The Protective Effect Of Gnrha On Chemotherapy-induced Ovarian Damage In Breast Cancer Patients

Objective:Conventional chemotherapy may lead to ovarian damage for most of patients with breast cancer, even menopause in advance. Through to the postoperative adjuvant chemotherapy patients and application of gonadotropin-releasing hormone agonists (GnRHa), this study discusses GnRHa for chemotherapy patients ovarian function protection.Methods:From January2011to January2012,21patients with breast cancer were collected in guang xi medical university first affiliated hospital, whose the pathologic diagnosis were breast cancer.They were required postoperative adjuvant systemic chemotherapy.21patients with breast cancer were randomly divided into the control group (11eases) and the study group(10cases). The patients in the control group were treated with conventional chemotherapy. The patients in the study group were treated with Diphereline3.75mg im qd and then with chemotherapy. Diphereline was used at3.75mg im qd every month subsequently. The FSH, LH and E2level of the patients were determined before, in and after the chemotherapy. They were inquiried menstruation, menopausal symptoms and sex.Results:1. The control group of11patients during the course of treatment had8cases appearring amenorrhoea, average in the third period of treatment appearring amenorrhoea,3cases not amenorrhoea. After chemotherapy,3cases recovered menstruation. The time of recovery was1-3months, with an average of2.45months.5cases continued to amenorrhea. The study group of10cases all appearred amenorrhoea in two course of treatment. After chemotherapy,9cases had menstrual recovery. The recovery time was46to70days. Only1case appearred menstrual disorders. The menstrual recovery rate of the test group was higher than those in the control group (P<0.05).2. There were3groups, the age of20to30years old, the age of31to40years old and the age of>40years old. The incidence of amenorrhoea was positively associated with age.3. The amenorrhoea incidence had no difference between using chemotherapy regimen of AC and chemotherapy regimen of AC-T (P>0.05).4. When the chemotherapy was stopped, the sex hormones level of amenorrhoea between the control group and the study group was more statistically significant (P<0.05).5. After the restoration of menstruation, the level of FSH and LH in the control group was higher than in the study group, and the level of E2was belower than in the study group, but the difference was not statistically significant (P>0.05).6. When the chemotherapy was stopped, the FSH and LH level of those who were not amenorrhoea was higher than before treatment level, and the level of E2have no significant differences before treatment (P>0.05). After the treatment in the control group, the FSH and LH level of those who were not menstrual recovery was higher than before treatment level, and the E2level was belower than the level before treatment (P<0.05).7. After the treatment, the incidence of menopausal symptoms in control group was higher than the study group, and the quality of sex in the control group was worse than the study group (P<0.05).Conclusion:1.Conventional chemotherapy can lead to ovarian function damage in breast cancer patients, even to appear amenorrhoea, and into the menopause early. The incidence of amenorrhoea was positively associated with age. The ovarian function damage of chemotherapy was irreversible.2. The amenorrhoea incidence have no difference between using chemotherapy regimen of AC and chemotherapy regimen of AC-T (P>0.05).3.The application of GnRHa combined with chemotherapy can restrain the pituitary gland and ovarian function. The ovarian function can be restored to the level before therapy after discontinuation.Chemotherapy combined with GnRHa was one of the effective means to protect ovarian function those who were required postoperative adjuvant systemic chemotherapy.