Sourouni Marina, Kiesel Ludwig
Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Münster, Münster, Germany.
Geburtshilfe Frauenheilkd. 2021 May;81(5):549-554. doi: 10.1055/a-1390-4353. Epub 2021 May 20.
Rapid advances in oncology have led to an increased survival rate in cancer patients, who live long enough to reach the natural age of menopause or experience the end of gonadal function as a side effect of oncological treatment. Survivors after gynaecological malignancies are a major challenge as these diseases are hormone-dependent and hormone replacement therapy (HRT) possibly increases the risk of recurrence. This article is based on a selective literature search for relevant studies and guidelines regarding HRT after gynaecological malignancies and provides a broad overview of current research. The data for assessing the oncological safety of HRT after gynaecological malignancy are insufficient overall. According to current knowledge, HRT is fundamentally contraindicated after breast and endometrial cancer. After ovarian cancer, HRT can be used after assessment of the risks and benefits, while there is usually no contraindication to HRT after vulvar, vaginal or cervical cancer.
肿瘤学的快速发展提高了癌症患者的生存率,使他们能够活到自然绝经年龄,或因肿瘤治疗副作用而经历性腺功能衰退。妇科恶性肿瘤幸存者面临着重大挑战,因为这些疾病依赖激素,而激素替代疗法(HRT)可能会增加复发风险。本文基于对妇科恶性肿瘤后HRT相关研究和指南的选择性文献检索,对当前研究进行了全面概述。总体而言,评估妇科恶性肿瘤后HRT肿瘤学安全性的数据不足。根据目前的知识,乳腺癌和子宫内膜癌后根本禁忌使用HRT。卵巢癌后,在评估风险和益处后可使用HRT,而外阴癌、阴道癌或宫颈癌后通常对HRT无禁忌。