Yuan Jialing, Lai Yi, Li Tao
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
The Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Ann Transl Med. 2022 Apr;10(7):409. doi: 10.21037/atm-22-928.
This meta-analysis was performed using Stata (15.0), and sought to systematically evaluate the domestic application value of the gonadotropin-releasing hormone agonist (GNRH-a) after cervical cancer, and explore its protective effect on the ovaries during chemotherapy. In many studies, the effectiveness and safety of GNRH-a are not consistent, and there is great controversy. Therefore, it is very important to systematically evaluate the protection and safety of GNRH-a after cervical cancer surgery.
PubMed, Cochrane Library, and Web of Science databases were systematically searched to retrieve articles on domestic trials examining the use of GNRH-a treatment in cervical cancer patients, published from January 2014 to January 2021, which were reviewed according to the inclusion and exclusion criteria of this study. The meta-analysis of the included study data was conducted using Stata 15.0.
In total, 10 articles were included in the meta-analysis, comprising 579 ovarian-reserved cervical cancer subjects, all of whom received 4-6 standardized courses of PC (Paclitaxel + Cisplatin) chemotherapy. The following statistically significant differences were found: bovine follicle stimulating hormone [odds ratio (OR) =1.82, 95% confidence interval (CI): 1.38-2.38; P<0.0001], bovine estrogen 2 (OR =2.39, 95% CI: 1.69-3.37; P<0.00001), anti-Mullerian hormone (OR =2.39, 95% CI: 1.71-3.34; P<0.00001), and bovine antral follicle count (OR =2.11, 95% CI: 1.49-2.99; P<0.0001); but there is no statistically significant difference incidence of coincidences (OR =0.80, 95% CI: 0.49-1.31; P=0.38).
The use of GNRH-a in cervical cancer patients receiving the PC chemotherapy regimen plays a significant role in protecting ovarian function.
本荟萃分析使用Stata（15.0）软件进行，旨在系统评估促性腺激素释放激素激动剂（GNRH-a）在宫颈癌治疗后的国内应用价值，并探讨其在化疗期间对卵巢的保护作用。在许多研究中，GNRH-a的有效性和安全性并不一致，存在很大争议。因此，系统评估宫颈癌手术后GNRH-a的保护作用和安全性非常重要。
系统检索PubMed、Cochrane图书馆和Web of Science数据库，以获取2014年1月至2021年1月发表的关于国内宫颈癌患者使用GNRH-a治疗的试验文章，并根据本研究的纳入和排除标准进行综述。使用Stata 15.0对纳入研究的数据进行荟萃分析。
荟萃分析共纳入10篇文章，包括579例保留卵巢的宫颈癌患者，所有患者均接受4-6个标准化疗程的PC（紫杉醇+顺铂）化疗。发现以下具有统计学意义的差异：促卵泡生成素[比值比（OR）=1.82，95%置信区间（CI）：1.38-2.38；P<0.0001]、雌二醇（OR =2.39，95%CI：1.69-3.37；P<0.00001）、抗苗勒管激素（OR =2.39，95%CI：1.71-3.34；P<0.00001）和窦卵泡计数（OR =2.11，95%CI：1.49-2.99；P<0.0001）；但在并发症发生率方面无统计学意义（OR =0.80，95%CI：0.49-1.31；P=0.38）。
GNRH-a在接受PC化疗方案的宫颈癌患者中使用对保护卵巢功能具有显著作用。
