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绝经前乳腺癌患者化疗后加用促黄体生成素释放激素激动剂和他莫昔芬治疗后的月经恢复。

Menstruation recovery after chemotherapy and luteinizing hormone-releasing hormone agonist plus tamoxifen therapy for premenopausal patients with breast cancer.

机构信息

Division of Breast and Endocrine Surgery, Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo 173-8610, Japan.

出版信息

Surg Today. 2011 Jan;41(1):48-53. doi: 10.1007/s00595-009-4226-z. Epub 2010 Dec 30.

Abstract

PURPOSE

Little is known about the period required for menstruation recovery after long-term luteinizing hormone-releasing hormone (LH-RH) agonist plus tamoxifen therapy following chemotherapy. In this study we investigated the period required for menstruation recovery after the therapy.

METHODS

The subjects comprised 105 premenopausal breast cancer patients who had undergone surgery. All patients were administered an LH-RH agonist for 24 months and tamoxifen for 5 years following the postoperative adjuvant chemotherapy, and the status of menstruation recovery was examined.

RESULTS

Menstruation resumed in 16 cases (15.2%) after the last LH-RH agonist treatment session. The mean period from the last LH-RH agonist treatment to the recovery of menstruation was 6.9 months. The rate of menstruation recovery was 35.5% in patients aged 40 years or younger and 8.0% in those aged 41 years or older, and it was significantly higher in those aged 40 years or younger. The period until menstruation recovery tended to be longer in older patients at the end of treatment.

CONCLUSION

This study showed that menstruation resumed after treatment at higher rates in younger patients. However, because it is highly likely that ovarian function will be destroyed by the treatment even in young patients, it is considered necessary to explain the risk to patients and obtain informed consent before introducing this treatment modality.

摘要

目的

关于化疗后长期使用黄体生成素释放激素(LH-RH)激动剂加他莫昔芬治疗后月经恢复所需的时间知之甚少。本研究旨在探讨该治疗后月经恢复所需的时间。

方法

本研究纳入了 105 例接受手术的绝经前乳腺癌患者。所有患者在术后辅助化疗后均接受 24 个月的 LH-RH 激动剂和 5 年的他莫昔芬治疗,并检查月经恢复情况。

结果

末次 LH-RH 激动剂治疗后,16 例(15.2%)恢复月经。末次 LH-RH 激动剂治疗至月经恢复的平均时间为 6.9 个月。年龄在 40 岁及以下的患者中,月经恢复率为 35.5%,年龄在 41 岁及以上的患者中为 8.0%,年龄在 40 岁及以下的患者明显更高。治疗结束时,年龄较大的患者月经恢复所需的时间趋于延长。

结论

本研究表明,年轻患者的治疗后月经恢复率更高。然而,由于即使是年轻患者,卵巢功能也很可能因治疗而受到破坏,因此在引入这种治疗方法之前,有必要向患者解释风险并获得知情同意。

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