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      Gonadotropin-Releasing Hormone Agonists during Gonadal Chemotherapy for the Effect on Pregnancy Outcome and Ovarian Function in Premenopausal Patients with Breast Cancer: A Systematic Review and Meta-Analysis

      meta-analysis

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          Abstract

          Objectives: The aim of this study was to evaluate the effects of gonadotropin-releasing hormone agonists (GnRHas) on pregnancy outcomes, premature ovarian failure (POF), menstrual recovery, disease-free survival (DFS), and adverse events in premenopausal breast cancer patients during gonadal chemotherapy. Methods: We systematically searched PubMed, Cochrane Library, and Embase databases. The trials were eligible if they included premenopausal breast cancer patients treated with chemotherapy alone or with concurrent GnRHa and reported ovarian function recovery data. Heterogeneity for the eligible data was assessed, and a pooled risk ratio (RR) with 95% confidence interval (CI) was calculated. A meta-analysis was conducted using a fixed-effect model. Results: Fifteen randomized controlled trials were included in this analysis. The results indicated that GnRHa combined with chemotherapy significantly increased pregnancy rates compared with chemotherapy alone (RR = 1.76; 95% CI: 1.16–2.67) and decreased rates of POF (RR = 0.42; 95% CI: 0.35–0.51). For secondary endpoints, the GnRHa group improved menstrual recovery rates (RR = 1.20; 95% CI: 1.11–1.30) and decreased the rate of amenorrhea 1–2 years after chemotherapy (RR = 0.50; 95% CI: 0.40–0.63). Furthermore, the 5-year DFS and overall survival (OS) rates were significantly improved in the GnRHa group. Conclusion: For premenopausal breast cancer patients receiving gonadal toxic chemotherapy, adjuvant chemotherapy with GnRHa can better protect the ovarian function of patients, reduce the rate of POF and amenorrhea, and improve the pregnancy rate, menstrual recovery rate, DFS rate, and OS rate of patients.

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          Author and article information

          Journal
          BRC
          BRC
          10.1159/issn.1661-3791
          Breast Care
          Breast Care
          S. Karger AG
          1661-3791
          1661-3805
          2023
          August 2023
          13 March 2023
          : 18
          : 4
          : 270-277
          Affiliations
          [_a] aDepartment of Pharmacy, General Hospital of Northern Theater Command, Shenyang, China
          [_b] bDepartment of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
          Article
          528028 Breast Care 2023;18:270–278
          10.1159/000528028
          37900550
          a49f227e-f623-4148-a7e8-59aede38f966
          © 2023 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.

          History
          : 08 June 2022
          : 07 November 2022
          Page count
          Figures: 3, Tables: 1, Pages: 8
          Funding
          There are no funding received.
          Categories
          Meta-Analysis

          Medicine
          Meta-analysis,Ovarian function,Fertility preservation,Gonadotropin-releasing hormone agonists,Breast cancer

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