Goserelin toxicities and preferences for ovarian suppression method in pre-menopausal women with breast cancer
Goserelin toxicities and preferences for ovarian suppression method in pre-menopausal women with breast cancer
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DOI：
10.1111/imj.13169
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发表时间：
2016-10-01
影响因子：
2.1
通讯作者：
Koczwara, B.
中科院分区：
文献类型：
--
作者：
Hsieh, A. H. -C.;Kichenadasse, G.;Koczwara, B.
背景：戈舍瑞林是一种药物卵巢抑制剂，是治疗绝经前乳腺癌（PMBC）的有效药物。荟萃分析数据显示，药物卵巢抑制和非药物卵巢抑制（NPOS）-卵巢切除术或卵巢放疗的疗效相似。接受率NPOS仍然low.Aims：本研究探讨了报告的PMBC妇女的毒性和他们的首选卵巢抑制方法，而对戈舍瑞林。方法：一个邮政调查组成的22个研究特定的问题被发送到PMBC妇女谁收到戈舍瑞林在弗林德斯医疗中心。分别有12名和7名妇女在辅助治疗和转移性治疗中接受戈舍瑞林治疗。13人（68.4%）对调查作出了答复。辅助队列中的女性更有可能报告毒性。最常见的是潮热（100% vs 50%，P = 0.033）、肌痛/关节痛（71.4% vs 16.7%，P = 0.048）和性欲减退（57/ 1% vs 16.7%，P = 0.135）。NPOS被召回提供给5名（38.5%）妇女，其中一名BRCA 2携带者接受。NPOS最初由于害怕手术、手术/麻醉风险、侵入性和计划未来怀孕而被拒绝。如果有选择，前期卵巢切除术，在七（53.8%）妇女由于每月戈舍瑞林的不便，结论：一半的PMBC妇女表示偏好NPOS，但只有少数回忆NPOS正在讨论。每月使用戈舍瑞林的不便是偏好NPOS的主要驱动因素。需要从研究患者关于卵巢抑制的决策过程和偏好的大型试验中澄清，以验证我们的发现。
Background: Goserelin, a form of medical ovarian suppression, is an effective treatment for pre-menopausal women with breast cancer (PMBC). Meta-analysis data showed that similar efficacy is achieved with medical ovarian suppression and nonpharmacological ovarian suppression (NPOS) - oophorectomy or ovarian irradiation. The acceptance rate of NPOS remains low.Aims: This study explored the reported toxicities of PMBC women and their preferred ovarian suppression method whilst on goserelin.Methods: A postal survey consisting of 22 study-specific questions was sent to PMBC women who received goserelin at the Flinders Medical Centre.Results: Nineteen women were identified from the database; 12 versus 7 women received goserelin in the adjuvant versus metastatic setting respectively. Thirteen (68.4%) responded to the survey. Women in the adjuvant cohort were more likely to report toxicities. The most common were hot flushes (100% vs 50% P = 0.033), myalgia/arthralgia (71.4% vs 16.7%, P = 0.048) and decreased libido (57/ 1% vs 16.7%, P = 0.135). NPOS was recalled to be offered to five (38.5%) women, with acceptance by one BRCA2 carrier. NPOS was declined initially due to fear of procedure, surgical/anaesthetic risk, invasiveness and planned future pregnancies. If given the option, upfront oophorectomy was indicated in seven (53.8%) women due to inconveniences with monthly goserelin.Conclusion: Half of PMBC women indicated a preference to NPOS, but only a minority recollected NPOS being discussed. Inconvenience with monthly goserelin is the main driver toward a preference of favouring NPOS. Clarification from larger trials that research patients' decision process and preferences regarding ovarian suppression is needed to validate our findings.