青少年妇科恶性肿瘤患者治疗后生理、生育功能保护及预后

摘要/Abstract

摘要：

青少年恶性肿瘤患者保留生育手术后，辅助化疗会导致卵巢功能损害。严重者发生早绝经。不同化疗药物、接受化疗的年龄、单次及累积剂量影响受损程度。预防卵巢早衰主要手段包括：使用GnRHa、自体或异体卵巢移植、性激素替代治疗补救。肿瘤生殖学领域的大量难题尚待大规模的深入研究。

关键词: 恶性肿瘤, 化疗, 卵巢功能, 生殖, 卵巢早衰

Abstract:

Abstract:Chemotherapies after fertility preserved surgeries among adolescents and young women with gynecologic malignancies may induce damages of ovarian function. A comparatively part of them is severe cases which induce premature ovarian failure (POF). The composition of chemical, the age of receiving chemotherapies and the dose of drugs are main factors. The possibilities to preserve fertility in women exposed to chemotherapy are:the administration of a gonadotropin-releasing hormone (GnRH) agonist, autogenously or exogenous ovarian transplantation and hormone replacement treatment. 

Key words: malignancies, chemotherapies, ovarian function, fertility, premature ovarian failure

中图分类号:

R711.74

王朝华，崔恒. 青少年妇科恶性肿瘤患者治疗后生理、生育功能保护及预后[J]. 中国实用妇科与产科杂志.

参考文献

[1] Dargent D, Brun JL, Remy I. Pregnancies following radical trachelectomy for invasive cervical concer: Society of Gynecologic. Oncologists-Abstracts[J]. Gynecol Oncol, 1994,52:105-108. \

[2] Green DM, Sklar CA, Boice JD, et al. Ovarian failure and reproduction outcomes after childhood cancer treatment: results from the childhood cancer survivor study[J]. J Clin Oncol, 2009,27(14):2374-2381.\

[3] Falcone T, Bedaiwy MA. Fertility preservation and pregnancy outcome after malignancy[J]. Current Opinion in Obstetrics ＆ Gynecology, 2005,17(1):21-26.\

[4] 郭奕倩，白文佩. 化疗导致青少年卵巢功能损伤及其保护措施[J]. 中国实用妇科与产科杂志,2010, 26:514-516. \

[5] Manger K, Wilklt L, Kalden JR,et al. Prevention of gonadaltoxicity and preservation of gonadal function and fertility in young women with systemic lupusematosus treated by cyclophosphamide, the PREGO-Study[J]. Autoimmune Rev, 2006,5:269-272. \

[6] 付霞霏，何援利，王雪峰，等. 骨髓间充质干细胞移植修复化疗所致卵巢损伤的实验研究[J]. 现代妇产科进展, 2010,19:410-414. \

[7] Edgar AB, Wallace WH.Pregnancy in women who had cancer in childhood[J].Eur J Cancer, 2007,43(13):1890-1894.\

[8] Goldhirsch A, Gelber RD, Castiglione M. The magnitude of endocrine effects of adjuvant chemotherapy for premenopausal breast cancer patients, The International Breast Cancer Study Group[J]. Ann Oncol, 1990,1(3):183-188.\

[9] Franchi-Rezgui P, Rousselot P, Espie M,et al. Fertility in young women after chemotherapy with alkylating agents for Hodgkin and non-Hodgkin lymphomas[J]. Am J Hematol, 2003,4(2):116-220. \

[10] Cheng YC, Takagi M, Milbourne A,et al. Phase II study of gonadotropin-releasing hormone analog for ovarian function preservation in hematopoietic stemcell transplantation patients[J]. Oncologist, 2012, 17(2)233-238. \

[11] Blumenfeld Z.Preservation of fertility and ovarian function and minimalization of chemotherapy associated gonadotoxicity and premature ovarian failure: the role of inhibin-A and -B as markers[J].Mol Cell Endocrinol, 2002,87(1-2):93-105. \

[12] Green DM, Sklar CA, Boice JD Jr,et al.Ovarian failure and reproductive outcomes after childhood cancer treatment: results from the Childhood Cancer Survivor Study[J]. J Clin Oncol, 2009,27(14):2374-2381. \

[13] Sklar CA, Mertens AC, Mitby P, et al. Premature menopause in survivors of childhood cancer: a report from the childhood cancer survivor study[J].J Natl Cancer Inst, 2006,98:890-896.  \

[14] Pereyra Pacheco B, Mndez Ribas JM, Milone G,et al.Use of GnRH analogs for functional protection of the ovary and preservation of fertility during cancer treatment in adolescents: a preliminary report[J].Gynecol Oncol, 2001,81(3):391-397. \

[15] Blumenfeld Z, Eckman A.Preservation of fertility and ovarian function and minimization of chemotherapy-induced gonadotoxicity in young women by GnRHa[J]. J Natl Cancer Inst Monogr,2005;(34):40-43. \

[16] 宋荣娜，魏丽惠. 未成熟畸胎瘤术后应用促性腺激素释放激素激动剂保护卵巢化疗后自然妊娠1例[J]. 中国实用妇科与产科杂志， 2012,28（2）：157-158. \

[17] Beck-Fruchter R, Weiss A,Shalev E. GnRH agonist therapy as ovarian protectants in female patients undergoing chemotherapy: a review of the clinical data[J]. Human Reproduction Update, 2008,14(6):553-561.  \

[18] Donnez J, Silber S, Andersen CY,et al. Children born after auto-transplantation of cryopreserved ovarian tissue: a review of 13 live births[J]. Annals of Medicine, 2011,43(6):437-450. \

[19] Julie A, Ross1, Penny J,et al. Hormone replacement therapy is not associated with an increased risk of leukemia(United States)[J].Cancer Causes and Control,2005,16:483-488. \

[20] James R, Cerhan M,Thomas M,et al.Hormone Replacement Therapy and Risk of Non-Hodgkin Lymphoma and Chronic Lymphocytic Leukemia[J].Cancer Epidemiology Biomarkers & Prevention, 2002,11: 1466-1471. \

[21] Lee SJ, Schover LR, Partridge AH, et al.American society of clinical oncology:American Society of Clinical Oncology recommendations on fertility preservation in cancer patients[J]. J Clin Oncol, 2006,24(18):2917-2931.