Andrea Reh1, Ozgur Oktem, Kutluk Oktay. 1. Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York Presbyterian Weill Cornell Medical Center, New York, New York 10021, USA.
Abstract
OBJECTIVE: To determine whether addition of taxanes to anthracycline and cyclophosphamide regimens impact ovarian function as assessed by menstrual history and ovarian reserve markers. DESIGN: Prospective observational analysis. SETTING: Large university fertility center. PATIENT(S): Forty-five women with a history of breast cancer of stages I-IIIA who either received anthracycline, cyclophosphamide, and paclitaxel (ACT) or received anthracycline with cyclophosphamide (AC). INTERVENTION(S): Menstrual histories were obtained at 6 months and at a mean of 28 months after chemotherapy. Early follicular phase FSH and E(2) samples were obtained at the second follow-up. MAIN OUTCOME MEASURE(S): Incidence of amenorrhea and abnormal laboratory values. RESULT(S): There was no statistically significant difference in the rates of amenorrhea at 6 months after chemotherapy (AC group, 41.7%; ACT group, 29%). At the second follow-up, a mean of 28 months after chemotherapy, there was a trend toward higher amenorrhea in the ACT patients (35.7%, vs. 9.1% in the AC group). When the ovarian markers were included, an additional eight menstruating patients were identified with abnormally elevated FSH or E(2) levels. CONCLUSION(S): We found no significant long- or short-term impact of taxanes on rates of amenorrhea. Future studies on the reproductive effects of chemotherapeutic agents should incorporate ovarian reserve markers, because menstrual history alone may underestimate the impact of these cytotoxic agents.
OBJECTIVE: To determine whether addition of taxanes to anthracycline and cyclophosphamideregimens impact ovarian function as assessed by menstrual history and ovarian reserve markers. DESIGN: Prospective observational analysis. SETTING: Large university fertility center. PATIENT(S): Forty-five women with a history of breast cancer of stages I-IIIA who either received anthracycline, cyclophosphamide, and paclitaxel (ACT) or received anthracycline with cyclophosphamide (AC). INTERVENTION(S): Menstrual histories were obtained at 6 months and at a mean of 28 months after chemotherapy. Early follicular phase FSH and E(2) samples were obtained at the second follow-up. MAIN OUTCOME MEASURE(S): Incidence of amenorrhea and abnormal laboratory values. RESULT(S): There was no statistically significant difference in the rates of amenorrhea at 6 months after chemotherapy (AC group, 41.7%; ACT group, 29%). At the second follow-up, a mean of 28 months after chemotherapy, there was a trend toward higher amenorrhea in the ACTpatients (35.7%, vs. 9.1% in the AC group). When the ovarian markers were included, an additional eight menstruating patients were identified with abnormally elevated FSH or E(2) levels. CONCLUSION(S): We found no significant long- or short-term impact of taxanes on rates of amenorrhea. Future studies on the reproductive effects of chemotherapeutic agents should incorporate ovarian reserve markers, because menstrual history alone may underestimate the impact of these cytotoxic agents.
Authors: Lisa M Shandley; Amy Fothergill; Jessica B Spencer; Ann C Mertens; Hanh N Cottrell; Penelope P Howards Journal: Fertil Steril Date: 2018-02-07 Impact factor: 7.329
Authors: Lisa M Shandley; Jessica B Spencer; Amy Fothergill; Ann C Mertens; Amita Manatunga; Elisavet Paplomata; Penelope P Howards Journal: Fertil Steril Date: 2016-11-22 Impact factor: 7.329
Authors: F Cavagna; A Pontes; M Cavagna; A Dzik; N F Donadio; R Portela; M T Nagai; L H Gebrim Journal: Curr Oncol Date: 2018-12-01 Impact factor: 3.677