J Gynecol Oncol.  2019 Jul;30(4):e61. 10.3802/jgo.2019.30.e61.

A pilot study of gonadotropin-releasing hormone agonist combined with aromatase inhibitor as fertility-sparing treatment in obese patients with endometrial cancer

Affiliations
  • 1Department of Obstetrics and Gynecology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China. chengninghai@sina.com

Abstract


OBJECTIVE
This study aims to evaluate the effects and pregnancy outcomes of gonadotropin-releasing hormone agonist (GnRH agonist) combined with aromatase inhibitor (AI) in preserving the fertility of obese women with grade 1 endometrial cancer (EC).
METHODS
This study recruited obese EC patients who wished to preserve their fertility. The treatment regimen consisted of intramuscular GnRH agonist 3.75 mg every 4 weeks and oral AI 2.5 mg daily. The maintenance regimen was the same as the initial treatment regimen. Primary outcomes included response rate, time to complete response (CR), and time to recurrence; pregnancy outcomes included the time to pregnancy, pregnancy rate and live birth rate.
RESULTS
Six obese patients with EC were included in this study, with the age (mean±standard deviation [SD]) of 30.5±3.3 years and body mass index (mean±SD) of 35.0±1.4 kg/m2. CR rate was 100%, and time to CR was 3-6 months. None of the patients had recurrence after a median follow-up of 4.0 years (range, 1.3-7.0 years). The most common side effects were menopause-like symptoms. Among these patients, no weight gain was observed during treatment. The pregnancy rate and live birth rate was 50.0% and 75.0%, respectively, with a median time to pregnancy of 2.4 years (range, 1.0-5.5 years).
CONCLUSION
The combination of GnRH agonist and AI demonstrated promising long-term effect in young obese EC patients who wished to preserve their fertility. No weight gain side effects were observed. Further studies with a larger sample size are needed to fully evaluate this novel treatment regimen.

Keyword

Endometrial Cancer; Obesity; Organ Sparing Treatments; Gonadotropin-Releasing Hormone; Aromatase Inhibitors

MeSH Terms

Aromatase Inhibitors
Aromatase*
Body Mass Index
Endometrial Neoplasms*
Female
Fertility
Follow-Up Studies
Gonadotropin-Releasing Hormone*
Humans
Live Birth
Obesity
Organ Sparing Treatments
Pilot Projects*
Pregnancy
Pregnancy Outcome
Pregnancy Rate
Recurrence
Sample Size
Time-to-Pregnancy
Weight Gain
Aromatase
Aromatase Inhibitors
Gonadotropin-Releasing Hormone
Full Text Links
  • JGO
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr