妇科癌症中的激素替代疗法:瘤安全性和替代疗法
Ana Luzarraga Aznar1, Osnat Elyashiv2, Susan Dababou3
1Universitat Autònoma de Barcelona, Vall d'Hebron University Hospital, Department of Gynecologic Oncology, Barcelona, Spain; Tel Aviv University, Faculty of Medical and Health Sciences, Edith Wolfson Medical Center, Division of Gynecologic Oncology, Tel Aviv, Israel.
概括
激素替代疗法对许多妇科癌症幸存者来说是安全的,但风险因癌症类型和阶段而异. 对于那些有禁忌的人来说,存在替代方案,平衡症状缓解与瘤安全.
科学领域:
- 妇科瘤学 妇科瘤学
- 生殖内分泌学 生殖内分泌学
- 癌症的生存率 癌症的生存率
背景情况:
- 妇科癌症治疗通常会导致更年期,影响幸存者的生活质量.
- 激素替代疗法 (HRT) 对更年期症状有效,但其在癌症幸存者的瘤安全性仍在争论中.
- 越来越多的妇科癌症幸存者需要了解HRT的安全性和替代方案.
研究的目的:
- 在各种妇科癌症和遗传性癌症综合征的幸存者中全面审查HRT的安全性.
- 确定特定的妇科癌症亚型和阶段,在这些阶段,HRT被认为是安全的或禁用的.
- 评估非系统性荷尔蒙和非荷尔蒙替代品在高风险幸存者的更年期症状管理中的有效性.
主要方法:
- 对妇科癌症幸存者的HRT安全性研究的综合文献综述.
- 对不同类型的妇科癌症 (子宫内膜,卵巢,宫,,阴道) 和子宫瘤的HRT安全数据的分析.
- 对非全身性荷尔蒙和非荷尔蒙疗法用于更年期症状管理的证据的评估.
主要成果:
- 系统性HRT被认为对低风险的早期子宫内膜癌,大多数卵巢癌,宫癌和/阴道癌是安全的.
- 治疗HRT的禁忌包括晚期/非子宫内膜腺癌,子宫肉瘤和特定的卵巢癌 (例如,颗粒细胞瘤).
- 非全身激素 (阴道雌激素,奥斯佩米芬,DHEA) 和非激素疗法 (滑剂,激光疗法,CBT, gabapentin,fezolinetant,SSRI/SNRIs) 是有效的替代方案.
结论:
- 在妇科癌症幸存者的个性化HRT决策需要平衡瘤安全与生活质量.
- 在精选的妇科癌症幸存者中,HRT可以安全地使用,而替代品对于高风险病例至关重要.
- 有效地管理更年期症状对于这种患者群体的长期健康和福祉至关重要.
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