妇科恶性肿瘤患者激素补充治疗的研究进展

The Research Progress of Hormone Replacement Therapy for Patients with Malignant Gynecologic Tumors

激素补充治疗(HRT)可确切缓解妇科恶性肿瘤患者治疗后因雌激素缺乏引起的相关症状,但许多妇科恶性肿瘤的发生与女性激素尤其是雌激素密切相关,必须保证HRT在获益的同时不增加肿瘤的复发风险。目前认为,Ⅱ型子宫内膜癌、卵巢生殖细胞肿瘤、宫颈癌、外阴癌等为非性激素依赖肿瘤,应用HRT是安全的;虽然Ⅰ型子宫内膜癌和卵巢上皮性癌等为性激素依赖肿瘤,但至少目前没有证据支持HRT会影响患者的复发和预后。临床应用前要充分知情同意,并根据患者意愿和实际情况制订个体化方案。

Hormone replacement therapy （HRT）can exactly ease estrogen deficiency symptoms after gynecological malignant tumor patients treatment, but many gynecological malignant tumors are closely related to female hormones especially estrogens. We must ensure that the benifits of HRT won＇t increase the risk of tumor recurrence： It＇s now believed that type Ⅱ endometrial carcinoma, ovarian germ cell tumor, cervical car-cinoma and vulvar carcinoma are nonestrogen-positive tumors, where it＇s safe to apply HRT. Although type 1 endometrial carcinoma and ovarian epithelial carcinoma are estrogen-positive tumors, for now at least there is no evidence supporting that HRT will affect the recurrence and prognosis of patients. The doctor should have patients＇ fully-informed consent and develop individualized programs according to patient＇s preferences and the actual situation.