Effect Of Gonadotropin Releasing Hormone Analogs On Ovarian Function Protection In Premenopausal Breast Cancer Patients Undergoing Chemotherapy:Meta-analysis

Objective:To evaluate the protective effect of Gonadotropin releasing hormone analogues(GnRHa)on the ovarian function for premenopausal breast cancer patients receiving chemotherapy.Methods:The randomized controlled trials of GnRHa protecting ovarian function of premenopausal breast cancer patients undergoing chemotherapy were collected from PubMed,Cochrane Library,EMbase,China National Knowledge Infrastructure(CNKI)and Wanfang Databases,and the date range was from the establishment of the databases to March 2018.According to the inclusion and exclusion criteria,the literatures about amenorrhea rate,premature ovarian failure(POF)rate,menstrual recurrence rate,pregnancy rate,follicle-stimulating hormone(FSH)and luteinizing hormone(LH)levels in premenopausal breast cancer patients after chemotherapy combined with GnRHa or chemotherapy alone were screened out.The Meta-analysis was performed using RevMan 5.3 software.Results:The analysis results included 17 randomized controlled trials,1,590 patients in total.According to the meta-analysis,the chemotherapy combined with GnRHa group increased the amenorrhea rate in the duration of chemotherapy(OR=11.14,95%CI: 4.83?25.72,P<0.00001),significantly reduced the premature ovarian failure rate(OR=0.35,95% CI: 0.25?0.50,P < 0.00001)while improving the menstrual recurrence rate(OR=2.90,95% CI: 1.88?4.49,P<0.00001)and pregnancy rate(OR=1.81,95% CI: 1.08?3.02,P =0.02).Compared to chemotherapy alone group,the GnRHa group showed lower levels of follicle-stimulating hormone(FSH)and luteinizing hormone(LH)in three studies,two of them with statistical significance.Conclusion:Chemotherapy,combined with GnRHa,is able to increase the menstrual recurrence rate and pregnancy rate of premenopausal breast cancer patients after treatment.Therefore,GnRHa can take effect on the ovarian function protection forthose patients.