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中华乳腺病杂志(电子版) ›› 2012, Vol. 06 ›› Issue (03) : 309 -314. doi: 10.3877/cma. j. issn.1674-0807.2012.03.012

综述

乳腺癌患者化疗后绝经标准的综合评定
马焱1, 吴世凯1,(), 宋三泰1   
  1. 1.100071 北京,军事医学科学院附属医院乳腺肿瘤内科
  • 收稿日期:2011-03-24 出版日期:2012-06-01
  • 通信作者: 吴世凯

Comprehensive evaluation of criterion of menopause after chemotherapy for breast cancer

Yan MA, Shi-kai WU(), San-tai SONG   

  • Received:2011-03-24 Published:2012-06-01
  • Corresponding author: Shi-kai WU
引用本文:

马焱, 吴世凯, 宋三泰. 乳腺癌患者化疗后绝经标准的综合评定[J/OL]. 中华乳腺病杂志(电子版), 2012, 06(03): 309-314.

Yan MA, Shi-kai WU, San-tai SONG. Comprehensive evaluation of criterion of menopause after chemotherapy for breast cancer[J/OL]. Chinese Journal of Breast Disease(Electronic Edition), 2012, 06(03): 309-314.

表1 乳腺癌患者绝经的临床界定标准[4]
试验名称 绝经标准 参考文献
ABCSG8/ARNO95 1.停经时间≥12个月
2.LH和FSH达绝经后水平
3.双侧卵巢切除
5
ATAC 1.双侧卵巢切除
2.年龄≥60岁
3.45~59岁有完整子宫且停经≥12个月
4.若停经<12个月(包括子宫切除术后,激素替代治疗以及化疗后停经患者),FSH必须处于绝经后水平
6
IES 1.年龄≥55岁且停经2年
2.明确诊断时已停经>1年
7
BIG1-98 (一)无论是激素替代治疗还是子宫切除术
1.任何年龄,接受双侧卵巢切除术后的患者
2.任何年龄,接受放疗去势且停经≥3个月的患者
3.年龄≥45岁,辅助化疗前尚未绝经,完成6个周期CMF辅助化疗或4个周期AC辅助化疗的患者,FSH、LH、E2处于绝经后水平。
(二)未行激素替代治疗
1.子宫切除术后,年龄<55岁且辅助化疗前FSH、LH、E2处于绝经后水平
2.子宫切除术后,年龄≥55岁
(三)未行激素替代治疗及子宫切除术
1.停经>1年且年龄<55岁
2.停经>6个月且年龄>50岁
(四)行激素替代治疗(不管是否行子宫切除术)
1.激素替代治疗停止≥1个月且年龄<55岁,FSH、LH、E2在化疗前在绝经水平
2.激素替代治疗停止≥1个月且年龄≥55岁
8
ITA 1.月经不规律≥1年
2.年龄>50岁且已经接受子宫切除术
3.化疗后停经
4.若不明,检测FSH和E2
9
MA.17 1.有卵巢切除史
2.处于绝经前期且年龄≤50岁,他莫茜芬治疗中,但化疗中或他莫茜芬治疗中停经或此类患者FSH和LH处于绝经后水平
10
NCCN 1.双侧卵巢切除术后
2.年龄≥60岁
3.未接受化疗、他莫茜芬、托瑞米芬等治疗时,年龄<60岁且停经≥12个月或卵巢功能抑制且FSH和E2在绝经后水平
4.年龄<60岁,正在服用他莫茜芬或托瑞米芬,且FSH及雌二醇水平在绝经后范围内。
5.正在接受黄体生成激素释放激素(LH-RH)激动剂或抑制剂治疗的患者无法判定绝经
6.正在接受辅助化疗的绝经前妇女,停经不能作为判断绝经的依据
11
PENN-5 停经≥12个月 12
STRAW 停经≥12个月 12
SWAN 停经≥12个月 12
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