妇科癌症幸存者激素替代疗法的最新进展。

IF 4.7 2区 医学 Q2 ONCOLOGY
Current Treatment Options in Oncology Pub Date : 2025-03-01 Epub Date: 2025-03-05 DOI:10.1007/s11864-025-01298-5
Megan Gorman, Karin Shih
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引用次数: 0

摘要

意见声明:更年期症状和妇科癌症治疗的后遗症会对患者的身体和精神质量产生严重影响。某些妇科癌症的幸存者,即早期、低级别子宫内膜癌;上皮细胞和生殖细胞卵巢癌;早期宫颈鳞状细胞癌、外阴癌和阴道癌——以及那些因BRCA或Lynch综合征突变而接受降低风险手术的患者可以安全地使用激素替代疗法(HRT)。理想的治疗是在60岁以下或绝经10年内的患者开始。在与患者讨论风险、获益和症状严重程度后,应根据个人情况决定是否开始治疗。数据显示,在这一人群中,最安全的激素替代疗法包括治疗外阴阴道症状的低剂量阴道雌激素,或治疗血管舒缩症状的低剂量全身雌激素,并在子宫完整的患者中联合使用黄体酮。治疗,如SSRIs/SNRIs,阴道保湿剂,骨盆底物理治疗和心理社会咨询,也应考虑在适当的情况下有效地控制更年期症状,而不需要激素的潜在风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Updates in Hormone Replacement Therapy for Survivors of Gynecologic Cancers.

Opinion statement: Symptoms of menopause and the sequelae of gynecologic cancer treatment can be severe in their physical and mental impact on patient quality of life. Survivors of certain gynecologic cancers - namely, early-stage, low-grade endometrial cancers; epithelial and germ cell ovarian cancers; and early-stage squamous cell cervical, vulvar, and vaginal cancers - as well as those who have undergone risk-reducing surgery for BRCA or Lynch syndrome mutations may safely use hormone replacement therapy (HRT). Treatment is ideally initiated in patients younger than age 60 or within ten years of menopause. The decision to start treatment should be made on an individualized basis after discussion of risks, benefits, and symptom severity with patients. Data suggest that the safest HRT regimens in this population include low-dose vaginal estrogen for the treatment of vulvovaginal symptoms, or low-dose systemic estrogen for the treatment of vasomotor symptoms, combined with progesterone in patients with an intact uterus. Therapies such as SSRIs/SNRIs, vaginal moisturizers, pelvic floor physical therapy, and psychosocial counseling should also be considered when appropriate for their effectiveness in managing menopausal symptoms without the potential risk of hormones.

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来源期刊
CiteScore
7.10
自引率
0.00%
发文量
113
审稿时长
>12 weeks
期刊介绍: This journal aims to review the most important, recently published treatment option advances in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to facilitate worldwide approaches to cancer treatment. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as endocrine tumors, lymphomas, neuro-oncology, and cancers of the breast, head and neck, lung, skin, gastrointestinal tract, and genitourinary region. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known oncologists, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.
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