Kim S Samuel, Lee Jung Ryeol, Jee Byung Chul, Suh Chang Suk, Kim Seok Hyun, Ting Alison, Petroff Brian
Department of Obstetrics and Gynecology, University of Kansas School of Medicine, Kansas City, KS, USA.
Clin Obstet Gynecol. 2010 Dec;53(4):740-52. doi: 10.1097/GRF.0b013e3181f96cb1.
It is still controversial that GnRH agonist (GnRHa) protects ovarian function from chemotherapy-induced gonadotoxicity. Indeed, the results of many studies related to this issue are neither consistent nor convincing because of the weak study design and the inadequate sample size. We identified 11 prospective controlled studies (8 nonrandomized and 3 randomized) for the systemic review and meta-analysis. The meta-analysis showed that GnRHa cotreatment during chemotherapy can protect ovarian function. However, it is worthy to note that the result of this meta-analysis is influenced by nonrandomized studies. The protective effect of GnRHa will remain elusive until the currently ongoing large, prospective, randomized studies are completed. In addition, tamoxifen, a selective estrogen receptor modulator, may have the protective effect against loss of follicles and ovarian function, which was caused by chemotherapy.
促性腺激素释放激素激动剂（GnRHa）能否保护卵巢功能免受化疗所致性腺毒性影响仍存在争议。事实上，由于研究设计薄弱和样本量不足，许多与此问题相关的研究结果既不一致也缺乏说服力。我们筛选出11项前瞻性对照研究（8项非随机研究和3项随机研究）用于系统评价和荟萃分析。荟萃分析表明，化疗期间联合使用GnRHa可保护卵巢功能。然而，值得注意的是，该荟萃分析结果受非随机研究影响。在目前正在进行的大型前瞻性随机研究完成之前，GnRHa的保护作用仍难以确定。此外，他莫昔芬作为一种选择性雌激素受体调节剂，可能对化疗所致卵泡丢失和卵巢功能丧失具有保护作用。
