Abstract | BACKGROUND: METHODS: A literature search using PubMed, Embase, and the Cochrane Library, and the proceedings of major conferences, was conducted up to 30 April 2015. Odds ratios ( ORs) and 95% confidence intervals (CIs) for POF (i.e. POF by study definition, and POF defined as amenorrhea 1 year after chemotherapy completion) and for patients with pregnancy, as well hazard ratios (HRs) and 95% CI for DFS, were calculated for each trial. Pooled analysis was carried out using the fixed- and random-effects models. RESULTS: A total of 12 RCTs were eligible including 1231 breast cancer patients. The use of LHRHa was associated with a significant reduced risk of POF (OR 0.36, 95% CI 0.23-0.57; P < 0.001), yet with significant heterogeneity (I(2) = 47.1%, Pheterogeneity = 0.026). In eight studies reporting amenorrhea rates 1 year after chemotherapy completion, the addition of LHRHa reduced the risk of POF (OR 0.55, 95% CI 0.41-0.73, P < 0.001) without heterogeneity (I(2) = 0.0%, Pheterogeneity = 0.936). In five studies reporting pregnancies, more patients treated with LHRHa achieved pregnancy (33 versus 19 women; OR 1.83, 95% CI 1.02-3.28, P = 0.041; I(2) = 0.0%, Pheterogeneity = 0.629). In three studies reporting DFS, no difference was observed (HR 1.00, 95% CI 0.49-2.04, P = 0.939; I(2) = 68.0%, Pheterogeneity = 0.044). CONCLUSION: Temporary ovarian suppression with LHRHa in young breast cancer patients is associated with a reduced risk of chemotherapy-induced POF and seems to increase the pregnancy rate, without an apparent negative consequence on prognosis.
|
Authors | M Lambertini, M Ceppi, F Poggio, F A Peccatori, H A Azim Jr, D Ugolini, P Pronzato, S Loibl, H C F Moore, A H Partridge, P Bruzzi, L Del Mastro |
Journal | Annals of oncology : official journal of the European Society for Medical Oncology
(Ann Oncol)
Vol. 26
Issue 12
Pg. 2408-19
(Dec 2015)
ISSN: 1569-8041 [Electronic] England |
PMID | 26347105
(Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review)
|
Copyright | © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected]. |
Chemical References |
- Antineoplastic Agents, Hormonal
- Gonadotropin-Releasing Hormone
|
Topics |
- Antineoplastic Agents, Hormonal
(adverse effects)
- Female
- Fertility
(drug effects, physiology)
- Gonadotropin-Releasing Hormone
(agonists, metabolism)
- Humans
- Ovary
(drug effects, metabolism)
- Pregnancy
- Primary Ovarian Insufficiency
(chemically induced, drug therapy, metabolism)
- Randomized Controlled Trials as Topic
(methods)
|