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博来霉素、依托泊苷和顺铂治疗的恶性卵巢生殖细胞肿瘤患者中顺铂累积剂量与生殖和性功能之间的关联:一项病例系列研究

Association between cumulative cisplatin dose and reproductive and sexual functions in patients with malignant ovarian germ cell tumors treated with bleomycin, etoposide, and cisplatin therapy: a case series study.

作者信息

Akasaka Miki, Hirai Toshinori, Yoshida Kenta, Kondo Eiji, Ikeda Tomoaki, Iwamoto Takuya

机构信息

Department of Pharmacy, Mie University Hospital, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.

Department of Obsterics and Gynecology, Mie University Hospital, 2-174, Edobashi, Tsu, Mie, 514-8507, Japan.

出版信息

J Pharm Health Care Sci. 2022 Nov 17;8(1):33. doi: 10.1186/s40780-022-00265-8.

Abstract

BACKGROUND

The impact of cumulative dose of cisplatin on gonadal function has not been clarified. We evaluated whether the cumulative cisplatin dose affects the resumption of menses in patients treated with bleomycin, etoposide, and cisplatin (BEP).

MAIN BODY

A case series study of women < 40 years with malignant ovarian germ cell tumors receiving BEP was conducted at Mie University Hospital. Using linear regression analysis, the correlation between the cumulative dose and resumption of menses was determined. Additionally, we compared the resumption of menses stratified by age (age < 20 years or ≥ 20 years). Ten women (median age: 20 [interquartile range: 15-26] years) have received a median of 4 cycles of BEP. The median period of resumption of menses was 5 months, which had no correlation with cumulative doses of bleomycin (143 mg/m [71-220], y = -0.0069 x + 6.15, r = 0.19, P = 0.60), etoposide (1,533 mg/m [900-2,000], y = 0.0004 x + 4.56, r = 0.08, P = 0.82), and cisplatin (363 mg/m [225-400], y = 0.01 x + 1.67, r = 0.35, P = 0.32). Although the resumption of menses was comparable across ages, the cumulative doses of cisplatin were higher in patients aged < 20 years than in those aged ≥ 20 years (400 mg/m [363-450] vs. 225 mg/m [225-350], P = 0.02). Similarly, patients aged < 20 years had a higher cumulative etoposide dose than those aged ≥ 20 years (2,000 mg/m [1,533-2,250] vs. 900 mg/m[900-1,600], P = 0.03). Moreover, patients aged < 20 years received more cycles of BEP than those aged ≥ 20 years (4 cycles vs. 3 cycles, P = 0.03).

SHORT CONCLUSION

All patients can recover menses after BEP, and the resumption of menses appeared at the median period of 5 months after BEP. The timing of menses resumption did not correlate with the cumulative doses of cisplatin.

摘要

背景

顺铂累积剂量对性腺功能的影响尚未明确。我们评估了顺铂累积剂量是否会影响接受博来霉素、依托泊苷和顺铂(BEP)治疗的患者月经恢复情况。

主体

在三重大学医院对年龄小于40岁的恶性卵巢生殖细胞肿瘤患者接受BEP治疗进行了一项病例系列研究。采用线性回归分析确定累积剂量与月经恢复之间的相关性。此外,我们比较了按年龄分层(年龄<20岁或≥20岁)的月经恢复情况。10名女性(中位年龄:20岁[四分位间距:15 - 26岁])接受BEP治疗的中位周期数为4个周期。月经恢复的中位时间为5个月,这与博来霉素的累积剂量(143mg/m[71 - 220],y = -0.0069x + 6.15,r = 0.19,P = 0.60)、依托泊苷的累积剂量(1533mg/m[900 - 2000],y = 0.0004x + 4.56,r = 0.08,P = 0.82)和顺铂的累积剂量(363mg/m[225 - 400],y = 0.01x + 1.67,r = 0.35,P = 0.32)均无相关性。尽管各年龄组月经恢复情况相当,但年龄<20岁患者的顺铂累积剂量高于年龄≥20岁的患者(400mg/m[363 - 450]对225mg/m[225 - 350],P = 0.02)。同样,年龄<20岁患者的依托泊苷累积剂量高于年龄≥20岁的患者(2000mg/m[1533 - 2250]对900mg/m[900 - 1600],P = 0.03)。此外,年龄<20岁的患者接受BEP治疗的周期数多于年龄≥20岁的患者(4个周期对3个周期,P = 0.03)。

简短结论

所有患者在接受BEP治疗后均可恢复月经,月经恢复中位时间出现在BEP治疗后的5个月。月经恢复时间与顺铂累积剂量无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48bf/9673296/eda2dcd69687/40780_2022_265_Fig1_HTML.jpg

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