中国癌症杂志 ›› 2022, Vol. 32 ›› Issue (11): 1098-1104.doi: 10.19401/j.cnki.1007-3639.2022.11.008

• 综述 • 上一篇    下一篇

妇科恶性肿瘤术后激素替代治疗的研究进展

赵明明(), 王天佑 综述, 王超 审校()   

  1. 复旦大学附属妇产科医院妇科,上海 200011
  • 收稿日期:2022-06-25 修回日期:2022-08-03 出版日期:2022-11-30 发布日期:2022-12-14
  • 通信作者: 王超 审校
  • 作者简介:赵明明(ORCID: 0000-0002-7645-4768),硕士在读。

Progress in menopausal hormone therapy for postoperative patients with gynecological malignant cancer

ZHAO Mingming(), WANG Tianyou, WANG Chao()   

  1. Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai 200011, China
  • Received:2022-06-25 Revised:2022-08-03 Published:2022-11-30 Online:2022-12-14
  • Contact: WANG Chao

摘要:

激素替代治疗(menopausal hormone therapy,MHT)是缓解绝经后患者更年期症状的有效疗法,妇科恶性肿瘤术后患者使用MHT的安全性和有效性是临床上持续关注的重点问题。本文回顾近5年妇科恶性肿瘤术后MHT的相关临床研究,综合结果表明,早期子宫内膜癌(endometrial cancer,EC)术后行MHT不增加复发风险,且有利于提高生活质量。上皮性卵巢癌(ovarian cancer,OC)患者术后MHT对无病生存期和总生存期无不利影响,但不建议用于卵巢性索间质肿瘤等非上皮性卵巢肿瘤。宫颈鳞状细胞癌术后MHT相对安全,但关于宫颈腺癌、外阴癌、阴道癌患者术后使用MHT的研究较少,目前暂无确切结论。本综述旨在更新对妇科恶性肿瘤术后激素治疗的认识,为临床上合理选择MHT方案提供参考,以进一步提高患者生活质量。

关键词: 激素替代治疗, 妇科恶性肿瘤, 子宫内膜癌, 卵巢癌, 医源性绝经, 复发风险

Abstract:

Menopausal hormone therapy (MHT) is an effective therapy for alleviating menopausal symptoms in postmenopausal patients. Clinically, the safety and effectiveness of MHT in postoperative patients with gynecological malignant tumors are the most important. We reviewed the clinical studies on MHT after surgical treatment of gynecological malignant tumors in recent five years. The comprehensive results showed that MHT after surgical treatment of early endometrial cancer (EC) did not increase the risk of recurrence and improved the quality of life. Postoperative MHT has no adverse effect on disease-free survival and overall survival in patients with epithelial ovarian cancer (OC), however it is not recommended for other non-epithelial ovarian tumors such as ovarian sex cord stromal tumor. MHT is relatively safe after surgical treatment of cervical squamous cell carcinoma, however there are few studies on the postoperative use of MHT in cervical adenocarcinoma, vulvar cancer and vaginal cancer patients, and no definite conclusions are available at present. This review aimed to update the understanding of postoperative hormone therapy for gynecological malignant tumors and provide reference for improving the patients’ life quality and selecting MHT regimen rationally.

Key words: Menopausal hormone therapy, Gynecologic cancer, Endometrial cancer, Ovarian cancer, Iatrogenic menopause, Recurrence risk

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