In a nutshell
This paper studied whether goserelin (Zoladex) can protect the ovaries from damage caused by chemotherapy.
Some background
Chemotherapy is used in the treatment of breast cancer but it can damage to the ovaries. This can lead to infertility. Goserelin is a gonadotropin releasing hormone agonist and works to suppress production of sex hormones, and it is as yet unclear whether it can protect ovarian function in breast cancer patients.
Methods & findings
The authors studied the presence of ovarian failure and ovarian dysfunction in breast cancer patients. Ovarian failure was defined as having no menstruation for 6 months and high levels of follicle stimulating hormone (sex hormone). Ovarian dysfunction was defined as having no menstruation for the preceding 3 months.
105 patients received chemotherapy with goserelin. 113 patients received chemotherapy without goserelin. Patients were followed-up for an average of 4.1 years.
The authors studied the side effects of treatment. Of 111 patients receiving only chemotherapy, 3 had hot flashes (warmth around the head and neck). 1 patient had a headache and 1 patient had joint pain. Of 103 patients receiving goserelin, 1 had a thromboembolism (clumping of blood that travels and blocks other blood vessels). 4 patients had hot flashes, 2 had irregular menstruation and 1 had depression.
22% of patients receiving chemotherapy alone had ovarian failure. 8% of patients who also received goserelin had ovarian failure. After 1 year, 37% of patients receiving chemotherapy alone had ovarian dysfunction. 23% of patients receiving goserelin had ovarian dysfunction. After 2 years, 33% of patients receiving chemotherapy alone had ovarian dysfunction. 14% of patients receiving goserelin had ovarian dysfunction.
11% of patients receiving chemotherapy alone and 21% of patients receiving goserelin had at least one pregnancy.
After 4 years, 82% of patients receiving chemotherapy and 92% of patients receiving goserelin survived.
The bottom line
The authors concluded that administrating goserelin with chemotherapy reduced the rate of ovarian failure and improved fertility outcomes.
The fine print
There was some missing data which limited analysis of results.
What’s next?
If you are concerned about protecting your ovarian function and fertility, discuss the use of goserelin with your practitioner.
Published By :
The New England Journal of Medicine
Date :
Mar 05, 2015
