Yasumura T, Oka T, Honjo H, Okada H
Kyoto Prefectural University of Medicine, 2nd Department of Surgery.
Gan To Kagaku Ryoho. 1988 Oct;15(10):2947-52.
Menstrual status and ovarian function were studied in 24 premenopausal breast cancer patients receiving adjuvant therapy with chemotherapy and tamoxifen or chemotherapy alone. In 13 of 24 patients (54.1%), abnormal menses, including amenorrhea in 12 cases and oligomenorrhea in 1 case, developed during adjuvant therapy. In patients with abnormal menses, serum estradiol was significantly lower, and the levels of gonadotropins were significantly higher than in patients with normal menses. Among 13 patients with abnormal menses, 4 patients treated with cyclophosphamide revealed persistent amenorrhea during the whole period with adjuvant therapy, and the levels of serum estradiol and progesterone were extremely low. Furthermore, in these patients normal menses has not recovered and the levels of serum estradiol and progesterone remained low 4 to 5 months after cessation of cyclophosphamide administration. Thus, adjuvant chemotherapy caused depression of ovarian function, and cyclophosphamide induced ovarian failure, resulting in complete amenorrhea.
对24例接受化疗和他莫昔芬辅助治疗或仅接受化疗的绝经前乳腺癌患者的月经状况和卵巢功能进行了研究。24例患者中有13例(54.1%)在辅助治疗期间出现月经异常,其中12例闭经,1例月经过少。月经异常患者的血清雌二醇显著降低,促性腺激素水平显著高于月经正常患者。在13例月经异常的患者中,4例接受环磷酰胺治疗的患者在整个辅助治疗期间持续闭经,血清雌二醇和孕酮水平极低。此外,这些患者的月经未恢复正常,停用环磷酰胺4至5个月后,血清雌二醇和孕酮水平仍较低。因此,辅助化疗导致卵巢功能抑制,环磷酰胺诱导卵巢功能衰竭,导致完全闭经。