化疗对绝经前乳腺癌妇女卵巢功能的影响

Effect of chemotherapy on the ovarial function for premenopausal breast cancer patient.

目的:研究不同化疗方案对绝经前雌激素受体(ER)或伴孕激素受体(PR)阳性乳腺癌妇女卵巢功能的影响。方法:对我院2004年1月-2005年12月绝经前雌激素受体(ER)或伴孕激素受体(PR)阳性乳腺癌妇女行AC(ADM+CTX)和CEFCTX+EPI+5-FU)化疗50例,分析不同年龄组患者不同化疗方案及剂量与卵巢功能的关系。结果:不同年龄组绝经前乳腺癌妇女在化疗进程中闭经率不同,差异有显著性;含CTX的不同化疗方案对妇女闭经率分别为AC(达81.8%)和CEF(达78.6%),差异无显著性。CTX累积剂量与化疗所致的闭经率呈正相关。结论:提示化疗所致的闭经机制为卵巢的原发性损害;对ER(阳性)或伴PR阳性的绝经前乳腺癌患者在化疗时应选用对卵巢功能破坏较大的药物,或适当增加药物的累积剂量。

Objective：To investigate the influences of different chemotherapy schedules on the ovarial function of premenopausal breast cancer patients whose estrogen receptor（ER） and progesterone receptor（PR） were positive. Methods： Fifty premenopausal breast cancer patients whose ERand PR were positive accept AC（ADM＋CTX）or CEF（CTX＋EPI＋5-FU） chemotherapy from Jan 2004 to Dec 2005. The relationship between different chemotherapy schedule and ovarial function of various age groups was analyzed. Results：Menostasia rate varied with the age of premenopausle breast cancer patients during the chemotherapy proceeding, which indicated significant difference. For the patients whose schedule included CTX, the amenorrhea rates were 81.8 percent for AC and 78.6 percent for CEF,respectively, showing no significant dependabilities.While the accumulated doses of CTX had positive correlation with the amenorrhea rate. Conclusion： The mechanism of amenorrhea caused by chemotherapy is the primary lesion to the ovary. For the breast cancer patients with positive ER and PR, the chemotherapy with more destructive to ovary function or increasing accumulated dose should be selected. Adjuvant endocrine therapy using TAM after chemotherapeutics seems especially important for young females.