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Feasibility and efficacy of gonadotropin-releasing hormone agonists for the prevention of chemotherapy-induced ovarian insufficiency in patients with malignant ovarian germ cell tumours (KGOG 3048R)

Authors
 Min C Choi  ;  Young S Chung  ;  Jeong-Won Lee  ;  Byung S Kwon  ;  Byung K Park  ;  Se I Kim  ;  Seung-Hyuk Shim  ;  Kwang-Beom Lee  ;  Seok J Seong  ;  Sung J Lee  ;  San H Lee  ;  Heon-Jong Yoo  ;  Taejong Song  ;  Min K Kim  ;  Min-Hyun Baek  ;  Sokbom Kang  ;  Yong-Man Kim 
Citation
 EUROPEAN JOURNAL OF CANCER, Vol.133 : 56-65, 2020-07 
Journal Title
EUROPEAN JOURNAL OF CANCER
ISSN
 0959-8049 
Issue Date
2020-07
MeSH
Adolescent ; Adult ; Amenorrhea / chemically induced ; Amenorrhea / epidemiology ; Amenorrhea / prevention & control ; Antineoplastic Combined Chemotherapy Protocols / administration & dosage ; Antineoplastic Combined Chemotherapy Protocols / adverse effects* ; Bleomycin / administration & dosage ; Bleomycin / adverse effects ; Cisplatin / administration & dosage ; Cisplatin / adverse effects ; Etoposide / administration & dosage ; Etoposide / adverse effects ; Feasibility Studies ; Female ; Fertility Agents, Female / therapeutic use* ; Fertility Preservation / methods ; Gonadotropin-Releasing Hormone / agonists* ; Humans ; Infertility, Female / chemically induced ; Infertility, Female / epidemiology ; Infertility, Female / prevention & control ; Menopause, Premature / drug effects ; Menstruation / drug effects ; Neoplasms, Germ Cell and Embryonal / drug therapy* ; Neoplasms, Germ Cell and Embryonal / epidemiology ; Ovarian Neoplasms / drug therapy* ; Ovarian Neoplasms / epidemiology ; Ovary / drug effects ; Pregnancy ; Primary Ovarian Insufficiency / chemically induced* ; Primary Ovarian Insufficiency / epidemiology ; Primary Ovarian Insufficiency / prevention & control* ; Republic of Korea / epidemiology ; Retrospective Studies ; Treatment Outcome ; Young Adult
Keywords
Chemotherapy ; Gonadotropin releasing hormone agonist ; Ovarian germ cell cancer ; Ovarian insufficiency
Abstract
Background: This study assessed the effects of gonadotropin-releasing hormone agonists (GnRHa) on the prevention of chemotherapy-induced ovarian insufficiency among young patients with malignant ovarian germ cell tumour (MOGCT) receiving chemotherapy. Methods: This multicentre, retrospective study was conducted at 15 sites affiliated with the Korean Gynecologic Oncology Group and enrolled 354 patients between January 1995 and September 2018. Among them, 227 patients were included in this study and divided into two groups according to the use of GnRHa during chemotherapy (GnRHa versus no GnRHa groups). The primary objective was to compare the rates of menstrual resumption between the two groups. We also assessed the clinical determinants affecting menstrual resumption among the study groups. Results: There were no significant differences between the GnRHa (n = 63) and no GnRHa (n = 164) groups regarding age at diagnosis, parity, ethnicity, age at menarche, body mass index, International Federation of Gynecology and Obstetrics stage, mode of surgery and surgery type. The rate of menstrual resumption after chemotherapy was 100% (63 of 63) in the GnRHa group and 90.9% (149 of 164) in the no GnRHa group (p=0.013). The mean periods from last chemotherapy to menstrual resumption were 7.4 and 7.3 months in the GnRHa and no GnRHa groups, respectively. GnRHa co-administration during chemotherapy reduced the likelihood of amenorrhoea after chemotherapy, although statistical significance was not confirmed in the univariate analysis (odds ratio: 0.276; 95% confidence interval, 0.004-1.317; p = 0.077). Conclusion: Temporary ovarian suppression with GnRHa during chemotherapy does not significantly increase the chances of menstrual resumption in young patients with MOGCT.
Full Text
https://www.sciencedirect.com/science/article/pii/S0959804920302094
DOI
10.1016/j.ejca.2020.03.030
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Chung, Young Shin(정영신)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190057
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