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Gonadotropin-releasing hormone analogues for the prevention of chemotherapy-induced premature ovarian failure in cancer women: systematic review and meta-analysis of randomized trials.
- Source :
-
Cancer treatment reviews [Cancer Treat Rev] 2014 Jun; Vol. 40 (5), pp. 675-83. Date of Electronic Publication: 2013 Dec 08. - Publication Year :
- 2014
-
Abstract
- Background: The role of temporary ovarian suppression with gonadotropin-releasing hormone analogues (GnRHa) in the prevention of chemotherapy-induced premature ovarian failure (POF) is still controversial. We conducted a systematic review and meta-analysis of randomized trials evaluating the efficacy of GnRHa, given before and during chemotherapy, in the prevention of POF in premenopausal cancer patients.<br />Methods: Studies were retrieved by searching PubMed, Web of Knowledge database and the proceedings of major conferences. We calculated Odds Ratios (OR) and 95% confidence intervals (CIs) for POF from each trial and obtained pooled estimates through the random effects model as suggested by DerSimonian and Laird.<br />Results: Nine studies were included in the meta-analysis with 225 events of POF occurring in 765 analyzed patients. The pooled OR estimate indicates a highly significant reduction in the risk of POF (OR=0.43; 95% CI: 0.22-0.84; p=0.013) in patients receiving GnRHa. There was statistically significant heterogeneity among studies (I(2)=55.8%; p=0.012). There was no evidence of publication bias. Subgroups analyses showed that the protective effect of GnRHa against POF was similar in subgroups of patients defined by age and timing of POF assessment, while it was present in breast cancer but unclear in ovarian cancer and lymphoma patients.<br />Conclusions: Our pooled analysis of randomized studies shows that the temporary ovarian suppression induced by GnRHa significantly reduces the risk of chemotherapy-induced POF in young cancer patients.<br /> (Copyright © 2013 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Antineoplastic Agents therapeutic use
Breast Neoplasms pathology
Clinical Trials, Phase II as Topic
Clinical Trials, Phase III as Topic
Female
Gonadotropin-Releasing Hormone therapeutic use
Hodgkin Disease pathology
Humans
Patient Safety
Premenopause drug effects
Prognosis
Randomized Controlled Trials as Topic
Risk Assessment
Treatment Outcome
Young Adult
Antineoplastic Agents adverse effects
Breast Neoplasms drug therapy
Gonadotropin-Releasing Hormone analogs & derivatives
Hodgkin Disease drug therapy
Primary Ovarian Insufficiency chemically induced
Primary Ovarian Insufficiency prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1532-1967
- Volume :
- 40
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Cancer treatment reviews
- Publication Type :
- Academic Journal
- Accession number :
- 24360817
- Full Text :
- https://doi.org/10.1016/j.ctrv.2013.12.001