premenopausal levels and remained low while patients were on study. E2 levels remained at premenopausal values in patients treated with CMF alone. Downregulation of FSH and LH occurred with cytostatics plus depot buserelin, but fluctuated with the nasal administration; on CMF alone, FSH and LH levels increased. Buserelin plus cytostatics more effectively caused ovarian ablation than cytostatic treatment alone. Depot buserelin was more effective than nasal buserelin.
对147例接受乳腺癌治疗的绝经前女性进行了血清雌二醇(E2)、促卵泡激素(FSH)和促黄体生成素(LH)的系列测定,以评估化疗(无论是否联合促性腺激素释放激素类似物布舍瑞林)对卵巢功能的影响。81例患有转移性疾病的女性接受了环磷酰胺、阿霉素和5-氟尿嘧啶(CAF)加布舍瑞林治疗,66例女性被随机分配接受辅助性环磷酰胺、甲氨蝶呤和5-氟尿嘧啶(CMF)联合布舍瑞林治疗或仅接受CMF治疗。接受细胞毒性药物加布舍瑞林治疗的患者基线平均E2从绝经前水平下降,并在研究期间一直保持较低水平。仅接受CMF治疗的患者E2水平保持在绝经前值。细胞毒性药物加长效布舍瑞林可导致FSH和LH下调,但经鼻腔给药时会出现波动;仅接受CMF治疗时,FSH和LH水平升高。与单纯细胞毒性治疗相比,布舍瑞林加细胞毒性药物能更有效地导致卵巢去势。长效布舍瑞林比鼻腔用布舍瑞林更有效。