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绝经前乳腺癌患者的更年期症状风险和当前的药物预防策略。

The risk of menopausal symptoms in premenopausal breast cancer patients and current pharmacological prevention strategies.

机构信息

Department of Clinical Oncology, Prince of Wales Hospital, the Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.

Hong Kong Cancer Institute, State Key Laboratory in Oncology in South China, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.

出版信息

Expert Opin Drug Saf. 2021 Oct;20(10):1163-1175. doi: 10.1080/14740338.2021.1926980. Epub 2021 May 17.

DOI:10.1080/14740338.2021.1926980
PMID:33951990
Abstract

: For young premenopausal breast cancer (BC) patients, adjuvant chemotherapy and other anti-cancer treatments can increase the risk of menopausal symptoms and may cause chemotherapy-related amenorrhea (CRA), infertility and premature ovarian insufficiency (POI).: In this report, menopausal symptoms related to anti-cancer treatment are described. Menstrual disturbances associated with the use of adjuvant chemotherapy, endocrine therapy, and targeted therapy against human epidermal growth factor receptor 2 (HER2) in premenopausal women withBC are discussed. To prevent menopausal symptoms, CRA and POI, data on the efficacy of temporary ovarian suppression with gonadotropin-releasing hormone analogues (GnRHa) during chemotherapy are highlighted. Pooled analyses have confirmed that concurrent administration of GnRHa during chemotherapy could significantly reduce the risk of developing chemotherapy-induced POI in premenopausal women with early-stageBC. In addition, reports have suggested that embryo/oocyte cryopreservation may increase the chance of pregnancy after the diagnosis ofBC, although such data remain limited.: Commonly experienced by pre-menopausal women withBC, anti-cancer treatment could cause severe menopausal symptoms. Temporary ovarian suppression with GnRHa during chemotherapy provided asafe and efficient strategy to reduce the likelihood of chemotherapy-induced POI in premenopausal patients with early-stageBC undergoing (neo)-adjuvant chemotherapy.

摘要

对于年轻的绝经前乳腺癌(BC)患者,辅助化疗和其他抗癌治疗会增加绝经症状的风险,并可能导致化疗相关闭经(CRA)、不孕和卵巢早衰(POI)。本报告描述了与抗癌治疗相关的绝经症状。讨论了与辅助化疗、内分泌治疗以及针对 BC 绝经前妇女的人表皮生长因子受体 2(HER2)的靶向治疗相关的月经紊乱。为了预防绝经症状、CRA 和 POI,强调了化疗期间使用促性腺激素释放激素类似物(GnRHa)进行暂时卵巢抑制的数据。汇总分析证实,化疗期间同时使用 GnRHa 可显著降低早期 BC 绝经前妇女发生化疗诱导性 POI 的风险。此外,有报告表明胚胎/卵母细胞冷冻保存可能会增加 BC 诊断后的妊娠机会,但此类数据仍然有限。

常见于 BC 绝经前妇女,抗癌治疗会导致严重的绝经症状。化疗期间使用 GnRHa 进行暂时卵巢抑制是一种安全有效的策略,可以降低接受(新)辅助化疗的早期 BC 绝经前患者发生化疗诱导性 POI 的可能性。

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