Gonadotropin-releasing hormone agonists for the preservation of ovarian function among women with breast cancer who did not use tamoxifen after chemotherapy: a systematic review and meta-analysis

作者：Vitek Wendy S^*; Shayne Michelle; Hoeger Kathleen; Han Yu; Messing Susan; Fung Chunkit

来源：Fertility and Sterility, 2014, 102(3): 808-U525.

DOI：10.1016/j.fertnstert.2014.06.003

• GnRH agonist
• fertility preservation
• breast cancer
• systematic review
• meta-analysis

Objective: To determine whether concurrent use of GnRH agonists with chemotherapy preserves ovarian function in women with breast cancer who did not use tamoxifen.
Design: Systematic review and meta-analysis.
Setting: University-based hospitals.
Patient(s): Premenopausal women with breast cancer treated with chemotherapy who did not receive tamoxifen.
Intervention(s): Randomization to concurrent GnRH agonists with chemotherapy or chemotherapy alone.
Main Outcome Measure(s): Odds ratio (OR) of resumption of menses 1 year or more after chemotherapy.
Result(s): Searches were conducted in PubMed, Scopus, Cochrane Trials Register, and the National Research Register through March 2014, and all randomized trials that reported resumption of menses 1 year or more after GnRH agonist with chemotherapy or chemotherapy alone among women with breast cancer who did not receive tamoxifen were included. Four studies were analyzed in the meta-analysis and included 252 patients (GnRH agonist with chemotherapy, n = 131; chemotherapy alone, n = 121). There was no significant difference in the rate of return of menses between the two groups (OR, 1.47; 95% confidence interval [0.60-3.62]). Heterogeneity among the trials was not significant (I-2 = 16.6%).
Conclusion(s): Concurrent GnRH agonists with chemotherapy may not preserve ovarian function in women with breast cancer. Furthermore, randomized data are limited regarding fertility after concurrent use of GnRH agonists with chemotherapy.

• 出版日期2014-9