Edinburgh Cancer Research UK Centre, University of Edinburgh, Crewe Road South, Edinburgh, EH4 2XR, UK,
Support Care Cancer. 2014 Jun;22(6):1699-704. doi: 10.1007/s00520-014-2195-2. Epub 2014 Mar 15.
Opioids are the mainstay of analgesic therapy in patients with cancer-related pain. While many of the side effects of opioids are well documented, the effect on the hypogonadal axis is less well understood. The aim of this systematic review is to examine the relationship between opioid therapy and hypogonadism in patients with cancer.
An electronic search of the following databases was undertaken: MEDLINE, Embase and CINAHL from 1974 to August 2013. To be eligible for inclusion, studies had to meet the following criteria: adult patients (>18 years) with cancer taking any opioid by any route for any duration, gonadal function measured and the relationship between opioid use and gonadal function examined. All potentially eligible papers were reviewed independently and data extracted using a pro forma.
Four studies met the inclusion criteria. Due to the heterogeneous nature of the studies, it was not possible to amalgamate the results. Three studies suggested a relationship between opioid use and hypogonadism in patients with cancer. These studies also suggested this relationship to be dose dependent. There was evidence to suggest that hypogonadism was symptomatic and associated with reduced survival. One study showed no link between opioids and hypogonadism.
Studies conducted have suggested an association between opioids and hypogonadism in patients with cancer. This warrants further investigation. A longitudinal study examining the impact of opioids on the hypogonadal axis would be of interest.
阿片类药物是癌痛患者镇痛治疗的主要药物。虽然阿片类药物的许多副作用都有详细的记载，但对性腺轴的影响却知之甚少。本系统评价的目的是研究阿片类药物治疗与癌症患者性腺功能减退之间的关系。
对以下数据库进行电子检索：从 1974 年到 2013 年 8 月的 MEDLINE、Embase 和 CINAHL。为了符合纳入标准，研究必须满足以下标准：接受任何途径任何时间任何剂量阿片类药物治疗的成年癌症患者（>18 岁），测量性腺功能，并检查阿片类药物使用与性腺功能之间的关系。所有潜在的合格论文都进行了独立审查，并使用预定义表格提取数据。
四项研究符合纳入标准。由于研究的异质性，无法合并结果。三项研究表明阿片类药物使用与癌症患者的性腺功能减退之间存在关系。这些研究还表明这种关系是剂量依赖性的。有证据表明性腺功能减退是症状性的，并与生存率降低有关。一项研究表明阿片类药物与性腺功能减退之间没有联系。
已进行的研究表明，阿片类药物与癌症患者的性腺功能减退之间存在关联。这需要进一步调查。一项研究阿片类药物对性腺轴影响的纵向研究将是很有意义的。
