Abstract:

Objective　To evaluate the ability of goserelin in the protection of the ovarian function in premenopausal patients with breast cancer by meta-analysis. Methods　The China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, Web of Science, Scopus, and Cochrane Library were searched for the controlled trials of goserelin for premenopausal patients with breast cancer from their establishment to October 2023. Two investigators independently screened the literatures according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the included studies using the Cochrane Collaboration risk of bias assessment tool. The data were analyzed using the RevMan 5.3 software. Results　Twenty-eight studies and 8 782 patients were included, including 4 372 in the test group and 4 410 in the control group. The meta-analysis results showed that the total effective rate of the test group was higher than that of the control group (OR=2.87, 95%CI 1.94-4.26, P<0.000 01); the basal follicle-stimulating hormone (bFSH) level of the test group was lower than that of the control group (MD=-3.81, 95%CI -4.35 to -3.27, P<0.000 01); the basal antral follicle counting (bAFC) of the test group was higher than that of the control group (MD=3.27, 95%CI 2.83-3.72, P<0.000 01); the estradiol (E2) level in the test group was not significantly different from that in the control group (SMD=0.85, 95%CI -0.69 to -2.40, P=0.28); the luteinizing hormone (LH) in the test group was higher than that in the control group (MD=8.75, 95%CI 7.84-9.67, P<0.000 01); the premature ovarian failure (POI) in the test group was lower than that in the control group (OR=0.24, 95%CI 0.08-0.73, P=0.01); the menstrual recurrence rate in the test group was higher than that in the control group (OR=3.09, 95%CI 1.01-9.46, P=0.05); the disease-free survival (DFS) in the test group was higher than that in the control group (OR=1.91, 95%CI 1.28-2.85, P=0.002); the overall survival (OS) in the test group was higher than that in the control group (OR=1.35, 95%CI 1.14-1.59, P=0.000 4); the progression-free-survival (PFS) in the test group was higher than that in the control group (MD=30.15, 95%CI 29.47-30.83, P<0.000 01); the incidence of adverse reactions in the test group was lower than that in the control group (OR=0.48, 95%CI 0.25-0.90, P=0.02). Conclusion　Goserelin for premenopausal patients with breast cancer effectively protects their ovarian function and improves their survival time, and is safe.

Key words:

Goserelin, Premenopausal breast cancer, Ovarian function, Meta-analysis

摘要：

目的　通过meta分析方法系统评价戈舍瑞林对绝经前乳腺癌患者卵巢功能保护的能力。方法　检索中国知网、万方数据库、维普数据库、PubMed、Web of Science、Scopus及Cochrane Library，提取从建库至2023年10月戈舍瑞林治疗绝经前乳腺癌的对照试验。由2名研究者根据纳入与排除标准独立筛选文献、提取数据，并采用Cochrane协作网风险偏倚评价工具对纳入研究质量进行评价，运用RevMan 5.3软件进行数据分析。结果　共纳入28项研究，共8 782例研究对象，其中试验组4 372例，对照组4 410例。meta分析结果显示：试验组总有效率高于对照组（OR=2.87，95%CI 1.94～4.26，P<0.000 01）；试验组基础卵泡刺激素（bFSH）水平低于对照组（MD=-3.81，95%CI -4.35～-3.27，P<0.000 01）；试验组窦状卵泡数（bAFC）水平高于对照组（MD=3.27，95%CI 2.83～3.72，P<0.000 01）；两组雌二醇（E2）水平比较，差异无统计学意义（SMD=0.85，95%CI -0.69～2.40，P=0.28）；试验组促黄体生成素（LH）高于对照组（MD=8.75，95%CI 7.84～9.67，P<0.000 01）；试验组卵巢早衰（POI）低于对照组（OR=0.24，95%CI 0.08～0.73，P=0.01）；试验组月经复潮率高于对照组（OR=3.09，95%CI 1.01～9.46，P=0.05）；试验组无病生存期（DFS）高于对照组（OR=1.91，95%CI 1.28～2.85，P=0.002）；试验组总生存期（OS）高于对照组（OR=1.35，95%CI 1.14～1.59，P=0.000 4）；试验组无进展生存时间（PFS）高于对照组（MD=30.15，95%CI 29.47～30.83，P<0.000 01）；试验组不良反应发生率低于对照组（OR=0.48，95%CI 0.25～0.90，P=0.02）。结论　戈舍瑞林治疗绝经前乳腺癌患者能有效保护其卵巢功能，提高患者生存时间，同时具有较好的安全性。

关键词:

戈舍瑞林, 绝经前乳腺癌, 卵巢功能, meta分析