Department of Gynaecological, Tianjin Central Obstetrics and Gynecology Hospital, Nankai District, Tianjin, China.
Adv Ther. 2018 Jun;35(6):857-863. doi: 10.1007/s12325-018-0715-z. Epub 2018 Jun 5.
Hormone therapy is widely used in the treatment of patients with ovarian endometriosis after surgery, and progestin and gonadotropin-releasing hormone (GnRH) are two of the most widely used hormones. This study aimed to compare the outcomes of progestin and GnRH in the treatment of ovarian endometriosis after surgery.
A total of 399 patients with ovarian endometriosis were included and divided into four groups to receive different treatments. Group A received no postoperative hormone therapy; patients in group B1 and B2 were treated with different doses of norethindrone (progestin, 1.2 and 5 mg/day, respectively); patients in group C were treated with GnRH (2.0 mg every 2 weeks). Treatment outcomes including menstrual bleeding profiles, cumulative recurrence rate, incidence of complications, and endometrioma diameter in the case of recurrence were recorded and compared between groups.
Compared with group A, group B1, B2 and C showed significantly improved menstrual bleeding profiles and reduced cumulative recurrence rate and endometrioma diameter after recurrence. In addition, compared with group C, menstrual bleeding profiles were significantly improved and cumulative recurrence rate and endometrioma diameter were significantly reduced in group B1 and B2. No significant differences in incidence of complications during treatment were found among groups. After treatment, recurrence rate and endometrioma diameter were significantly increased in group B1, B2, and C.
Both progestin and GnRH can significantly improve the conditions of patients with ovarian endometriosis after surgery, but progestin may be a better choice. Both therapies are challenged by the increased recurrence rate and endometrioma diameter after treatment.
激素治疗广泛应用于卵巢子宫内膜异位症术后患者的治疗中,孕激素和促性腺激素释放激素(GnRH)是两种最常用的激素。本研究旨在比较孕激素和 GnRH 在卵巢子宫内膜异位症术后治疗中的疗效。
共纳入 399 例卵巢子宫内膜异位症患者,分为四组接受不同治疗。A 组术后不接受激素治疗;B1 组和 B2 组分别给予不同剂量的炔诺酮(孕激素,分别为 1.2 和 5mg/天);C 组给予 GnRH(每 2 周 2.0mg)。记录并比较各组的治疗结局,包括月经出血模式、累积复发率、并发症发生率以及复发时的内异囊肿直径。
与 A 组相比,B1、B2 和 C 组的月经出血模式明显改善,累积复发率和复发时的内异囊肿直径降低。此外,与 C 组相比,B1 和 B2 组的月经出血模式明显改善,累积复发率和复发时的内异囊肿直径明显降低。各组治疗期间并发症发生率无显著差异。治疗后,B1、B2 和 C 组的复发率和内异囊肿直径明显增加。
孕激素和 GnRH 均可显著改善卵巢子宫内膜异位症术后患者的病情,但孕激素可能是更好的选择。两种治疗方法均面临治疗后复发率和内异囊肿直径增加的挑战。