Ameta-Analysis Of GnRHa Protect Ovarian Fuction In Patients With Breast Cancer During Chemotherapy

OBJECTIVE.The current conventional chemotherapy regimens of breast cancer will make most of the premenopausal women suffer from ovarian damage, and even premature ovarian failure, which seriously Influence their health and quality of life. The method of evidence-based medicine was applied to this study in order to assess the clinical efficacy of GnRH analogues during chemotherapy to protect the ovarian function of premenopausal women and further to provide a reference for clinical decision-making and practice.METHODS:We searched pubmed(1966-December 2014), The Cochrance Library(1966-December 2014),Embase(1966-December 2014),CNKI(1994-December 2014), VIP(1989-December 2014),CBM(1978-December 2014).We adopted randomized control trials (RCTs),which have been completed and published before December 2014 about treating the premenopausal women with gonadotropin releasing hormone analogues (GnRHa) to prevent the ovarian damage of breast cancer patients undergone chemotherapy.The processes of document screening, data extraction, quality assessment were completed by two researchers independently.We statistics the menstruation recovery rate, premature ovarian failure rate, spontaneous pregnancy rate, FSH level,and LH level, and the RevMan5.2 statistical software was applied to this meta-analysis.RESULTS:There were 10 eligible RCTs, including a total of 1005 premenopausal women with breast cancer,which involving 524 patients received chemotherapy combined with GnRHa and 491 cases received chemotherapy alone.The Meta analysis outcome showed that:① The chemotherapy combined with GnRHa group of menstruation recovery rate is higher than the chemotherapy alone group (OR=2.62,95%CI (1.58-4.35), P=0.0002}, there is a moderate statistical heterogeneity between studies, sensitivity analysis results are stable,no publication bias; ②The chemotherapy combined with GnRHa group of POF rate is lower than the chemotherapy alone group {OR=0.33,95%CI (0.16-0.69), P=0.003), there is a low statistical heterogeneity between studies, sensitivity analysis results are stable; ③The FSH and LH level in the chemotherapy combined with GnRHa group was lower than the control group (P<0.05).There is a high statistical heterogeneity between the studies and only for descriptive analysishigh.CONCLUSION:The chemotherapy combined with GnRHa appears to improve the spontaneous menses recovery rate, reduce the rate of POF.It suggests that the administration of GnRHa appears to have a protective effectt on ovarian function among the premenopausal breast cancer patients undergone chemotherapy.