Efficacy of gonadotropin-releasing hormone analogues in protecting ovarian function of premenopausal breast cancer patients undergoing chemotherapy: A meta-analysis / 肿瘤

ABSTRACT

Objective: To evaluate the therapeutic efficacy of gonadotropin-releasing hormone analogues (GnRHa) in protecting ovarian function of premenopausal breast cancer patients undergoing chemotherapy. Methods: The randomized controlled trials of GnRHa protecting ovarian function of premenopausal breast cancer patients undergoing chemotherapy were collected from PubMed, Cochrane Library, EMbase, China National Knowledge Infrastructure (CNKI) and Wanfang Databases, and the date range was from the establishment of the databases to March 2018. According to the inclusion and exclusion criteria, the literatures about amenorrhea rate, premature ovarian failure (POF) rate, menstrual recurrence rate, pregnancy rate, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels in premenopausal breast cancer patients after chemotherapy combined with GnRHa or chemotherapy alone were screened out. The outcome measurements were odds ratio (OR) and 95% confidence interval (CI). The Meta-analysis was performed using RevMan 5.3 software. Results: A total of 17 randomized controlled trials involving 1 590 patients were included in this Metaanalysis. As compared with chemotherapy alone, the chemotherapy combined with GnRHa increased the amenorrhea rate during chemotherapy (OR = 11.14, 95% CI 4.83-25.72, P < 0.000 01), reduced the POF rate (OR = 0.35, 95% CI 0.25-0.50, P < 0.000 01), while improved the menstrual recurrence rate (OR = 2.90, 95% CI 1.88-4.49, P < 0.000 01) and pregnancy rate (OR = 1.81, 95% CI 1.08-3.02, P = 0.02). Moreover, three studies showed that the levels of FSH and LH in chemotherapy combined with GnRHa group were lower than those in chemotherapy alone group, and there were significant differences in two studies (both P < 0.01). Conclusion: Chemotherapy combined with GnRHa can increase the menstrual recurrence rate and pregnancy rate of premenopausal breast cancer patients after chemotherapy, suggesting that GnRHa has a protective effect on ovarian function of those patients.