Monitoring Of Hormone Levels In Patients With Cervical Squamous Cell Carcinoma During Concurrent Chemoradiotherapy

Background: Cervical cancer is one of the common malignant tumors in gynecology.With the development of diagnosis and treatment technology,the survival rate of cervical cancer patients has been significantly improved.However,in recent years,cervical cancer has gradually become younger.According to the epidemiological and statistical survey of FIGO in 2001,the incidence of cervical cancer decreased from an average of 60 years old in the early 20 th century to 50 years old in the late 20 th century.We call patients with cervical cancer younger than 35 years of age young cervical cancer.According to the statistics of Elliot et al.in the middle and late 20 th century,the incidence of young cervical cancer increased from 9% to 24%,and the proportion of young cervical cancer in China increased from 3.42% to 24.91%.These young cervical cancer patients are under psychological,emotional and social pressure after treatment,and they are also faced with loss of fertility function and early menopause after the gradual recovery of body function.Therefore,the quality of life(QOL)of cervical cancer patients deserves attention.Cervical cancer patients during treatment inevitably cause hormone levels drop,triggered a series of climacteric syndrome hot flashes and night sweats,emotional irritability,anxiety,vaginal atrophy,decreased sexual desire,sexual intercourse pain,neurological symptoms such as spirit,at the same time also can cause or aggravate diseases such as hypertension,heart disease and osteoporosis,seriously affect the patient's physical and mental health.While ensuring the survival rate of cervical cancer patients,how to improve the quality of life of cervical cancer patients and carry out safe and effective hormone replacement therapy has become the focus of contemporary gynecological oncologists.Whether hormone replacement therapy can be used in patients with cervical cancer or not,the current unified view is that the application of HRT in patients with cervical squamous cell carcinoma neither increases the recurrence rate nor affects the overall survival time,but can significantly relieve the iatrogenic menopausal symptoms caused by hormone deficiency and improve the quality of life of patients.Therefore,patients with cervical squamous cell carcinoma are encouraged to add HRT after comprehensive treatment.However,the occurrence of cervical adenocarcinoma is closely related to hormone levels.At present,it is not clear whether the use of HRT affects its survival and recurrence rate in mass data.Therefore,caution should be taken when using HRT.For cervical cancer patients,patients with hormone replacement therapy should be based on cancer of different pathological type,clinical stage,symptoms of the menopausal transition,the individualized treatment,choice of different drug delivery system,preparation and,let patients at the lowest dose,with minimal risk to alleviate symptoms so as to achieve the aim of improve sex life,improve the quality of life.HRT time window for cervical cancer:1.Postoperative cervical cancer2.After comprehensive treatment3.The specific time of radiotherapy and chemotherapy for cervical cancer is not exact.No matter in which period MHT related research was given,it was suggested that the benefit was greater.What we need to do is explore the changes of hormone drop in the body,improve the basis for hormone replacement therapy,and avoid excessive medical treatment or improper treatment.In this study,hormone levels in vivo were monitored before,during and after treatment of cervical squamous cell carcinoma,and the effects of concurrent chemoradiotherapy on hormones in vivo were investigated.Guide the following window period of estrogen administration and dosage.Purpose:1.Observe the changes of hormone levels in cervical cancer patients during chemoradiotherapy.2.To explore the best time for hormone replacement therapy3.To explore the optimal dosage of hormone replacement therapy4.To explore the application value and significance of hormone replacement therapy.Methods and materials: The clinical data of 43 patients with cervical squamous cell carcinoma who received concurrent chemoradiotherapy in our hospital from December 2018 to March 2020 were retrospectively collected.The patients were divided into observation group and control group according to whether they had menopause before diagnosis.Serum follicular stimulating hormone(FSH),luteinizing hormone(LH)and estradiol(E2)levels in each group were measured by radioimmunoassay(RIA),and the changes of serum hormones in each group were compared to explore the optimal treatment time for menopausal symptoms after the application of MHT in the treatment of cervical squamous cell carcinoma.Conclusion:1.For young cervical cancer patients,concurrent chemoradiotherapy can rapidly destroy ovarian function.From the second week of treatment,hormone levels in the body rapidly drop,and by the fifth week,ovarian function is completely lost.2.For pre-menopausal patients,concurrent chemoradiotherapy did not significantly change their hormone levels,which may be because the secretion of estrogen in postmenopausal women is not completely dependent on the ovary.3.If there is no contraindication,we can timely give hormone replacement therapy(MHT)in combination with the patient's symptoms.The hormone level of pre-menopausal patients fluctuates greatly between the 2nd and 5th week.We should communicate with patients in a timely manner.If there are obvious menopausal symptoms,MHT can be added according to the patient's situation.Menopausal patients can add MHT at any time in combination with the patient's physical conditions.