Vogel Marie, Franik Sebastian, Kiesel Ludwig
Department of Gynecology and Obstetrics, Münster University Hospital, Münster, Germany.
Breast Care (Basel). 2023 Jun;18(3):158-163. doi: 10.1159/000529695. Epub 2023 Feb 15.
In breast cancer patients, menopausal symptoms are often reached earlier and in a more severe manner than in healthy women. They can dramatically reduce a patient's quality of life. Treatment for breast cancer patients remains difficult due to hormone replacement therapy being contraindicated. Therefore, treatment alternatives like herbal phytoestrogen preparations are considered to be a treatment option.
All randomized controlled trials (RCTs) that investigated comparisons of food products, extracts, or dietary supplements containing phytoestrogens in women with a diagnosis of breast cancer were included in the analysis.
There was no evidence that phytoestrogen preparations had a benefit over placebo in the treatment of breast cancer patients with menopausal symptoms. Neither the frequency nor severity of menopausal symptoms and the quality of life or occurrence of adverse events were reduced in comparison to a placebo.
As we cannot prove a benefit of plant extracts in the treatment of menopausal symptoms in breast cancer patients, different herbal preparations should be analyzed in RCTs in order to find sufficient and safe new treatment options for symptomatic menopausal breast cancer patients. A focus should also be laid on developing a core outcome set to simplify pooling of different studies.
在乳腺癌患者中，更年期症状往往比健康女性出现得更早且更严重。这些症状会显著降低患者的生活质量。由于激素替代疗法存在禁忌，乳腺癌患者的治疗仍然困难。因此，像草药植物雌激素制剂这样的治疗替代方案被视为一种治疗选择。
分析纳入了所有调查含植物雌激素的食品、提取物或膳食补充剂对已确诊乳腺癌女性疗效比较的随机对照试验（RCT）。
没有证据表明植物雌激素制剂在治疗有更年期症状的乳腺癌患者方面比安慰剂更具优势。与安慰剂相比，更年期症状的频率和严重程度、生活质量或不良事件的发生率均未降低。
由于我们无法证明植物提取物对治疗乳腺癌患者的更年期症状有益，因此应在随机对照试验中分析不同的草药制剂，以便为有症状的更年期乳腺癌患者找到充分且安全的新治疗选择。还应着重制定一个核心结局指标集，以简化不同研究的汇总。
