Shamberger R C, Sherins R J, Ziegler J L, Glatstein E, Rosenberg S A
J Natl Cancer Inst. 1981 Dec;67(6):1213-8.
Ovarian function was evaluated in 11 women 16 to 43 years of age at treatment who received doxorubicin, cyclophosphamide, and high doses of methotrexate with or without radiotherapy in adjuvant therapy of soft tissue sarcoma. Five women (16-33 yr old) who received chemotherapy alone or combined with radiotherapy only at sites distant from the ovaries (chest wall, thigh, and leg) had minimal menstrual irregularities or temporary cessation of menses during therapy; cyclic menses returned promptly after therapy. Gonadotropin levels (expressed as means +/- SD [follicle-stimulating hormone (FSH), 10 +/- 5 mlU/ml; luteinizing hormone (LH), 10 +/- 4 mlU/ml] and 17 beta-estradiol (E2) levels (means +/- SD, 208 +/- 147 pg/ml) were normal. By contrast, 4 older women (ages 36-43 yr) who received similar treatment developed persistent amenorrhea with postmenopausal levels of gonadotropin (FSH, 108 +/- 29 mlU/ml; LH, 72 +/- 19 mlU/ml) and E2 (19 +/- 8 pg/ml). Two additional women (ages 21 and 39 yr) who received radiation (7,000 rad) to the pelvis plus chemotherapy developed prompt cessation of menses and became functional castrates (FSH, 77 and 80 mlU/ml; LH, 40 and 58 mlU/ml; E2, 10 and 19 pg/ml). However, this result would be expected from the radiation dose alone. The data demonstrated that ovarian dysfunction may follow the use of doxorubicin, cyclophosphamide, and high doses of methotrexate and that the injury is age related.
在11名年龄在16至43岁接受治疗的女性中评估了卵巢功能，这些女性在软组织肉瘤的辅助治疗中接受了阿霉素、环磷酰胺和高剂量甲氨蝶呤治疗，部分患者还接受了放疗。5名女性（年龄16 - 33岁）仅接受化疗或仅在远离卵巢的部位（胸壁、大腿和腿部）联合放疗，她们在治疗期间月经仅有轻微不规律或暂时停经；治疗后月经周期迅速恢复。促性腺激素水平（以平均值±标准差表示[促卵泡激素（FSH），10±5 mIU/ml；促黄体生成素（LH），10±4 mIU/ml]）和17β - 雌二醇（E2）水平（平均值±标准差，208±147 pg/ml）均正常。相比之下，4名年龄较大的女性（36 - 43岁）接受类似治疗后出现持续性闭经，促性腺激素水平达到绝经后水平（FSH，108±29 mIU/ml；LH，72±19 mIU/ml），E2水平为（19±8 pg/ml）。另外2名女性（年龄21岁和39岁）接受盆腔放疗（7000拉德）加化疗后迅速停经，成为功能性去势（FSH，77和80 mIU/ml；LH，40和58 mIU/ml；E2，10和19 pg/ml）。然而，仅从放疗剂量来看，这个结果是可以预期的。数据表明，使用阿霉素、环磷酰胺和高剂量甲氨蝶呤后可能会出现卵巢功能障碍，且这种损伤与年龄相关。
